“Suspicious” salivary gland FNA: Risk of malignancy and interinstitutional variability

Maleki, Zahra; Miller, James A.; Arab, Seyedeh Elham; Fadda, Guido; Bo, Ping; Wise, Olga; Rossi, Esther Diana; Jhala, Nirag; Chandra, Ashish; Ali, Syed Z.; Wang, He

doi:10.1002/cncy.21939

Cited by 31 publications

(38 citation statements)

References 33 publications

(59 reference statements)

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“…Prior institutional studies have applied MSRSGC retrospectively to their patient cohorts to establish the ROM for each of the categories . To further bolster the current data available for the MSRSGC, we attempted to retrospectively categorize the salivary gland FNA specimens over the past 5 years from the study institution based on the criteria proposed by the MSRSGC .…”

Section: Discussionmentioning

confidence: 99%

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The role of the Milan System for Reporting Salivary Gland Cytopathology: A 5‐year institutional experience

Viswanathan

Sung

Scognamiglio

et al. 2018

Cancer Cytopathology

113

183

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Section: Discussionmentioning

confidence: 99%

“…The risk of malignancy (ROM) and the overall risk of malignancy (OROM) for the different categories were calculated as previously described . Briefly, the ROM is defined as the ratio of FNAs with malignant follow‐up to the total number of FNAs with follow‐up for that category.…”

Section: Methodsmentioning

confidence: 99%

The role of the Milan System for Reporting Salivary Gland Cytopathology: A 5‐year institutional experience

Viswanathan

Sung

Scognamiglio

et al. 2018

Cancer Cytopathology

113

183

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“…The accuracy of SG-FNA is high for the diagnosis of most common salivary gland tumors such as pleomorphic adenoma and Warthin tumor [1-9, 12-15]. The accuracy is also high for distinguishing benign and low-grade neoplasms from high-grade carcinomas.…”

Section: Is There a Need For A Tiered Classification System For Repormentioning

confidence: 99%

“…SG-FNA has gained its popularity because it can be easily applied in an outpatient setting to sample and diagnose the majority of non-neoplastic and neoplastic salivary gland lesions. Moreover, in most cases, SG-FNA can effectively identify many common benign tumors and is usually able to discriminate between low- and high-grade malignant tumors [12-15]. However, despite the advantages of SG-FNA, there are certain factors which can influence its effectiveness.…”

Section: Is There a Need For A Tiered Classification System For Repormentioning

confidence: 99%

“…However, despite the advantages of SG-FNA, there are certain factors which can influence its effectiveness. These include: the FNA technique, the use of ultrasound guidance and rapid-on-site evaluation, sample preparation techniques, experience of the cytopathologist, and the general inherent heterogeneity of SG tumors as a group [1-9, 12-15]. …”

Section: Is There a Need For A Tiered Classification System For Repormentioning

confidence: 99%

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The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC): An ASC-IAC-Sponsored System for Reporting Salivary Gland Fine-Needle Aspiration

Rossi¹,

Baloch²,

Pusztaszeri³

et al. 2018

Acta Cytologica

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The diagnostic role of salivary gland fine-needle aspiration (SG-FNA) is well established in the preoperative evaluation of patients with salivary gland lesions. At present, most salivary SG-FNA specimens are diagnosed based on conventional diagnostic criteria. However, there exists a lack of uniform reporting for these specimens to guide the clinical management of patients. This void motivated a group of experienced cytopathologists to spearhead the development of a uniform reporting system. This international panel, under the sponsorship of the American Society of Cytopathology (ASC) and the International Academy of Cytology (IAC), gathered in September 2015 at the European Congress of Cytology, held in Milan, Italy, to propose the “Milan System for Reporting Salivary Gland Cytopathology” (MSRSGC). This effort sparked the interest of many and brought forth an agreement to develop an evidence-based tiered classification consisting of 6 diagnostic categories. It is hoped that this standard reporting system will enhance the overall effectiveness of SG-FNA reporting across institutions, with the ultimate result being better communication and improved patient care.

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Application of the Milan System for Reporting Submandibular Gland Cytopathology: An international, multi‐institutional study

Maleki

Baloch

et al. 2019

Cancer Cytopathology

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BACKGROUND:The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) is a 6-tier diagnostic category system with associated risks of malignancy (ROMs) and management recommendations. Submandibular gland fineneedle aspiration (FNA) is uncommon with a higher frequency of inflammatory lesions and a higher relative proportion of malignancy, and this may affect the ROM and subsequent management. This study evaluated the application of the MSRSGC and the ROM for each diagnostic category for 734 submandibular gland FNAs. METHODS: Submandibular gland FNA cytology specimens from 15 international institutions (2013-2017) were retrospectively assigned to an MSRSGC diagnostic category as follows: nondiagnostic, nonneoplastic, atypia of undetermined significance (AUS), benign neoplasm, salivary gland neoplasm of uncertain malignant potential (SUMP), suspicious for malignancy (SM), or malignant. A correlation with the available histopathologic follow-up was performed, and the ROM was calculated for each MSRSGC diagnostic category. RESULTS: The case cohort of 734 aspirates was reclassified according to the MSRSGC as follows: nondiagnostic, 21.4% (0%-50%); nonneoplastic, 24.2% (9.1%-53.6%); AUS, 6.7% (0%-14.3%); benign neoplasm, 18.3% (0%-52.5%); SUMP, 12% (0%-37.7%); SM, 3.5% (0%-12.5%); and malignant, 13.9% (2%-31.3%). The histopathologic follow-up was available for 333 cases (45.4%). The ROMs were as follows: nondiagnostic, 10.6%; nonneoplastic, 7.5%; AUS, 27.6%; benign neoplasm, 3.2%; SUMP, 41.9%; SM, 82.3%; and malignant, 93.6%. CONCLUSIONS: This multi-institutional study shows that the ROM of each MSRSGC category for submandibular gland FNA is similar to that reported for parotid gland FNA, although the reported rates for the different MSRSGC categories were variable across institutions. Thus, the MSRSGC can be reliably applied to submandibular gland FNA.

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“Suspicious” salivary gland FNA: Risk of malignancy and interinstitutional variability

Cited by 31 publications

References 33 publications

The role of the Milan System for Reporting Salivary Gland Cytopathology: A 5‐year institutional experience

The role of the Milan System for Reporting Salivary Gland Cytopathology: A 5‐year institutional experience

The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC): An ASC-IAC-Sponsored System for Reporting Salivary Gland Fine-Needle Aspiration

Application of the Milan System for Reporting Submandibular Gland Cytopathology: An international, multi‐institutional study

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