Three‐year cytohistological correlation of salivary gland FNA cytology at a tertiary center with the application of the Milan system for risk stratification

Rohilla, Manish; Singh, Priya; Rajwanshi, Arvind; Gupta, Nalini; Srinivasan, Radhika; Dey, Pranab; Vashishta, Rakesh Kumar

doi:10.1002/cncy.21900

Cited by 126 publications

(281 citation statements)

References 24 publications

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“…The ROM in the neoplastic group was found to be 12%, which is within the range seen in other studies (0-13%) and comparable to the NEG category ROM [12,18]. The ROM for SUMP in the available literature ranges from 0 to 100% [13]; in our study it was found to be 44%.…”

Section: Discussionsupporting

confidence: 74%

“…These cases turned out to be non-malignant on histological follow-up, resulting in a ROM of 0%, as was seen in the study by Thiryayi et al [19]. The ROM for the AUS category was 19% in the study by Layfield et al [20], while Rohilla et al [18] found a ROM of 100%.…”

Section: Discussionmentioning

confidence: 52%

“…The non-neoplastic group (constituting 7% of MSR-SGC) and the NEG category (constituting 47% of FTRS) had a similar ROM (8 and 13% each). Previous studies have seen a ROM of 10% with a range of 0-37% in the non-neoplastic category [12,18].…”

Section: Discussionmentioning

confidence: 99%

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Application of the Milan System for Risk Stratification and Its Comparison with a Previous Reporting System of Parotid Gland Cytopathology in a Tertiary Care Centre

et al. 2018

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Objective: To compare the recently proposed Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) with the four-tiered reporting system (FTRS) followed at our institute. Methods: Parotid gland fine-needle aspirates reported over a period of 5 years were analysed. These aspirates had been placed into 4 categories according to the FTRS: unsatisfactory (UNS), no evidence of malignancy/negative (NEG), inconclusive for malignancy (INC), and diagnostic for malignancy/positive (POS). Aspirates with follow-up histopathology were then categorized according to the MSRSGC as follows: non-diagnostic, non-neoplastic, atypia of undetermined significance (AUS), neoplasm, suspicious for malignancy, and malignant. The risk of malignancy (ROM) was calculated. Results: A total of 893 parotid region aspirates were evaluated and histopathology was available for 190 cases (21%). ROM in MSRSGC groups, namely non-diagnostic, non-neoplastic, AUS, neoplasm, suspicious for malignant neoplasm, and malignant, was 44, 8, 0, 12, 81 and 100%, respectively. ROM in FTRS groups, namely UNS, NEG, INC, and POS, was 45, 13, 67 and 100%, respectively. Conclusions: MSRGC and FTRS are comparable with respect to the ROM across groups. Compared to FTRS, the further subcategorisation of the non-malignant group, the use of specific nomenclature, and the reproducibility of MSRGC provide proper risk stratification, thereby guiding better management and resulting in improved patient care.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 52%

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Application of the Milan System for Risk Stratification and Its Comparison with a Previous Reporting System of Parotid Gland Cytopathology in a Tertiary Care Centre

et al. 2018

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“…The Milan System was introduced in 2017 for standardizing FNAC reports . Several studies have proven its efficacy and determined the risk of malignancies according to each category of the Milan System …”

Section: Discussionmentioning

confidence: 99%

Risk of high‐grade malignancy in parotid gland tumors as classified by the Milan System for Reporting Salivary Gland Cytopathology

Park

Bae

Park

et al. 2019

J Oral Pathology Medicine

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Background The Milan System for Reporting Salivary Gland Cytopathology (Milan System) has previously shown its diagnostic utility by categorizing the seven cytology findings in salivary gland lesions. However, there has been lack of study about the risk of high‐grade malignancy in the cytology diagnosis based on the Milan System. Thus, we tried to identify the diagnostic ability of the Milan System for high‐grade malignancy and to suggest an improved diagnostic approach for preoperative estimation of high‐grade malignancy using the Milan System. Methods A total of 413 patients with parotid gland tumors, who had undergone surgical resection from 2011 to 2015 were included in the present study retrospectively. Cytopathology was reclassified according to the Milan System by two independent reviewers. The outcomes were risk of malignancy and risk of high‐grade malignancy. The diagnostic performance of the Milan System category [Malignant] for detecting high‐grade malignancy was calculated. Results The risk of malignancy was 83.3% and 100% in the Milan System categories [Suspicious for Malignancy] and [Malignant], respectively. Meanwhile, the risk of high‐grade malignancy was 16.7% and 55.9% in these two categories. Disease‐free survival of patients with high‐grade malignancy was significantly worse than those with low‐ and intermediate‐grade malignancy. Union combining the Milan System category [Malignant] with the presence of nodal metastasis suggested high‐grade malignancy with an acceptable diagnostic sensitivity (0.889‐0.963) and negative predictive value (0.900‐0.966). Conclusions The Milan System category [Malignant] with the presence of nodal metastasis suggested parotid gland tumors as high‐grade malignancy in a pretreatment setting.

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“…Several studies focusing on the criteria outlined in the MSRSGC have already been initiated and published [28, 29]. These early studies have demonstrated the applicability of the MSRSGC in general cytology practice while also highlighting some issues that can be resolved with its implementation.…”

Section: What Were the Steps In The Development Of Msrsgc? The Histormentioning

confidence: 99%

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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Three‐year cytohistological correlation of salivary gland FNA cytology at a tertiary center with the application of the Milan system for risk stratification

Cited by 126 publications

References 24 publications

Application of the Milan System for Risk Stratification and Its Comparison with a Previous Reporting System of Parotid Gland Cytopathology in a Tertiary Care Centre

Application of the Milan System for Risk Stratification and Its Comparison with a Previous Reporting System of Parotid Gland Cytopathology in a Tertiary Care Centre

Risk of high‐grade malignancy in parotid gland tumors as classified by the Milan System for Reporting Salivary Gland Cytopathology

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

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