A CYTOLOGICAL AND HISTOPATHOLOGICAL CORRELATIVE STUDY ON NEOPLASTIC LESIONS WITH MILAN SYSTEM FOR REPORTING SALIVARY GLAND CYTOPATHOLOGY
DOI:
https://doi.org/10.32471/exp-oncology.2312-8852.vol-44-no-3.18577Keywords:
fine needle aspiration cytology, Milan system of reporting, neoplastic lesions, risk of malignancy, risk of neoplasm, salivary glandAbstract
Background: Salivary gland tumors are rare. Nevertheless, the accurate preoperative diagnosis of the malignant potential of the lesion is essential for appropriate patient management. The recently published Milan system for reporting salivary gland cytology (MSRSGC) is an effort to provide better communication regarding the nature of lesions to clinicians. Aim: To evaluate the diagnostic utility of fine-needle aspiration cytology (FNAC) of neoplastic salivary gland lesions and the MSRSGC applicability in risk stratification. Materials and Methods: This was a retrospective study of the cytological and histopathological correlation between neoplastic lesions of salivary gland lesions conducted over four years (August 2010 — September 2014) in two tertiary care hospitals. There were 66 cases of FNAC of salivary gland neoplasms. The sensitivity, specificity, positive predictive value, negative predictive value, and overall diagnostic accuracy of FNAC were analyzed. The risk of malignancy for MSRSGC was calculated. Results: The overall diagnostic accuracy, sensitivity, specificity, and positive and negative predictive values were 93.94; 95.5; 99.8; 96.8, and 98.7%, respectively. By correlating the cytological diagnosis of benign neoplasm with histopathological diagnosis, the risk of malignancy was 0% and risk of neoplasm was 100%. For cases in the category suspicious of malignancy, risk of neoplasm was 100% and risk of malignancy was 85%. Conclusion: The present study demonstrated that this salivary gland cytology reporting system was useful in classifying the lesions in well-delineated categories with ease. MSRSGC system of standardized reporting is helpful for guiding clinicians in appropriate management of the patient. However, many multicenter studies with large sample sizes and long-term follow-up are needed along with wide propagation of its standardized reporting format to be adopted universally.
References
Al-Ghazal SK. Al-Zahrawi (Albucasis)-a light in the dark middle ages in Europe. JISHIM. 2003; 1: 37–8. http://www.ishim.net/ishimj/3/08.pdf
Martin HE, Stewart FW. The advantages and limitations of aspiration biopsy. Am J Roentgenol 1936; 35: 245–7.
Lascaratos I. Hispanic-Arabic Medicine. In: History of Medicine. Lascaratos I, ed. Vol. 1. Athens: P.H. Paschalides; 2003: 355–6.
Makki AI. Needles and Pins. Al Shindagah 2006; 68–78.
Sood S, McGurk M, Vaz F. Management of salivary gland tumours: United Kingdom national multidisciplinary guidelines. J Laryngol Otol 2016; 130: S142–9. https://doi.org/10.1017/S0022215116000566
Speight PM, Barrett AW. Salivary gland tumours: diagnostic challenges and an update on the latest WHO classification. Diagn Histopathol 2020; 26: 147–58. https://doi.org/10.1016/j.mpdhp.2020.01.001
Griffith CC, Pai RK, Schneider F, et al. Salivary gland tumor fine-needle aspiration cytology: a proposal for a risk stratification classification. Am J Clin Pathol 2015; 143: 839–53. https://doi.org/10.1309/AJCPMII6OSD2HSJA
Rossi ED, Faquin WC, Baloch Z, et al. The Milan system for reporting salivary gland cytopathology: analysis and suggestions of initial survey. Cancer Cytopathol 2017; 125:757–66. / https://doi.org/10.1002/cncy.21898
Vaidhya S, Sinha A, Narayan S, et al. A comparative study of fine needle aspiration cytology and histopathology in salivary gland lesions. J Pathol Nepal 2011; 1: 108–13. https://doi.org/10.3126/jpn.v1i2.5403
Das DK, Petkar MA, Al-Mane NM, et al. Role of fine needle aspiration cytology in the diagnosis of swellings in the salivary gland regions: a study of 712 cases. Med Princ Pract 2004; 13: 95–106. https://doi.org/10.1159/000075637
Dhanalakshmi M, Lakshmana Rao, Krishnaswamy, et al. Fine needle aspiration cytology and histopathology of salivary gland lesions: A correlative study in rural teaching hospital. JCCM 2009; 12: 674–80.
Nagarkar NM, Bansal S, Dass A, et al. Salivary gland tumors — our experience. Ind J Otolaryngol Head Neck Surg 2004; 56: 31–4. https://doi.org/10.1007/bf02968769
Hafez NH, Abusinna ES. Risk assessment of salivary gland cytological categories of the Milan system: a retrospective cytomorphological and immunocytochemical institutional study. Turk Patol Derg 2020; 36: 142–53. https://doi.org/10.5146/tjpath.2019.01469
Viswanathan K, Sung S, Scognamiglio T, et al. The role of the Milan System for Reporting Salivary Gland Cytopathology: a 5-year institutional experience. Cancer Cytopathol 2018; 126: 541–51. https://doi.org/10.1002/cncy.22016
Song SJ, Shafique K, Wong LQ, et al. The utility of the Milan System as a risk stratification tool for salivary gland fine needle aspiration cytology specimens. Cytopathology 2019; 30: 91–8. https:// https://doi.org/10.1111/cyt.12642
Savant D, Jin C, Chau K, et al. Risk stratification of salivary gland cytology utilizing the Milan system of classification. Diagn Cytopathol 2019; 47: 172–80. https://doi.org/10.1002/dc.24063
Rohilla M, Singh P, Rajwanshi A, et al. Three-year cytohistological correlation of salivary gland FNA cytology at a tertiary center with the application of the Milan system for risk stratification. Cancer Cytopathol 2017; 125: 767–75. https://doi.org/10.1002/cncy.21900
Rossi ED, Wong LQ, Bizzarro T, et al. The impact of FNAC in the management of salivary gland lesions: institutional experiences leading to a risk-based classification scheme. Cancer Cytopathol 2016; 124: 388–96. https://doi.org/10.1002/cncy.21710
Jayaram G, Dashini M. Evaluation of fine needle aspiration cytology of salivary glands: an analysis of 141 cases. Malaysian J Pathol 2001; 23: 93–100. PMID: 12166598
Mallappa LB, Balakrishna SV, Raghupathi AR. A study of salivary gland lesions-by fine needle aspiration cytology. Int J Health Sci Res (IJHSR) 2014; 4: 44–8.
Rajwanshi A, Gupta K, Gupta N, et al. Fine-needle aspiration cytology of salivary glands: diagnostic pitfalls — revisited. Diagn Cytopathol 2006; 34: 580–4. https://doi.org/10.1002/dc.20353
Wei S, Layfield LJ, LiVolsi VA, et al. Reporting of fine needle aspiration (FNA) specimens of salivary gland lesions: a comprehensive review. Diagn Cytopathol 2017; 45: 820–7. https:// https://doi.org/10.1002/dc.23716
Maleki Z, Miller JA, Arab SE, et al. “Suspicious” salivary gland FNA: risk of malignancy and interinstitutional variability. Cancer Cytopathol 2018; 126: 94–100. https://doi.org/10.1002/cncy.21939
Farahani SJ, Baloch Z. Retrospective assessment of the effectiveness of the Milan system for reporting salivary gland cytology: a systematic review and meta-analysis of published literature. Diagn Cytopathol 2019; 47: 67–87. https://doi.org/10.1002/dc.24097
Postema RJ, van Velthuysen ML, van den Brekel MW, et al. Accuracy of fine-needle aspiration cytology of salivary gland lesions in the Netherlands Cancer Institute. Head & Neck 2004; 26: 418–24. https://doi.org/10.1002/hed.10393
Eneroth CM. Salivary gland tumors in the parotid gland, submandibular gland, and the palate region. Cancer 1971; 27: 1415–8. https:// https://doi.org/10.1002/1097-0142(197106)27: 6<1415::aid-cncr2820270622>3.0.co;2-x
Awan MS, Ahmad Z. Diagnostic value of fine needle aspiration cytology in parotid tumors. J Pakistan Med Assoc 2004; 54: 617. PMID: 16104489.
Jan IS, Chung PF, Weng MH, et al. Analysis of fine-needle aspiration cytology of the salivary gland. J Formosan Med Assoc 2008; 107: 364–70. https://doi.org/10.1016/S0929-6646(08)60101-1
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