Implentation of Milans System for Reporting Salivary Gland Cytopathology in Our Institute

Abstract

Background
Fine needle aspiration cytology of salivary glands (FNAC) has become a most accepted method of evaluating salivary gland tumors preoperatively. It has many pitfalls, to overcome this the Milan System for reporting Salivary gland Cytopathology (MSRGC) was introduced. The Milan System for reporting Salivary gland Cytopathology (MSRGC) represents a standardized, evidence based
reporting system for salivary gland lesions. The present study was undertaken to study and categorize various salivary gland lesion according to MSRSGC and do histological correlation. Methods Present study is a retrospective study done over a period of four year duration. Cytological slides were retrieved and reviewed and categorised into six categories according to MSRGC. Histopathological correlation was done wherever possible.
Results A total of 273 cases were studied, males were commonly affected compared to females. Percentage of cases in each category as follows: nondiagnostic-2.93%, Nonneoplastic-58.6%, AUS-0%, benign 34.4%, suspicious of uncertain malignant potential-0.73%, suspicious of malignancy-1.46% and malignant in 1.83% cases. Surgical follow up was available in 85 cases, out of which 96.5% (82 cases) showed concordance and 3 cases showed discordance. Sensitivity, specificity, positive predictive value and negative predictive value of salivary gland lesions with the application of Milan system was 66.7%,100%, 100% and 96.25%. ROM was calculated for
each category which is category I-0, category II- 56%, category III- 0, category Iva- 2.63%, category IVb-50%, category V & VI-100%.
Conclusion MSRSGC on FNA of salivary gland lesion has standardized the reporting method to classify the lesions, facilitating risk stratification and deciding the treatment protocol.