“Atypical” salivary gland fine needle aspiration: Risk of malignancy and interinstitutional variability

2017 ◽  
Vol 45 (12) ◽  
pp. 1088-1094 ◽  
Author(s):  
He Wang ◽  
Aatika Malik ◽  
Zahra Maleki ◽  
Esther Diana Rossi ◽  
Bo Ping ◽  
...  
Keyword(s):  
Salivary Gland ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Aspiration Risk ◽  
Risk Of Malignancy

scholarly journals Moving Toward a Systematic Approach for Reporting Salivary Gland Cytopathology: An Institutional Experience and Literature Review

2018 ◽  
Vol 143 (6) ◽  
pp. 664-669 ◽  
Author(s):  
Xunda Luo ◽  
Nirag Jhala ◽  
Jasvir S. Khurana ◽  
Christopher Fundakowski ◽  
Darshana N. Jhala ◽  
...  
Keyword(s):  
Salivary Gland ◽  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Reporting System ◽  
Collaborative Work ◽  
Benign Neoplasm ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Tier System ◽  
Risk Of Malignancy

Context.— Despite the clinical utility of fine-needle aspiration for the diagnosis of salivary pathologies, salivary lesions remain one of the most challenging areas in cytopathology. This is partially because there is no consensus on how to report salivary gland cytopathology, which has resulted in inconsistent terminology among institutions and individual cytopathologists and in confusion in communication among cytopathologists and ordering providers. Objective.— To summarize our experience with an institutional salivary gland cytopathology reporting system, as an initiative to promote collaborative work toward a consensus on a reporting system. Design.— We developed an empirical 6-tier classification reporting system. Slides of 107 salivary gland fine-needle aspirations with subsequent histology slides were reviewed and reclassified using the 6-tier system. The performance of the cytology reporting system was evaluated with the histology diagnoses serving as the gold standard. Results.— Fine-needle aspiration diagnoses made based on the institutional 6-tier classification system were generally consistent with histology diagnoses for the disease spectrum reported in this study. The sensitivity, specificity, positive predictive value, and negative predictive value for diagnosing malignancies with the system were 86% (12 of 14), 93% (40 of 43), 80% (12 of 15), and 95% (40 of 42), respectively. The risk of malignancy increased from 0% (0 of 13) for negative for neoplasm to 7% (2 of 29) for benign neoplasm, 67% (2 of 3) for suspicious for malignancy, and 83% (10 of 12) for positive for malignancy. Conclusions.— The institutional 6-tier system provides a succinct, risk-of-malignancy–based system to report salivary gland cytology. Our experience with this system helps to pave the way for the adoption of the Milan System for Reporting Salivary Gland Cytopathology.

Risk of malignancy in “atypia of undetermined significance” category of salivary gland fine‐needle aspiration: A bi‐institutional experience

2019 ◽  
Vol 48 (2) ◽  
pp. 138-143 ◽  
Author(s):  
Fatimah Alruwaii ◽  
Jen‐Fan Hang ◽  
Bao‐Rung Zeng ◽  
Harvey M. Cramer ◽  
Chiung‐Ru Lai ◽  
...  
Keyword(s):  
Salivary Gland ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Risk Of Malignancy ◽  
Institutional Experience ◽  
Undetermined Significance

scholarly journals Milan System for Reporting Salivary Gland Cytopathology - A Two Years’ Experience in a Referral Centre of Western Odisha

2021 ◽  
Vol 8 (17) ◽  
pp. 1146-1151
Author(s):  
Bijayalaxmi Sahoo ◽  
Sunanda Nayak ◽  
Gitimadhuri Dutta ◽  
Shailaja Prabhala ◽  
Kulwant Lakra
Keyword(s):  
Salivary Gland ◽  
Fine Needle Aspiration ◽  
Classical System ◽  
Needle Aspiration ◽  
Medical Sciences ◽  
Aspiration Cytology ◽  
Original Diagnosis ◽  
Fine Needle ◽  
Risk Of Malignancy ◽  
Needle Aspiration Cytology

BACKGROUND Neoplasms of salivary gland account for 2 - 6.5 % of all head and neck neoplasms. Fine needle aspiration cytology (FNAC) is sufficiently sensitive and relevant to the diagnosis and treatment of salivary gland pathologies for salivary gland lesions. The Milan system for reporting salivary gland cytopathology (MSRSGC) represents a stage for a structured, evidence-based international reporting system for salivary gland fine-needle aspiration (FNA). This system provides a guidance for diagnosis and management according to the risk of malignancy (ROM) in different categories. We wanted to study the various cytomorphological lesions of salivary gland and their cytological categorisation based on the MILAN system of reporting. METHODS A 2-year record-based study (January 2018 to December 2019) was conducted on FNAC of salivary gland lesions in the Department of Pathology, VSSIMSAR (Veer Surendra Sai Institute of Medical Sciences and Research), Burla, Odisha. Based on the classical system, all smears were studied and re-categorized into six groups according to the MILAN classification. Histological correlation was carried out in the available cases. RESULTS A total of 103 FNA cases were examined and 20 different categories were there in the original diagnosis. As per the categorisation based on MILAN System there were six categories, maximum cases were non-neoplastic 34 (33.0 %) followed by benign neoplasms 22 (21.35 %), malignant 14 (13.5 %), non-diagnostic 10 (9.7 %), atypia of undetermined significance 9 (8.7 %), suspicious for malignancy 8 (7.7 %) and neoplasms of uncertain malignant potential 6 (5.8 %). 43 cases (80.4 %) were found to be concordant out of 54 histopathology correlated cases. CONCLUSIONS The Milan system of reporting salivary gland cytopathology provided a uniform system of reporting salivary gland cytomorphology that may increase the effectiveness. KEYWORDS Milan System, Salivary Gland Lesions, FNAC, Risk of Malignancy (ROM)

scholarly journals Prediction of Malignancy in Salivary Gland Tumors by a New Cytology Reporting System

2020 ◽  
pp. 014556132092791
Author(s):  
Doh Young Lee ◽  
Seulki Song ◽  
Seung Koo Yang ◽  
Min Hyung Lee ◽  
Ji Eun Kim ◽  
...  
Keyword(s):  
Salivary Gland ◽  
Cell Carcinoma ◽  
Malignant Tumor ◽  
Fine Needle Aspiration ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Salivary Gland Tumors ◽  
Fine Needle ◽  
Risk Of Malignancy ◽  
Undetermined Significance

Objectives: The aim of this study was to analyze the risk of malignancy in salivary gland tumors on the basis of the Milan System for Reporting Salivary Gland Cytopathology. Methods: A retrospective review was performed of the charts of patients with salivary gland tumors in whom the final diagnosis was confirmed by surgical excision. Preoperative fine needle aspiration results were categorized according to the Milan System for Reporting Salivary Gland Cytopathology: non-diagnostic (category I), nonneoplastic (category II), atypia of undetermined significance (category III), neoplasm (category IV), suspicious for malignancy (category V), and malignant (category VI). Fine needle aspiration and final diagnosis were compared, and the risk of malignancy and operative/oncological outcomes were analyzed. Results: A total of 288 patients were enrolled in this study. Postoperative histopathologic salivary gland malignancies were found in 30 (10.4%) patients. Risk of malignancy was 7.1%, 0%, 48.0%, 4.8%, 88.7%, and 100% in categories I, II, III, IV, V, and VI, respectively. The most common malignant tumor in category III was salivary duct carcinoma (37.5%), followed by acinic cell carcinoma (25.0%), mucoepidermoid carcinoma (25.0%), and squamous cell carcinoma (12.5%). The 5-year survival rate of patients with malignant tumors showed no statistical difference between category III and category V/VI ( P = .140). Risk of malignancy was 88.9% and 100% in category V and VI, respectively. Conclusions: A half of atypia of undetermined significance (category III) cases were malignant. Once diagnosed, the prognosis of malignant tumor in category III was similar with that in category V/VI.

Risk of malignancy and neoplasia predicted by three molecular testing platforms in indeterminate thyroid nodules on fine-needle aspiration

2019 ◽  
Vol 47 (9) ◽  
pp. 853-862 ◽  
Author(s):  
Kristen L. Partyka ◽  
Karen Trevino ◽  
Melissa L. Randolph ◽  
Harvey Cramer ◽  
Howard H. Wu
Keyword(s):  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Molecular Testing ◽  
Fine Needle ◽  
Risk Of Malignancy
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