Details

Autor(en) / Beteiligte

• Lee, Jaslyn Jie Lin
• Tan, Hui Min
• Chua, Darren Yee Shuen
• Chung, Jocelycn Gaik Kooi
• Nga, Min En

Titel

The Milan system for reporting salivary gland cytology: A retrospective analysis of 1384 cases in a tertiary Southeast Asian institution

Ist Teil von

• Cancer cytopathology, 2020-05, Vol.128 (5), p.348-358

Ort / Verlag

United States: Wiley Subscription Services, Inc

Erscheinungsjahr

2020

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• Background The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) aims to provide a common language for risk stratification and management. We examine the incidence of MSRSGC categories and the corresponding risk of malignancy (ROM) within a tertiary referral centre in Southeast Asia. Methods Salivary gland fine needle aspirations (FNAs) performed within a 10‐year period were classified retrospectively according to the MSRSGC. Cytohistologic correlation was performed. The results were compared with the existing literature, including Asian and Western studies. Results A total of 1384 salivary gland FNAs were evaluated, 421 with corresponding histology. The category distribution was: nondiagnostic, 28.9%; nonneoplastic, 18.0%; atypia of undetermined significance (AUS), 9.8%; benign neoplasm, 32.9%; salivary gland neoplasm of uncertain malignant potential (SUMP), 5.7%; suspicious for malignancy, 1.6%; and malignant, 3.2%. The ROMs were: nondiagnostic, 10.0%; nonneoplastic, 17.5%; AUS, 29.5%; benign neoplasm, 0.5%; SUMP, 17.1%; suspicious for malignancy, 83.3%; and malignant, 100.0%. Our relatively high nondiagnostic rate likely reflects preanalytical factors, whereas our low malignancy rate may be related to population and health care accessibility. Our nonneoplastic ROM was 17.5% compared with 5% to 10% in the literature, likely due to the relatively small number of excised cases; the ROM for SUMP was 17.1% versus 21% to 44% in the literature, possibly reflecting a significant proportion of benign basaloid neoplasms on histology. Interestingly, all false‐negative cases in the nonneoplastic category were lymphoid‐rich lesions. Conclusion This is one of the largest single‐institution studies in the existing literature documenting both the incidence and ROMs of MSRSGC categories. We also highlight specific challenges surrounding lymphoid‐rich lesions. This article presents the incidence and corresponding risk of malignancy of diagnostic categories in salivary gland fine needle aspirations, using The Milan System for Reporting Salivary Gland Cytopathology, within a tertiary referral center in Southeast Asia. The data are compared with the current literature, with a discussion of differences as well as challenges in reporting fine needle aspirations of salivary gland lesions.