Cytopathological Spectrum of Salivary Gland Lesions According to Milan Reporting System: A Retrospective Study

Background: The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was developed in 2015 to standardize reporting of salivary gland cytology, promote better communication between clinicians and institutions, and ultimately improve patient outcomes care. The current study aims to determine the cytopathological spectrum of salivary gland lesions using the Milan System for reporting in a tertiary care hospital of northeast India. Methods: Clinical data and cytology smears of salivary gland lesions diagnosed from January 2016 to May 2021 were retrieved. All the cytology smears were reviewed again and reclassified to one of the six categories after applying strict criteria given by MSRSGC. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of FNAC to detect malignant lesions were calculated considering HPE as the gold standard. Results: A total of 57 salivary gland lesions were examined, 31 (54.38%) were males, and 26 (45.6%) were females with a median age of 34 years (range 6-70 years). Statistical analysis showed the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy as 75%, 100%, 100%, 95%, and 95.65%, respectively. MSRSGC Category IVa was the commonest with 29 cases of pleomorphic adenoma. Conclusion: The overall diagnostic accuracy of cytologic reporting of salivary gland lesions based on Milan nomenclature in our institution was 95.65%. Our findings reflect the positive contribution of the MSRSGC towards accurately identifying the malignant lesions and thus further helping the clinicians regarding the specific management decisions.