A CYTOLOGICAL AND HISTOPATHOLOGICAL CORRELATIVE STUDY ON NEOPLASTIC LESIONS WITH MILAN SYSTEM FOR REPORTING SALIVARY GLAND CYTOPATHOLOGY.

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.