Application of the Milan System for Reporting Submandibular Gland Cytopathology: An international, multi-institutional study

Giovanni Fadda, Z Maleki, Z Baloch, R Lu, K Shafique, SJ Song, K Viswanathan, RA Rao, H Lefler, A Fatima, A Wiles, VY Jo, H Wang, CN Powers, SZ Ali, L Pantanowitz, MT Siddiqui, R Nayar, J Klijanienko, GA BarkanJF Krane, ED Rossi, F Callegari, I Kholova, M Bongiovanni, WC Faquin, MP Pusztaszeri

Risultato della ricerca: Contributo in rivistaArticolo in rivista

16 Citazioni (Scopus)

Abstract

Background The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) is a 6-tier diagnostic category system with associated risks of malignancy (ROMs) and management recommendations. Submandibular gland fine-needle aspiration (FNA) is uncommon with a higher frequency of inflammatory lesions and a higher relative proportion of malignancy, and this may affect the ROM and subsequent management. This study evaluated the application of the MSRSGC and the ROM for each diagnostic category for 734 submandibular gland FNAs. Methods Submandibular gland FNA cytology specimens from 15 international institutions (2013-2017) were retrospectively assigned to an MSRSGC diagnostic category as follows: nondiagnostic, nonneoplastic, atypia of undetermined significance (AUS), benign neoplasm, salivary gland neoplasm of uncertain malignant potential (SUMP), suspicious for malignancy (SM), or malignant. A correlation with the available histopathologic follow-up was performed, and the ROM was calculated for each MSRSGC diagnostic category. Results The case cohort of 734 aspirates was reclassified according to the MSRSGC as follows: nondiagnostic, 21.4% (0%-50%); nonneoplastic, 24.2% (9.1%-53.6%); AUS, 6.7% (0%-14.3%); benign neoplasm, 18.3% (0%-52.5%); SUMP, 12% (0%-37.7%); SM, 3.5% (0%-12.5%); and malignant, 13.9% (2%-31.3%). The histopathologic follow-up was available for 333 cases (45.4%). The ROMs were as follows: nondiagnostic, 10.6%; nonneoplastic, 7.5%; AUS, 27.6%; benign neoplasm, 3.2%; SUMP, 41.9%; SM, 82.3%; and malignant, 93.6%. Conclusions This multi-institutional study shows that the ROM of each MSRSGC category for submandibular gland FNA is similar to that reported for parotid gland FNA, although the reported rates for the different MSRSGC categories were variable across institutions. Thus, the MSRSGC can be reliably applied to submandibular gland FNA.
Lingua originaleEnglish
pagine (da-a)306-315
Numero di pagine10
RivistaCancer cytopathology
Volume127
Stato di pubblicazionePubblicato - 2019

Keywords

  • Milan System for Reporting Salivary Gland Cytopathology (MRSSGC)
  • atypia of undetermined significance (AUS)
  • benign neoplasm
  • fine-needle aspiration (FNA)
  • malignant
  • nondiagnostic
  • nonneoplastic
  • risk of malignancy (ROM)
  • salivary gland neoplasm of uncertain malignant potential (SUMP)
  • submandibular gland
  • suspicious for malignancy (SM)

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