Assessment of Milan System for reporting salivary gland cytopathology and risk of malignancy

Abstract

Background:Salivary gland cancers are uncommon, representing 6.1% of head and neck cancers, and about 0.2% of all malignancies. The present study was conducted to assess Milan System for reporting salivary gland cytopathology and risk of malignancy. Materials & Methods: 180 FNAC specimen from salivary gland lesions were involved. The cytological features were evaluated, and then cases were reclassified according to MSRSGC as follows: category 1: Non-diagnostic (ND), category 2: Non-neoplastic (NN), category 3: Atypia of undetermined significance (AUS), category 4a: Neoplasm: Benign (NB), category 4b: Neoplasm: salivary gland neoplasm of uncertain malignant potential (SUMP), category 5: Suspicious of malignancy (SM) and category 6: Malignant (M).Results: Age group < 20 years had 40 males and 35 females, 21-40 years had 30 males and 20 females, 41-60 years had 24 males and 13 females and >60 years had 6 males and 12 females. Parotid gland was involved in 95, submandibular in 50 and minor salivary gland in 35 cases. Cat 1, Cat 2, Cat 3, Cat 4a, Cat 4b, Cat 5 and Cat 6 had 10, 70, 4, 64, 3, 2 and 27 cases respectively and histological follow-upwas 6,60, 3, 60, 1, 2 and 25 respectively. Benign non- neoplastic lesions were 3, 46, 1, 6, 0, 0 and 1, benign neoplastic lesions were 2, 10, 2, 52, 0, 1 and 4, malignant lesions were 1, 4, 1, 2, 1, 1 and 20 and risk of malignancy as seen in 1 (16.6%), 4 (6.6%), 1 (33.3%), 2 (3.33%), 1 (100%), 1 (50%) and 20 (80%) in Cat 1, Cat 2, Cat 3, Cat 4a, Cat 4b, Cat 5 and Cat 6 respectively. Conclusion: Milan system was effective in categorizing salivary gland pathologies and limits the chances of false positive and negative.