Background: Interpretation of salivary gland cytology often leads to inter-observer variability due to heterogenous and complex nature of these lesions. This creates a dilemma regarding their management by clinicians. Proposal of a universal system of reporting of salivary gland lesions leading to agreement in diagnosis and better understanding among clinicians was the need of the hour. Hence Milan system for reporting salivary gland cytopathology (MSRSGC) was proposed in 2015 by the American society of cytopathology and the International Academy of Cytology. Present study was undertaken to assess inter-observer variability in reporting by conventional system and MSRSGC.Material and methods: One hundred and seventy-six cases of salivary gland lesions were subjected to fine needle aspiration cytology. Cases were interpreted by two experienced cytopathologists and were reported by both conventional system and MSRSGC. Histopathological correlation was available in 81 cases.Results: Inter-observer variability was noted in six cases reported by conventional system and in two cases by MSRSGC. Moreover three cases out six cases had different management protocols while both cases of Milan system for reporting salivary gland cytology had same management. Thirteen cases diagnosed by Milan system and 17 cases diagnosed by conventional system were discordant with histopathological diagnosis. Conclusion:Milan system for reporting salivary gland cytology has an edge over conventional system of reporting as it provides better agreement among cytopathologists and better management guidelines for clinicians with the added advantage of assessment of risk of malignancy. K E Y W O R D S conventional system of reporting, interobserver variability, Milan system for reporting salivary gland cytology (MSRSGC) Fine needle aspiration (FNA) is a rapid, nonsurgical diagnostic technique, which can establish a definitive diagnosis for a salivary gland lesion. It is a preferred method because incisional biopsy can be associated with an increased risk of infection and potential contamination of surgical planes. 1 It has been shown that unnecessary surgery can be avoided based on the preoperative FNA diagnosis in approximately

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BACKGROUND Breast carcinoma is the most well-known malignancy in women. Different predictive and prognostic factors, for example, estrogen receptors (ER), progesterone receptors (PR) and human epidermal growth factor receptor (Her2neu), and Ki67 could inuence breast carcinoma behaviour, yet to date no authoritative connection has been set up among them and breast carcinoma subtypes. In this way present study was done to determine the interrelationships of these predictive and prognostic factors for breast carcinoma. METHODS In this cross sectional study, a total of 50 lumpectomy, modied radical mastectomy specimens of diagnosed carcinoma breast were included in this study. The histopathological grading of the breast carcinoma was performed by Nottingham modication of the Bloom Richardson grading system. All the cases went through immunohistochemistry for ER, PR, Her2neu and Ki67 expression. Association of ER, PR, Her2neu and Ki67 with different histomorphology was established. RESULTS The ER positivity was signicantly lower in tumors >5 cm size whereas Ki67was signicantly increased with increased tumor size. The ER positivity was signicantly lower in high grade tumors as compared to low grade tumors. The positive ER, PR, Her2neu and Ki67 were comparable in between premenopausal and post-menopausal age groups CONCLUSION The present study concludes that ER, PR show inverse while ki67 showed a direct relationship with the tumor grade. Correlation of histomorphology of breast tumor and Her2neu status could not be established.

During the last two decades, bone marrow examination has become an indispensable adjuvant to diagnose the malignant diseases of the blood and other body systems. The ease with which a marrow trephine biopsy can now be combined with aspiration, it is suggested that this can be used more frequently with suspected neoplastic diseases. This will obviate the need for many other expensive and time-consuming investigations. AIMS & OBJECTIVES: We decided to study the comparison of relative efficacy of bone marrow aspiration and trephine biopsy, and cytological and histological features in different haematological and non-haematological malignancies. METHODOLOGY: Total 52 patients with clinical suspicion or diagnosis of any haematological or non-haematological malignancies were studied from March 2011 to Feb 2012. Patients were enquired about their presenting complaints along with clinical course and duration, and past illnesses. Aspiration smears were examined for cellularity, M: E ratio, megakaryocytes, erythropoiesis, myelopoiesis, plasma cells and abnormal cells. Trephine was also examined for trabecular structure; intertrabecular spaces; cellularity; number, distribution pattern and morphology of megakaryocytes; myelopoiesis; erythropoiesis; fibre content; and lymphoid tissue morphology and distribution. Imprint smears aided cytomorphological characterization of immature cells, observing the pattern and reticulin grading from 0 to IV. OBSERVATION AND RESULTS: Of the total 52 cases 67.3% (35) were haematological and 32.7% (17) non-haematological malignancy cases. Of these 11.5% were AML, 23.0% ALL, 13.5% CML, 7.7% CLL, 5.8% NHL, 1.9% MDS, 3.9% MM, 21.2% CAB, 7.7% CAP, and 3.9% CAS. 75% of 12 ALL cases were in between 11-20 years and M: F was 11:1. Majority had anemia and fever; and 91.6% were classified as ALL-L2 and the remaining as ALL-L1. 16.6% cases had 'dry tap' and were diagnosed on imprints. 42.9% of 7 CML cases belonged to 31-40 years and M: F was 6:1. All had anemia and splenomegaly; and 28.5% yielded 'dry tap' and diagnosed on trephine and cellularity & topographic relationship was also better appreciated. 50% of our 4 CLL cases belonged to 61-70 years and M: F was 3:1. All had anemia as the only clinical presentation. Trephine was done only in 3. In MM 50% belonged to 61-70 years while the other 50% belonged to 71-80 years and both were male. Both had bone pain and 50% also had fracture hip. Rouleaux formation was seen in one while other showed leukoerythroblastic peripheral blood picture. One was classified as plasmacytic type while the other as plasmablastic type. Both aspiration and trephine was done in all non-haematological malignancy cases and bone marrow was normoblastic normocellular. 45.4% showed fibrosis in CAB of which 60% were grade II. Similarly 75% showed fibrosis in CAP of which 33% were grade II. Only one case of CAS showed grade III fibrosis. The 'test of proportion' performed between success rates of Trephine biopsy and Aspiration provided a significant Z value of 2.0008 (Z>1.96 and p 0.05...