Diagnostic accuracy of fine-needle aspiration cytology of salivary gland lesions: A 6-year retrospective review

Consamus, Erin N.; Smith, Deborah; Oviedo, Sergio Pina; Mody, Dina R.; Takei, Hiroyuki

doi:10.1016/j.jasc.2014.11.003

Cited by 18 publications

(18 citation statements)

References 17 publications

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“…and 84% to 100%, respectively, for FNAC for salivary gland lesions. 6,[9][10][11] The sensitivity and specificity rates in our study was within the reported values (92.9% and 93%, respectively), although it could be difficult to compare these values between studies since the methodology, specifically statistical analysis approach, could differ. In our study we did not consider the AUS and SUMP categories as a positive for malignancy test result, whereas SM was included since it usually carries a major change in the management (Table 3).…”

Section: Illustrative Casessupporting

confidence: 72%

“…Several authors have reported difficulties in the diagnosis of high grade MEC. 6,11,14,15 Table 4 showed FNAC cases categorized as AUS and SUMP. The AUS category at our institution showed an overall frequency of 5.3%, in agreement with the MSRSGC recommendation to keep them as <10% of all salivary gland diagnoses.…”

Section: Illustrative Casesmentioning

confidence: 99%

“…Fine-needle aspiration cytology (FNAC) is an important tool in the diagnosis of salivary gland lesions, it can differentiate non-neoplastic lesions from neoplasms, and benign from malignant neoplasms with reasonable accuracy. [1][2][3][4][5][6] However, given the heterogeneity and overlapping morphologic features of salivary gland tumors, as well as occasional unusual presentations, an accurate diagnosis can sometimes be challenging. In an attempt to bring uniformity to the reporting of salivary gland FNAC, the American Society of Cytopathology and the International Academy of Cytology proposed an international classification scheme, the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC).…”

Section: Introductionmentioning

confidence: 99%

“…Fine‐needle aspiration cytology (FNAC) is an important tool in the diagnosis of salivary gland lesions, it can differentiate non‐neoplastic lesions from neoplasms, and benign from malignant neoplasms with reasonable accuracy 1‐6 . However, given the heterogeneity and overlapping morphologic features of salivary gland tumors, as well as occasional unusual presentations, an accurate diagnosis can sometimes be challenging.…”

Section: Introductionmentioning

confidence: 99%

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Salivary gland fine‐needle aspiration cytology with the application of the Milan system for risk stratification and histological correlation: A retrospective 6‐year study

Rolon

Schnadig

Faiz

et al. 2020

Diagnostic Cytopathology

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Background: The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) is based on risk stratification. We presented our experience with fineneedle aspiration cytology (FNAC) for the diagnosis of salivary glands lesions by applying the MSRSGC categorization to the cytological diagnoses, and determined risk of malignancy (ROM) for each category. Methods: Fine-needle aspiration cytology of salivary gland lesions performed over a 6-year period was retrieved. FNAC results were retrospectively categorized according to the MSRSGC criteria, and correlated with corresponding histologic follow-up. ROM for each diagnostic category was calculated. Results: A total of 208 FNAC of salivary gland lesions were reviewed and retrospectively categorized as: non-diagnostic (ND) 23 (11%), non-neoplastic (NN) 54 (26%), atypia of undetermined significance (AUS) 10 (4.8%), benign neoplasms (BN) 77 (37%), salivary gland of uncertain malignant potential (SUMP) 13 (6.3%), suspicious for malignancy (SM) 7 (3.4%), and malignant (M) 24 (11.5%). Histopathological follow-up was available for 84 of 208 cases (40.4%). Overall concordance rate between FNAC and histology was 78.8%. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated as 93.3%, 94.6%, 82.4%, and 98.2%, respectively. Diagnostic accuracy to distinguish benign from malignant disease was 94.4%. ROM for each category was ND 0%, NN 0%, AUS 75%, BN 2.2%, SUMP 28.6%, SM 50%, and M 100%. Conclusion: Fine-needle aspiration cytology continues to be an accurate diagnostic tool for most salivary gland neoplasms showing classical morphologic features. However, difficult cases with unusual or overlapping features will occur. In these situations, the use of MSRSGC risk-stratification could be helpful to define appropriate management.

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Section: Illustrative Casessupporting

confidence: 72%

Section: Illustrative Casesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Salivary gland fine‐needle aspiration cytology with the application of the Milan system for risk stratification and histological correlation: A retrospective 6‐year study

Rolon

Schnadig

Faiz

et al. 2020

Diagnostic Cytopathology

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“…FNA cytology of the salivary gland has been reported to have acceptable sensitivity, high specificity and high diagnostic accuracy. However, these values vary across studies and sensitivity can be as low as 58% . Cytology provides additional information which may help clinicians to risk‐stratify patients and decide whether clinical follow‐up or surgery is required.…”

Section: Introductionmentioning

confidence: 99%

Agreement between rapid on‐site evaluation and the final cytological diagnosis of salivary gland specimens

2017

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Risk of malignancy in “atypia of undetermined significance” category of salivary gland fine‐needle aspiration: A bi‐institutional experience

Alruwaii

Hang

Zeng

et al. 2019

Diagnostic Cytopathology

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BackgroundMany prior institutional and multi‐institutional studies have applied the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) retrospectively to their specimens to determine the risk of malignancy (ROM) of each category. Most of these studies focused on general assessment of the system and risk classification. However, there seems to be less focus on the category of atypia of undetermined significance (AUS) that could be attributed to the low number of cases that could fit into this category. Herein, we present a bi‐institutional experience with this category.MethodsA computerized search of the databases was performed to identify all salivary gland fine‐needle aspiration (FNA) in two institutions over a period of 12 years. The final diagnosis of each case was reclassified based on MSRSGC, and histology follow‐up was retrieved.ResultsSixty AUS cases (out of 1560 salivary gland FNA) were identified with a rate of 3.8%. Forty cases (66%) had a subsequent tissue material. Correlation with histology revealed that the estimated ROM is 37.5% (15/40) and the overall ROM is 25% (15/60). Fifty percent of the cases had a prominent lymphoid component and most commonly represented lymphomas, reactive lymph node or sialadenitis.ConclusionThe AUS category is a heterogeneous group of lesions with predominant lymphoid‐rich entities. Some variability exists between institutions with most having higher ROM than the suggested 20% by the MSRSGC atlas.

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Diagnostic accuracy of fine-needle aspiration cytology of salivary gland lesions: A 6-year retrospective review

Cited by 18 publications

References 17 publications

Salivary gland fine‐needle aspiration cytology with the application of the Milan system for risk stratification and histological correlation: A retrospective 6‐year study

Salivary gland fine‐needle aspiration cytology with the application of the Milan system for risk stratification and histological correlation: A retrospective 6‐year study

Agreement between rapid on‐site evaluation and the final cytological diagnosis of salivary gland specimens

Risk of malignancy in “atypia of undetermined significance” category of salivary gland fine‐needle aspiration: A bi‐institutional experience

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