Salivary gland <scp>FNA</scp> cytology: role as a triage tool and an approach to pitfalls in cytomorphology

Mairembam, P.; Jay, Amrita; Beale, Tim; Morley, Simon; Vaz, Francis; Kalavrezos, N.; Kocjan, Gabrijela

doi:10.1111/cyt.12232

Cited by 76 publications

(64 citation statements)

References 21 publications

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“…The commonest malignant neoplasm was mucoepidermoid carcinoma, as seen in other studies [5,14,16]. Histological follow-up was available only in 21%, similar to a study from the UK by Mairembam et al [17] on 920 aspirates. The 190 cases which had histological follow-up were further analysed.…”

Section: Discussionsupporting

confidence: 72%

Application of the Milan System for Risk Stratification and Its Comparison with a Previous Reporting System of Parotid Gland Cytopathology in a Tertiary Care Centre

et al. 2018

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Objective: To compare the recently proposed Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) with the four-tiered reporting system (FTRS) followed at our institute. Methods: Parotid gland fine-needle aspirates reported over a period of 5 years were analysed. These aspirates had been placed into 4 categories according to the FTRS: unsatisfactory (UNS), no evidence of malignancy/negative (NEG), inconclusive for malignancy (INC), and diagnostic for malignancy/positive (POS). Aspirates with follow-up histopathology were then categorized according to the MSRSGC as follows: non-diagnostic, non-neoplastic, atypia of undetermined significance (AUS), neoplasm, suspicious for malignancy, and malignant. The risk of malignancy (ROM) was calculated. Results: A total of 893 parotid region aspirates were evaluated and histopathology was available for 190 cases (21%). ROM in MSRSGC groups, namely non-diagnostic, non-neoplastic, AUS, neoplasm, suspicious for malignant neoplasm, and malignant, was 44, 8, 0, 12, 81 and 100%, respectively. ROM in FTRS groups, namely UNS, NEG, INC, and POS, was 45, 13, 67 and 100%, respectively. Conclusions: MSRGC and FTRS are comparable with respect to the ROM across groups. Compared to FTRS, the further subcategorisation of the non-malignant group, the use of specific nomenclature, and the reproducibility of MSRGC provide proper risk stratification, thereby guiding better management and resulting in improved patient care.

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Section: Discussionsupporting

confidence: 72%

Application of the Milan System for Risk Stratification and Its Comparison with a Previous Reporting System of Parotid Gland Cytopathology in a Tertiary Care Centre

et al. 2018

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“…1,15 CAexPA may occasionally represent a challenge in that only the precursor PA component may be sampled and therefore classified as a benign neoplasm. 1,15 CAexPA may occasionally represent a challenge in that only the precursor PA component may be sampled and therefore classified as a benign neoplasm.…”

Section: B a S A L O I D N E O P L A S M Smentioning

confidence: 99%

“…1,2 Despite this very good performance of salivary gland FNA there are limitations and these are mainly related to the inability to provide specific diagnosis in some cases. Multiple studies have shown high sensitivity, specificity and accuracy in the differentiation of benign versus malignant tumors (sensitivity 80-89% and specificity 97% for malignancy).…”

Section: Introductionmentioning

confidence: 99%

Ancillary testing strategies in salivary gland aspiration cytology: A practical pattern‐based approach

Griffith

Siddiqui

Schmitt

2017

Diagnostic Cytopathology

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Fine needle aspiration of salivary gland tumors is a common preoperative triage as it is useful in determining which patients should undergo surgical resection and in guiding the extent of surgery in those cases deemed appropriate for resection. While a specific diagnosis can be achieved on a cytologic specimen in many cases, there is also a considerable amount of morphologic diversity that prevents such confident preoperative classification and in these cases it can be a challenge to confidently determine if a tumor is benign or malignant. Recently, a pattern based risk stratification approach was proposed for salivary gland cytology in which basaloid neoplasms are separated by stromal characteristics and oncocytoid neoplasms are separated primarily by background material such as mucus. In addition to potentially providing a stratification in risk of malignancy for salivary gland tumors, this approach is also useful to narrow differential diagnostic considerations and guide ancillary testing. In this review we use this proposed pattern based approach as a framework to discuss immunostains and fluorescence in situ hybridization studies which we find useful in our practice.

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“…In the majority of cases, the salivary gland lesions are easily accessible for FNA, either superficially by palpation or by USG. The technique is minimally invasive and well tolerated by patients without significant complications, and is a cost‐effective diagnostic tool with a high sensitivity and specificity of approximately 54% to 98% and 88% to 98%, respectively . FNA plays a key role in guiding clinical management and provides useful information such as distinguishing between a neoplastic and a non‐neoplastic lesion, ascertaining whether a lesion is benign or malignant, and, last, providing prognostic information and a sample for ancillary testing such as molecular studies …”

Section: Introductionmentioning

confidence: 99%

The role of the Milan System for Reporting Salivary Gland Cytopathology: A 5‐year institutional experience

Viswanathan

Sung

Scognamiglio

et al. 2018

Cancer Cytopathology

121

183

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Salivary gland FNA cytology: role as a triage tool and an approach to pitfalls in cytomorphology

Cited by 76 publications

References 21 publications

Application of the Milan System for Risk Stratification and Its Comparison with a Previous Reporting System of Parotid Gland Cytopathology in a Tertiary Care Centre

Application of the Milan System for Risk Stratification and Its Comparison with a Previous Reporting System of Parotid Gland Cytopathology in a Tertiary Care Centre

Ancillary testing strategies in salivary gland aspiration cytology: A practical pattern‐based approach

The role of the Milan System for Reporting Salivary Gland Cytopathology: A 5‐year institutional experience

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