The risk of malignancy according to Milan reporting system of salivary gland fine‐needle aspiration with Becton Dickinson SurePath liquid‐based processing

Sadullahoğlu, Canan; Yıldırım, Hülya Tosun; Çekiç, Bülent; Selçuk, Ömer Tarık; Osma, Üstün; Alparslan, Ahmet Şükrü; Sezer, Cem

doi:10.1002/dc.24214

Cited by 17 publications

(23 citation statements)

References 21 publications

(57 reference statements)

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“…Among all FNAs with histological follow-up, 22 out of 90 cases (24.4%) were non-neoplastic lesions, whereas 68 lesions (75.6%) were neoplastic and 16 lesions (17.8%) were malignant. The risk of neoplasm, the risk of malignancy, and the overall risk of malignancy were calculated for each MSRSGC category (Table 3) and compared with other MSRSGC studies [8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26] and MSRSGC estimated ROMs (Table 4).…”

Section: Resultsmentioning

confidence: 99%

Salivary Gland FNA Diagnostics in a Real-Life Setting: One-Year-Experiences of the Implementation of the Milan System in a Tertiary Care Center

Tommola

Porre

et al. 2019

Cancers

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The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was introduced in 2018 following other organ specific cytopathological reporting systems and it aimed at bringing a practical, evidence-based, user-friendly classification system with characterization and management algorithms. At the Department of Pathology, Fimlab Laboratories, Tampere, Finland all salivary fine needle aspirations (FNAs) have been given cytopathological diagnoses according to the MSRSGC since January 2018. Analyses of a one-year-period (January 2018–December 2018) consisted of 183 salivary FNA samples from 138 patients with correlation to histopathology in 90 cases with surgical follow-up. The MSRSGC performance in patient based analysis was as follows: accuracy was 90.9%, sensitivity was 61.5%, specificity was 100%, positive predictive value was 100%, and negative predictive value was 89.4%, respectively. Risks of malignancy (ROMs) in MSRSGC categories were: 0.0% (0/15) in non-diagnostic category, 100.0% (1/1) in non-neoplastic category biased by only one falsely-negative lymphoma case, 14.3% (1/7) in atypia of undetermined significance category, 0.0% (0/28) in benign neoplasm category, 27.3% (3/11) in neoplasm of uncertain malignant potential category, and 100% for both suspicious for malignancy (4/4) and malignancy (4/4) categories, respectively. The MSRSGC has been proven as a reliable classification system in salivary gland FNA routine diagnostics in a tertiary care center.

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Section: Resultsmentioning

confidence: 99%

Salivary Gland FNA Diagnostics in a Real-Life Setting: One-Year-Experiences of the Implementation of the Milan System in a Tertiary Care Center

Tommola

Porre

et al. 2019

Cancers

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“…Approximately 58% of studies exceeded this suggested figure (14.5%‐40.4% of all cases in the ND category). The use of US‐guided FNA decreases the percentage ND cases, 38 and some studies showed that conventional smears have lower ND rates compared to liquid‐based preparations 35 …”

Section: Discussionmentioning

confidence: 99%

“…Only the studies which separated the NN from the benign neoplastic diagnoses upon histopathological follow‐up were included in calculating the FNA accuracy in detecting neoplasm 11,12,15,17,19,20,22,23,25,26,28,30‐38,40,45 . The studies which solely reported the cytologic‐histopathological correlation among the AUS, SUMP, and/or SM were excluded from the accuracy analyses.…”

Section: Methodsmentioning

confidence: 99%

“…In addition, the uniform terminology allows cross communication between pathologists and institutions. Since the print publication of the MSRSGC in 2018, many institutions across the world retrospectively applied this tired diagnostic scheme to their institutional cohort of cases or those collected from multiple institutions and reported their findings with and without surgical follow‐up 6‐43 …”

Section: Introductionmentioning

confidence: 99%

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The Milan system for reporting salivary gland cytopathology: A comprehensive review of the literature

Jalaly

Farahani

Baloch

2020

Diagnostic Cytopathology

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Background The Milan system for Reporting Salivary Gland Cytopathology (MSRSGC) was published in 2018. Since then, many authors have published their institutional experience by retrospectively assigning salivary gland fine‐needle aspiration cases to each of the MSRSGC categories and calculated their risk of malignancy (ROM) accordingly. Methods We reviewed all published articles available online in English that used the MSRSGC since or near its publication. We calculated the risk of neoplasm and ROM for each diagnostic category. In addition, the false‐negative and false‐positive rates from all studies were examined. Results Thirty‐seven articles were identified in the English literature; 2 were published in 2017, 14 in 2018, 18 in 2019, and 3 in 2020. The total number of cases was 16 394, and 8 468 had surgical follow‐up. The mean ROM was 16.9% for category I, 10.5% for category II, 39.3% for category III, 2.9% for category IVa, 39.4% for category IVb, 84.2% for category V, and 97.5% for category VI. The mean false‐negative rate for MSRSGC categories II and IVa was 4.5%. Similarly, the mean false‐positive rate for MSRSGC categories V and VI was 5.1%. Conclusion A tiered classification scheme of MSRSGC is helpful in effectively guiding clinical management of patients with salivary gland lesions. The reported mean ROM for each category in most studies is within the recommended range published by the MSRSGC.

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“…In a series of 6249 reviewed cases performed by the College of American Pathologists, the lymphoma cases featured the highest false-negative rate at 57% [33]. In recent MSRSGC analyses, 10 lymphoma cases were misinterpreted in a non-neoplastic category and 9 lymphoma cases in an AUS category [4,23,25,26,34].…”

Section: Discussionmentioning

confidence: 99%

The Contributory Role of Cell Blocks in Salivary Gland Neoplasms Fine Needle Aspirations Classified by the Milan System for Reporting Salivary Gland Cytology

et al. 2021

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(1) Background: The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was introduced in 2018, bringing an organ-specific classification system for salivary gland cytopathology. The aim of present study is to evaluate the MSRSGC prospectively, based on a two-year experience in the tertiary care center pathology department, and evaluate the role of routine cell block (CB) preparation in salivary gland cytopathological diagnostics. (2) Methods: In our institution, the Department of Pathology, Fimlab Laboratories, Tampere, Finland, the MSRSGC has been implemented in salivary gland cytopathology since January 2018 and, over a two-year period (January 2018–December 2019), there were 365 fine-needle aspirations, of which 164 had a surgical follow-up. The CB methods used were Plasma-thrombin, the collection of visible fragments, and the Shandon and in-house methods. (3) Results: The MSRSGC diagnostic figures were as follows: accuracy 87.5%, sensitivity 45.8% and specificity 98.9%. For diagnostic categories of MSRSGC (non-neoplastic, benign neoplasm and malignant neoplasm) (n = 63) diagnostic accuracy was 98.4%, and for undetermined categories (atypia of undetermined significance, salivary gland neoplasm of uncertain malignant potential and suspicious for malignancy) (n = 49) diagnostic accuracy was 73.5%. Non-contributory cell blocks resulted more often in a false negative diagnosis (25%, 3/12) than a true negative diagnosis (10%, 7/73, p < 0.001), and is, most likely, an insufficient cytological diagnosis (86%, 18/21, p < 0.001). (4) Conclusion: The application of MSRSGC and CBs are beneficial in salivary gland cytological diagnosis, increasing diagnostic accuracy and, thus, patients’ management and treatment.

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The risk of malignancy according to Milan reporting system of salivary gland fine‐needle aspiration with Becton Dickinson SurePath liquid‐based processing

Cited by 17 publications

References 21 publications

Salivary Gland FNA Diagnostics in a Real-Life Setting: One-Year-Experiences of the Implementation of the Milan System in a Tertiary Care Center

Salivary Gland FNA Diagnostics in a Real-Life Setting: One-Year-Experiences of the Implementation of the Milan System in a Tertiary Care Center

The Milan system for reporting salivary gland cytopathology: A comprehensive review of the literature

The Contributory Role of Cell Blocks in Salivary Gland Neoplasms Fine Needle Aspirations Classified by the Milan System for Reporting Salivary Gland Cytology

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