Milan System for Reporting Salivary Gland Cytopathology - A Two Yearsâ?? Experience in a Referral Centre of Western Odisha

Abstract

Bijayalaxmi Sahoo1, Sunanda Nayak2, Gitimadhuri Dutta3, Shailaja Prabhala4, Kulwant Lakra5

BACKGROUND
Neoplasms of salivary gland account for 2 - 6.5 % of all head and neck neoplasms.
Fine needle aspiration cytology (FNAC) is sufficiently sensitive and relevant to the
diagnosis and treatment of salivary gland pathologies for salivary gland lesions.
The Milan system for reporting salivary gland cytopathology (MSRSGC) represents
a stage for a structured, evidence-based international reporting system for salivary
gland fine-needle aspiration (FNA). This system provides a guidance for diagnosis
and management according to the risk of malignancy (ROM) in different
categories. We wanted to study the various cytomorphological lesions of salivary
gland and their cytological categorisation based on the MILAN system of reporting.
METHODS
A 2-year record-based study (January 2018 to December 2019) was conducted on
FNAC of salivary gland lesions in the Department of Pathology, VSSIMSAR (Veer
Surendra Sai Institute of Medical Sciences and Research), Burla, Odisha. Based on
the classical system, all smears were studied and re-categorized into six groups
according to the MILAN classification. Histological correlation was carried out in
the available cases.
RESULTS
A total of 103 FNA cases were examined and 20 different categories were there in
the original diagnosis. As per the categorisation based on MILAN System there
were six categories, maximum cases were non-neoplastic 34 (33.0 %) followed by
benign neoplasms 22 (21.35 %), malignant 14 (13.5 %), non-diagnostic 10 (9.7
%), atypia of undetermined significance 9 (8.7 %), suspicious for malignancy 8
(7.7 %) and neoplasms of uncertain malignant potential 6 (5.8 %). 43 cases (80.4
%) were found to be concordant out of 54 histopathology correlated cases.
CONCLUSIONS
The Milan system of reporting salivary gland cytopathology provided a uniform
system of reporting salivary gland cytomorphology that may increase the
effectiveness.

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