Original Research Article
Year: 2020 | Month: February | Volume: 7 | Issue: 2 | Pages: 201-207
Milan System for Reporting of Salivary Gland Cytopathology: To Recognize Accuracy of Fine Needle Aspiration and Risk of Malignancy- A 4 Years Institutional Study
Manju Kumari1, Anjali Sharma2, Mukul Singh3, Gireesha Rawal1
1Senior resident, 2Specialist and assistant professor, 3Professor,
Department of pathology, VMMC and Safdarjung Hospital, New Delhi, India.
Corresponding Author: Mukul Singh
ABSTRACT
Introduction: Fine needle aspiration cytology (FNAC) is a well established technique for categorization of salivary gland lesions preoperatively .It has apt sensitivity and specificity to diagnose various salivary gland pathologies. However, there is lack of uniformity in reporting of various pathologists. This results in lack of appropriate communication and management of the patients. To overcome this problem ‘Milan system for reporting of salivary gland cytopathology’ (MSRSGC) was introduced.
Aims and Objectives: This is a retrospective study to reclassify the previously diagnosed salivary gland lesions and to evaluate the risk of malignancy in different categories.
Material and methods: The clinical details, FNAC smears, histological reports were retrieved from the hospital records and the cases were reclassified according to Milan system. False positive, false negative, true positive and true negative cases were calculated by comparing with the final histopathological diagnosis and then the accuracy and risk of malignancy of each diagnostic category were calculated.
Results: A total of 288 cases were included in the study of which histological follow up was present in 118 cases. The sensitivity, specificity, negative predictive value and positive predictive value were 78.57 %, 98.83 %, 90.43 % and 97.06 % respectively. The overall diagnostic accuracy to differentiate the benign and malignant cases was 92.19%. Also, the risk of malignancy in each category was 20%, 14.3%, 100%, 4.2%, 100%, 83.3% and 100% respectively. The highest risk of malignancy in the present study was noted in category III and V.
Conclusion: Milan system for reporting of salivary gland cytopathology provides a better communication between pathologists and clinicians. This also results in effectiveness along with lesser false positive and false negative results. The ROM in the present study were according to MSRSGC except category III, atypia of undetermined significance which was 100%.
Keywords: Milan system, salivary gland, FNAC, Cytology, histopathology, risk of malignancy.
[PDF Full Text]