Journal article
Application of the Milan System for Reporting Submandibular Gland Cytopathology: An international, multi-institutional study.
- Maleki Z Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland.
- Baloch Z Department of Pathology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
- Lu R Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland.
- Shafique K Department of Pathology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
- Song SJ Department of Pathology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
- Viswanathan K Department of Pathology, Weill Cornell Medicine, New York, New York.
- Rao RA Department of Pathology, Weill Cornell Medicine, New York, New York.
- Lefler H Department of Pathology, Northwestern University, Chicago, Illinois.
- Fatima A Department of Pathology, Rutgers Robert Wood Johnson University, New Brunswick, New Jersey.
- Wiles A Department of Pathology, Virginia Commonwealth University, Richmond, Virginia.
- Jo VY Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts.
- Wang H Department of Pathology, Rutgers Robert Wood Johnson University, New Brunswick, New Jersey.
- Fadda G Department of Anatomic Pathology and Histology, Agostino Gemelli School of Medicine, Catholic University of the Sacred Heart, Rome, Italy.
- Powers CN Department of Pathology, Virginia Commonwealth University, Richmond, Virginia.
- Ali SZ Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland.
- Pantanowitz L Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania.
- Siddiqui MT Department of Pathology, Weill Cornell Medicine, New York, New York.
- Nayar R Department of Pathology, Northwestern University, Chicago, Illinois.
- Klijanienko J Department of Pathology, Curie Institute, Paris, France.
- Barkan GA Department of Pathology, Loyola University, Chicago, Illinois.
- Krane JF Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts.
- Rossi ED Department of Anatomic Pathology and Histology, Agostino Gemelli School of Medicine, Catholic University of the Sacred Heart, Rome, Italy.
- Callegari F Department of Pathology, Sao Paulo Federal University, Sao Paulo, Brazil.
- Kholová I Department of Pathology, Fimlab Laboratories, Tampere, Finland.
- Bongiovanni M Service of Clinical Pathology, Lausanne University Hospital, Institute of Pathology, Lausanne, Switzerland.
- Faquin WC Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts.
- Pusztaszeri MP Department of Pathology, McGill University, Montreal, Quebec, Canada.
- 2019-05-04
Published in:
- Cancer cytopathology. - 2019
Milan System for Reporting Salivary Gland Cytopathology (MRSSGC)
atypia of undetermined significance (AUS)
benign neoplasm
fine-needle aspiration (FNA)
malignant
nondiagnostic
nonneoplastic
risk of malignancy (ROM)
salivary gland neoplasm of uncertain malignant potential (SUMP)
submandibular gland
suspicious for malignancy (SM)
Adolescent
Adult
Aged
Aged, 80 and over
Algorithms
Biopsy, Fine-Needle
Child
Child, Preschool
Cytodiagnosis
Female
Follow-Up Studies
Health Facilities
Humans
Infant
International Agencies
Male
Medical Records
Middle Aged
Precancerous Conditions
Retrospective Studies
Risk Assessment
Salivary Gland Neoplasms
Submandibular Gland
Young Adult
English
BACKGROUND
The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) is a 6-tier diagnostic category system with associated risks of malignancy (ROMs) and management recommendations. Submandibular gland fine-needle aspiration (FNA) is uncommon with a higher frequency of inflammatory lesions and a higher relative proportion of malignancy, and this may affect the ROM and subsequent management. This study evaluated the application of the MSRSGC and the ROM for each diagnostic category for 734 submandibular gland FNAs.
METHODS
Submandibular gland FNA cytology specimens from 15 international institutions (2013-2017) were retrospectively assigned to an MSRSGC diagnostic category as follows: nondiagnostic, nonneoplastic, atypia of undetermined significance (AUS), benign neoplasm, salivary gland neoplasm of uncertain malignant potential (SUMP), suspicious for malignancy (SM), or malignant. A correlation with the available histopathologic follow-up was performed, and the ROM was calculated for each MSRSGC diagnostic category.
RESULTS
The case cohort of 734 aspirates was reclassified according to the MSRSGC as follows: nondiagnostic, 21.4% (0%-50%); nonneoplastic, 24.2% (9.1%-53.6%); AUS, 6.7% (0%-14.3%); benign neoplasm, 18.3% (0%-52.5%); SUMP, 12% (0%-37.7%); SM, 3.5% (0%-12.5%); and malignant, 13.9% (2%-31.3%). The histopathologic follow-up was available for 333 cases (45.4%). The ROMs were as follows: nondiagnostic, 10.6%; nonneoplastic, 7.5%; AUS, 27.6%; benign neoplasm, 3.2%; SUMP, 41.9%; SM, 82.3%; and malignant, 93.6%.
CONCLUSIONS
This multi-institutional study shows that the ROM of each MSRSGC category for submandibular gland FNA is similar to that reported for parotid gland FNA, although the reported rates for the different MSRSGC categories were variable across institutions. Thus, the MSRSGC can be reliably applied to submandibular gland FNA.
The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) is a 6-tier diagnostic category system with associated risks of malignancy (ROMs) and management recommendations. Submandibular gland fine-needle aspiration (FNA) is uncommon with a higher frequency of inflammatory lesions and a higher relative proportion of malignancy, and this may affect the ROM and subsequent management. This study evaluated the application of the MSRSGC and the ROM for each diagnostic category for 734 submandibular gland FNAs.
METHODS
Submandibular gland FNA cytology specimens from 15 international institutions (2013-2017) were retrospectively assigned to an MSRSGC diagnostic category as follows: nondiagnostic, nonneoplastic, atypia of undetermined significance (AUS), benign neoplasm, salivary gland neoplasm of uncertain malignant potential (SUMP), suspicious for malignancy (SM), or malignant. A correlation with the available histopathologic follow-up was performed, and the ROM was calculated for each MSRSGC diagnostic category.
RESULTS
The case cohort of 734 aspirates was reclassified according to the MSRSGC as follows: nondiagnostic, 21.4% (0%-50%); nonneoplastic, 24.2% (9.1%-53.6%); AUS, 6.7% (0%-14.3%); benign neoplasm, 18.3% (0%-52.5%); SUMP, 12% (0%-37.7%); SM, 3.5% (0%-12.5%); and malignant, 13.9% (2%-31.3%). The histopathologic follow-up was available for 333 cases (45.4%). The ROMs were as follows: nondiagnostic, 10.6%; nonneoplastic, 7.5%; AUS, 27.6%; benign neoplasm, 3.2%; SUMP, 41.9%; SM, 82.3%; and malignant, 93.6%.
CONCLUSIONS
This multi-institutional study shows that the ROM of each MSRSGC category for submandibular gland FNA is similar to that reported for parotid gland FNA, although the reported rates for the different MSRSGC categories were variable across institutions. Thus, the MSRSGC can be reliably applied to submandibular gland FNA.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1002/cncy.22135
- PMID 31050186
- Persistent URL
- https://sonar.ch/global/documents/1678
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