TY - JOUR
T1 - Application of the Milan System for Reporting Submandibular Gland Cytopathology
T2 - An international, multi-institutional study
AU - Maleki, Zahra
AU - Baloch, Zubair
AU - Lu, Ryan
AU - Shafique, Khurram
AU - Song, Sharon J.
AU - Viswanathan, Kartik
AU - Rao, Rema A.
AU - Lefler, Holly
AU - Fatima, Aisha
AU - Wiles, Austin
AU - Jo, Vickie Y.
AU - Wang, He
AU - Fadda, Guido
AU - Powers, Celeste N.
AU - Ali, Syed Z.
AU - Pantanowitz, Liron
AU - Siddiqui, Momin T.
AU - Nayar, Ritu
AU - Klijanienko, Jerzy
AU - Barkan, Guliz A.
AU - Krane, Jeffrey F.
AU - Rossi, Esther D.
AU - Callegari, Fabiano
AU - Kholová, Ivana
AU - Bongiovanni, Massimo
AU - Faquin, William C.
AU - Pusztaszeri, Marc P.
N1 - Publisher Copyright:
© 2019 American Cancer Society
PY - 2019/5
Y1 - 2019/5
N2 - 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.
AB - 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.
KW - Milan System for Reporting Salivary Gland Cytopathology (MRSSGC)
KW - atypia of undetermined significance (AUS)
KW - benign neoplasm
KW - fine-needle aspiration (FNA)
KW - malignant
KW - nondiagnostic
KW - nonneoplastic
KW - risk of malignancy (ROM)
KW - salivary gland neoplasm of uncertain malignant potential (SUMP)
KW - submandibular gland
KW - suspicious for malignancy (SM)
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U2 - 10.1002/cncy.22135
DO - 10.1002/cncy.22135
M3 - Article
C2 - 31050186
AN - SCOPUS:85065321438
SN - 1934-662X
VL - 127
SP - 306
EP - 315
JO - Cancer Cytopathology
JF - Cancer Cytopathology
IS - 5
ER -