TY - JOUR
T1 - Mucoepidermoid carcinoma, acinic cell carcinoma, and adenoid cystic carcinoma on fine-needle aspiration biopsy and The Milan System
T2 - an international multi-institutional study
AU - Miller, James A.
AU - An, Daniel
AU - Shafique, Khurram
AU - Song, Sharon
AU - Rao, Rema A.
AU - Viswanathan, Kartik
AU - Eykman, Elizabeth
AU - Wiles, Austin
AU - Ali, Syed Z.
AU - Field, Andrew
AU - Fadda, Guido
AU - Barkan, Guliz A.
AU - Layfield, Lester J.
AU - Rossi, Esther D.
AU - Powers, Celeste N.
AU - Siddiqui, Momin T.
AU - Kholova, Ivana
AU - Baloch, Zubair
AU - Maleki, Zahra
N1 - Publisher Copyright:
© 2019 American Society of Cytopathology
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Background: We evaluated the diagnostic accuracy (DA), risk of neoplasm (RON), and risk of malignancy (ROM) for the commonly encountered malignant salivary gland tumors mucoepidermoid carcinoma (MECa), acinic cell carcinoma (ACCa), and adenoid cystic carcinoma (ADCa) applying The Milan System for Reporting Salivary Gland Cytology (MSRSGC). Materials and methods: The cytology archives from 2007 to 2017 of 9 academic institutions were searched for salivary gland FNAs for the following key words mentioned either in the principal and/or differential diagnosis: MEC, ACCa, and ADCa. The original cytology diagnosis was retrospectively classified according to the MSRSGC. Patient demographics, biopsy site, and available surgical follow-up were recorded. The final analysis included only cases with surgical follow-up. Results: A total of 212 salivary gland FNAs were included. Based on retrospective reclassification according to MSRSGC, 97 of 212 (46%) FNA cases carried a diagnosis of malignancy specific for either MECa, ACCa, or ADCa. In the remaining 115 cases, 24 of 212 (11%) were reclassified as suspicious for malignancy (SM) and 91 of 212 (43%) as salivary gland neoplasm of uncertain malignant potential (SUMP). The DA for MECa, ACCa, and ADCa was 78.7%, 75% and 89%, respectively. The RON was 100% for all 3 tumors and the ROM was 93.6% for MECa, 96.8% for ACCa, and 94.4% for ADCa. Conclusions: The DA of 78.7% for MECa, 75% for ACCa, and 89% for ADCa is reasonable in FNA specimens. Although the management of definitive cases of malignancy remains unchanged, the MSRSGC provides a ROM for SM and SUMP categories, which can improve patient management.
AB - Background: We evaluated the diagnostic accuracy (DA), risk of neoplasm (RON), and risk of malignancy (ROM) for the commonly encountered malignant salivary gland tumors mucoepidermoid carcinoma (MECa), acinic cell carcinoma (ACCa), and adenoid cystic carcinoma (ADCa) applying The Milan System for Reporting Salivary Gland Cytology (MSRSGC). Materials and methods: The cytology archives from 2007 to 2017 of 9 academic institutions were searched for salivary gland FNAs for the following key words mentioned either in the principal and/or differential diagnosis: MEC, ACCa, and ADCa. The original cytology diagnosis was retrospectively classified according to the MSRSGC. Patient demographics, biopsy site, and available surgical follow-up were recorded. The final analysis included only cases with surgical follow-up. Results: A total of 212 salivary gland FNAs were included. Based on retrospective reclassification according to MSRSGC, 97 of 212 (46%) FNA cases carried a diagnosis of malignancy specific for either MECa, ACCa, or ADCa. In the remaining 115 cases, 24 of 212 (11%) were reclassified as suspicious for malignancy (SM) and 91 of 212 (43%) as salivary gland neoplasm of uncertain malignant potential (SUMP). The DA for MECa, ACCa, and ADCa was 78.7%, 75% and 89%, respectively. The RON was 100% for all 3 tumors and the ROM was 93.6% for MECa, 96.8% for ACCa, and 94.4% for ADCa. Conclusions: The DA of 78.7% for MECa, 75% for ACCa, and 89% for ADCa is reasonable in FNA specimens. Although the management of definitive cases of malignancy remains unchanged, the MSRSGC provides a ROM for SM and SUMP categories, which can improve patient management.
KW - Acinic cell carcinoma
KW - Adenoid cystic carcinoma
KW - Fine-needle aspiration
KW - Mucoepidermoid carcinoma
KW - Risk of malignancy
KW - Risk of neoplasm
KW - Salivary gland
KW - The Milan System for Reporting Salivary Gland Cytology
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UR - http://www.scopus.com/inward/citedby.url?scp=85065619687&partnerID=8YFLogxK
U2 - 10.1016/j.jasc.2019.04.001
DO - 10.1016/j.jasc.2019.04.001
M3 - Article
C2 - 31104944
AN - SCOPUS:85065619687
SN - 2213-2945
VL - 8
SP - 270
EP - 277
JO - Journal of the American Society of Cytopathology
JF - Journal of the American Society of Cytopathology
IS - 5
ER -