Background: Fine needle aspiration cytology (FNAC) is a widely acclaimed preoperative primary investigation in the management of salivary gland lesions. But, lack of standardized unambiguous reporting often poses challenge to the clinicians. The six-tiered category-based Milan system of reporting salivary gland cytology (MSRSGC) proposes standardization in the reporting with risk of malignancy (ROM).
Aim: To find out the applicability of Milan system to diagnose the salivary gland cytology by correlating with histological follow-up and to estimate ROM for each of its category.
Methods and materials: Cross-sectional study was conducted in a Tertiary Hospital over a period of 2 years. Fine needle aspiration cytology (FNAC) diagnosis was classified as per MSRSGC categories into (I) nondiagnostic (ND), (II) non-neoplastic (NN), (III) atypia of undetermined significance (AUS), (IVa) benign neoplasm, (IVb) salivary gland neoplasm of uncertain malignant potential (SUMP), (V) suspicious for malignancy, and (VI) malignant. Cytology diagnosis was correlated with histopathology, and ROM was calculated.
Results: Fine needle aspiration cytology (FNAC) diagnosis was made for 50 samples as per MSRSGC. Histopathology follow-up was done for 46 cases (92%). The cytohistopathological correlation was done, and the discrepancy was noted in five cases. Our ROM for non-neoplastic, AUS, benign neoplasm, SUMP, suspicious for malignancy, and malignant categories was 0, 0, 0, 100, 100, and 100%, respectively. The sensitivity, specificity, and accuracy of FNAC were found to be 75, 100, and 98%, respectively.
Conclusion: Implementing Milan system in salivary gland FNAC yields quality, standardized reporting, and also estimation of ROM helps in effective clinical management.
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