The Milan System at Memorial Sloan Kettering: Utility of the categorization system for in‐house salivary gland fine‐needle aspiration cytology at a comprehensive cancer center

• DOI: 10.1002/dc.24350
• Publication Date: 2019-12-06T14:00:49Z
• Authors: Daniel Lubin; Darren Buonocore; Xiao‐Jun Wei; Jean‐Marc Cohen; Oscar Lin
• Keywords: Cytopathology; Salivary gland cancer; Tertiary care

Abstract Background The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) provides a standardized reporting system salivary gland fine‐needle aspiration (SGFNA). We review the clinical utility of MSRSGC at tertiary care cancer center by assessing rates malignancy (ROM) among different categories. Methods A retrospective search was performed to retrieve all SGFNA cases our institution between 1/1/07 and 12/31/18. initial primary diagnoses were recorded then assigned appropriate ROM calculated Results total 976 identified, 373 with follow‐up. 19.7% (192/976) all‐comers 51.3% (192/374) Using MSRSGC, showed sensitivity, specificity, positive predictive value (PPV), negative (NPV) 65.6%, 87.4%, 100%, 72.6%, respectively. categories I, II, III, IVa, IVb, V, VI 20.7%, 30.0%, 45.8%, 3.3%, 50.7%, Utilizing resulted in nondiagnostic rate 14.4%. lower when procedure pathologists vs nonpathologists (12.9% 15.8%) but comparable rapid on site evaluation (ROSE) 11.6%). Conclusion In patient population, perfect PPV moderate NPV. results higher due inclusion benign elements or cyst contents only this category. Performing ROSE is more important attaining an adequate sample than specialty person performing SGFNA.