Milan system for reporting of salivary gland cytopathology. Pdf the milan system for reporting salivary gland cytopathology. Riskbased stratification of salivary gland lesions on. The milan system for reporting salivary gland cytopathology msrsgc was published in 2018 and was drawn up by the american society of cytology and the international academy of cytology 3. Malignancy rates of 82%, 43% and 25% have been recorded for the minor salivary gland.
Results were used to provide focus for the proposed milan system for reporting salivary gland cytopathology. Salivary gland fna diagnostics in a reallife setting. Fourteen cases originated from accessory salivary glands 4%, 291 89% from the. Fine needle aspiration fna of salivary gland tumours is still the favoured initial approach as it results in good sensitivity and specificity. Fnac is a well established technique for categorization of salivary gland lesions preoperatively. Effectuation to cognize malignancy risk and accuracy of. Salivary gland tumors are one of the most heterogeneous groups of neoplasms, and salivary gland tumors are one of the most difficult areas of evaluation in cytology. The american society of cytopathology and the international academy of cytology initiated a project to propose a classification scheme the milan system to report salivary gland fnac. Sfm milan system for reporting salivary gland cytopathology. This volume describes a uniform international approach for classifying and reporting salivary gland fna samples. Welcome to the milan system for reporting salivary gland cytopathology online atlas. The milan system for reporting salivary gland cytopathology msrsgc was introduced in 2018 following other organ specific cytopathological reporting systems and it aimed at bringing a practical. The milan system for reporting salivary gland cytopathology msrsgc. The milan system for reporting salivary gland cytopathology msrsgc was published in 2018 and was drawn up by the american society of cytology and the.
An introduction to cytopathology is in the cytopathology article salivary gland cytopathology and salivary gland cytology redirect to here. Incorporation of the milan system in reporting salivary. Salivary gland cytology and the milan system for reporting. This international panel, under the sponsorship of the american society of cytopathology asc and the international academy of cytology iac, gathered in september 2015 at the european congress of cytology, held in milan, italy, to propose the milan system for reporting salivary gland cytopathology. Mody, md director of cytology laboratories the ibrahim ramzy chair in pathology houston methodist hospital professor of pathology and laboratory medicine weill cornell medicine conflict of interest none with vendors of cytology equipment or hpv testing. The diagnoses were reclassified based on the msrsgc. Application of the milan system of reporting salivary cytopathology. Suspicious for malignancy sfm milan system for reporting. The cytopathology of salivary glands presents major challenges due to the heterogeneity of benign and malignant neoplasms, which is reflected in the large range of who 2017 classifications. Moving toward a systematic approach for reporting salivary. Each diagnostic category of this novel salivary gland. Pitfalls in salivary gland fineneedle aspiration cytology. A proposal for a risk stratification classification.
The milan system for reporting salivary gland cytology is a helpful classification system. Salivary gland tumor fine needle aspiration cytology. Threeyear cytohistological correlation of salivary gland fna cytology at a tertiary center with the application of the milan. Salivary gland fnac with application of milan system of. The milan system for reporting salivary gland cytopathology mucinous cyst contents, aspirates with atypia, is composed of 6 general diagnostic categories summarized below. An international panel of experts in the field of salivary gland cytology sgc, supported by the american society of. The milan system for reporting salivary gland cytopathology. May 2017the milan system for reporting salivary gland cytopathology was published jan. Milan system has been proposed to classify the salivary gland cytological. Fineneedle aspiration cytology fnac is a wellestablished technique for evaluation of salivary gland lesions, but because of the heterogenicity and.
Maria pia foschini, esther diana rossi, kayoko higuchi, nirag c. A total of 1,560 fineneedle aspirations of the salivary glands were retrieved from two institutions for a 12year period. A salivary gland fna is classified as sm when some, but not all the criteria for a specific diagnosis of malignancy are present, and yet the overall cytologic. The milan system of reporting salivary gland cytopathology is a risk stratification system having a great potential of escalating clinical. May 2018the milan system for reporting salivary gland cytopathology was published jan. The purpose of this atlas is to offer instructive images with explanatory text to illustrate the features of the milan system for practitioners and trainees alike. Milan system for reporting salivary gland cytopathology. The purpose of our study was to compare the conventional system and the proposed milan system to look for concordance rates in cytohistopathologic correlation and any value addition to the. Salivary gland cytology and the milan system for reporting dina r. The result was a tiered reporting system named the milan system for. The milan system for reporting salivary gland cytopathology was developed and introduced to provide enhanced communication and improved overall care. Mody, md director of cytology laboratories the ibrahim ramzy chair in pathology houston methodist hospital professor of pathology and laboratory medicine weill cornell medicine. The recently released milan system for reporting salivary gland cytopathology msrsgc is a bethesda styled reporting system that proposes a uniform reporting terminology with risk strati. Fine needle aspiration cytology for salivary gland lesions has shown to be adequately sensitive and specific for diagnosing and treating salivary gland pathologies.
This could be particularly important for aggressive salivary gland tumors, such as salivary duct carcinoma sdc. Designed as a practical book with easy readability, the milan system for reporting salivary gland cytopathology combines the highquality images of an atlas with a logical approach described in concise textform and in linedrawing algorithms. Milan system for reporting salivary gland cytopathology ncbi. Pitfalls in salivary gland fine needle aspiration cytology. Aim of this study was to evaluate the potency of salivary gland fnac reported under milan guidelines, to calculate. To accost things in a particular disciple, egress related to fine needle aspiration cytology fnac and to standardize reporting pattern, a framework milan system for reporting salivary gland cytopathology msrsgc has been sponsored. Fineneedle aspiration cytology fnac is a wellestablished technique for evaluation of salivary gland lesions, but because of the heterogenicity and morphological overlap between spectrum of lesion, there are a few challenges in its wide use. Diagnosing lymphoid lesions and warthin tumors is often a challenging issue in salivary gland fine needle aspiration cytology. Conclusion the primary role of fnac in salivary gland tumors is to offer a. The milan system for reporting salivary gland cytopathology dr. Recognize that parotid cysts or lymphadenopathy may be the presenting symptom of hiv 3. Salivary glands, fine needle aspiration cytology, milan system for reporting salivary gland cytology, risk of neoplasm, risk of malignancy introduction salivary gland neoplasms represent 4% to 6.
This article will focus on some of the new advances in salivary gland tumor pathology that have a potential for clinical impact. Understand that most salivary gland neoplasms are benign ii. The new reporting system is evidencebased using data from the literature as well as upon the experience of a multidisciplinary group of leading experts involved in the field of salivary gland cytopathology. Risk assessment of salivary gland cytological categories. Fineneedle aspiration cytology fnac is widely accepted tool for preoperative diagnosis and management of suspected salivary gland tumors. Head and neck cytopathology is a small part of cytopathology.
The study group, formed during the 2015 european congress of cytology held in milan, italy, generated a survey that included 49 specific questions related to the taxonomies, practices, and diagnostic entities of salivary cytology. Milan system for reporting salivary gland cytology msrsgc was introduced to standardise the terminology and reporting of salivary gland cytology. Salivary gland cytology is an exciting branch of cytology that over the years has matured for the development of its own unified system for reporting, the milan classification 25. Salivary gland cytopathology acgme competency checklist. Salivary gland fine needle aspiration and introduction of. The value of fine needle aspiration cytology in the. Introduction milan system for salivary gland cytology. Recently, the milan system for reporting salivary gland cytopathology msrsgc was introduced, providing guide for. In 2015, an international group of pathologists initiated the development of an evidencebased tiered classification system for reporting salivary gland fna specimens designated the milan system for reporting salivary gland cytopathology msrsgc that culminated with the publication of the msrsgc atlas in february 2018.
Additionally, this site will provide an opportunity for realtime updates of terminology and. It presents for the first time, an international cytologic reporting system for salivary gland lesions designed and endorsed by a panel of experts in the field. The milan system for reporting salivary gland cytopathology msrsgc is designed to include best practice guidelines pertaining to sgfna including. Application of the milan system of reporting salivary. The milan system for reporting salivary gland cytopathology msrsgc was introduced in 2018 following other organ specific.
Multiinstitutional studies are required for the validation of the milan system for reporting salivary gland cytopathology msrsgc. Fineneedle aspiration cytology of salivary gland lesions. Who keeps changing the names of salivary gland tumors dr. Each diagnostic category is associated with an implied risk of malignancy and recommendations for the clinical management table 1. Enhanced performance of the milan system for reporting. Application of the milan system for reporting salivary.