Context: Fine needle aspiration cytology is an effective tool for
diagnosing and differentiating the nonneoplastic and neoplastic
salivary gland lesions. However, there are varied reporting formats
which hinders the effective management. The proposed Milan
system for reporting salivary gland cytology provides a platform for
uniform reporting and effective communication among pathologists
and clinicians. Aim: The aim and objectives of this study is to evaluate
and categorize the previously diagnosed salivary gland lesions under
Milan reporting system, to determine the risk of malignancy for each
diagnostic categories and to ascertain the diagnostic accuracy of FNA
in differentiating benign from malignant lesions. Material and Methods:
This retrospective study was conducted in a tertiary care center for 2
years from 2017 to 2019. The cytological diagnosis of salivary gland
lesions were recategorised as per Milan reporting system. The risk of
malignancy and diagnostic accuracy were evaluated by comparing
with histopathological diagnoses. Results: Of 106 cases, highest
number of cases were observed in nonneoplastic category (51.9%).
Histopathological follow-up was available for 51.8% cases. The risk
of malignancy was highest in malignant category (100%) and no risk
of malignancy were identified in nondiagnostic and nonneoplastic
categories. The diagnostic accuracy for differentiating benign and
malignant lesions was 94.55%. Conclusion: This study emphasizes the
need for utility of the proposed Milan classification system in routine
cytology reporting of salivary gland lesions. This six-tier classification
is useful particularly when difficulty arises due to overlapping
morphological features.
Keywords: Salivary gland; Milan system; Risk of malignancy.