EVALUATION OF ACCURACY OF MILAN SYSTEM FOR REPORTING SALIVARY GLAND CYTOPATHOLOGY AND RISK STRATIFICATION

Introduction: Salivary gland tumours comprise around 3–10% of head and neck neoplasms. Fineneedle aspiration (FNA) is the rst line investigation for preoperative diagnosis of salivary gland lesions and for identifying the malignant potential of a tumour but because of its intratumoral heterogenecity, diversity and morphological overlap challenging the cytopathologist “The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was introduced to provide diagnosis and better management according to the risk of malignancy (ROM) in different categories. Methodology: A total of 100 specimen were evaluated cytologically and histopathologically. The histopathological ndings were compared with the pre-operative cytology of the FNAC specimens. The risk of malignancy (ROM) and the overall risk of malignancy (OROM) were also calculated. Results: Amongst the non-neoplastic lesions, Chronic sialadenitis was the most common. Pleomorphic adenoma (47.9%) and Mucoepidermoid carcinoma (11.26%) were the most common benign and malignant salivary gland neoplasms respectively. According to the MILAN system, the risk of malignancy was 20%, 6.6%, 50%, 3.3%, 50%, 100% and 100% in category I, II, III, IVA, IVB , V and VI respectively. The overall risk of malignancy was 14.2%, 4.5%, 25%, 2.2%, 33.3%, 75% and 50% in category I, II, III, IVA, IVB, V and VI respectively. A sensitivity, specicity, positive predictive value, negative predictive value and diagnostic accuracy of 84.6%, 100%, 100%, 96.29% and 96.9% respectively. Conclusion: The current investigation validates the diagnostic value of MSRSGC and helps guide the treatment of salivary gland diseases in clinical practice.