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An Official Publication of the Indian Association of Oral and Maxillofacial Pathologists

ORIGINAL ARTICLE Table of Contents   
Year : 2020  |  Volume : 24  |  Issue : 2  |  Page : 266-272
Application of Milan system for reporting of salivary gland pathology and risk stratification: An institutional experience

Department of Pathology, MMIMSR, MMDU, Mullana, Haryana, India

Correspondence Address:
Prem Singh
Department of Pathology, MMIMSR, MMDU, Mullana - 133 207, Haryana
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jomfp.JOMFP_6_20

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Background: Fine-needle aspiration cytology (FNAC) is a sensitive technique for diagnosing salivary gland pathologies. Milan system of reporting salivary gland cytopathology (MSRSGC) is an evidence-based system of reporting which has been introduced to improve reporting and communication between cytopathologist and clinician by introducing standardized categories with specified treatment protocols. Aims and Objectives: The aim of the present study is to find the diagnostic accuracy and risk of malignancy (ROM) in various categories when MSRSGC is applied. Materials and Methods: A single-institute-based 3-year retrospective study was done. All salivary gland lesions were reclassified according to MSRSGC. ROM, diagnostic specificity, sensitivity and accuracy of FNAC of salivary gland lesions were calculated. Results: A total of 133 cases were included in the study. Overall, the most common diagnosis was found to be pleomorphic adenoma comprising 61 (42.8%) of all cases. Adenoid cystic carcinoma was the most commonly diagnosed malignancy comprising of 6 (4.5%) of all lesions. Cases were further divided into Milan categories, namely nondiagnostic, nonneoplastic, atypia of undetermined significance, benign neoplasm, neoplasm of undetermined malignant potential, suspicious of malignancy and malignancy comprising 5 (3.7%), 29 (21.8%), 77 (57.8%), 4 (3%), 3 (2.2%), 1 (0.7%) and 14 (10.5%) cases, respectively, with ROM of 0, 14.28%, 33.33%, 5.71%, 66.66%, 100% and 80%, respectively. Sensitivity, specificity and diagnostic accuracy to separate benign from malignant lesions were 80%, 89.80% and 87.50%, respectively. Conclusion: FNAC of the salivary gland lesions is a safe and reliable diagnostic procedure. The Milan system of reporting is a risk stratification system which can improve the overall effectiveness of reporting and care of patients.

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Journal of Oral and Maxillofacial Pathology | Published by Wolters Kluwer - Medknow
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