“CYTOMORPHOLOGICAL STUDY OF VARIOUS SALIVARY GLAND LESIONS AND EVALUATION BY MILAN SYSTEM FOR REPORTING SALIVARY GLAND CYTOPATHOLOGY IN TERTIARY CARE CENTRE”

Background: Fine needle aspiration cytology (FNAC) is a well-established technique that plays a critical role in preoperative diagnosis of any salivary gland mass lesions. Because of heterogeneity of salivary gland lesions and cytomorphology overlap, a uniform 6 tier Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) helps standardize reporting systems and may aid in better communication between clinicians and pathologists and guide the clinical management of patients.Aims:We aimed to study the utility of FNAC in the diagnosis of salivary gland lesions and also study the cytomorphological features of various salivary gland lesions using Milan system classification. Methods and Material: We performed a retrospective analysis of salivary gland lesion FNAC in cytopathology department,tertiary care center from January 2018 to May 2019.All the cases of salivary gland aspirates were classified into six diagnostic categories according to the Milan system of reporting salivary gland cytology (MSRSGC) as follows: Category 1: Non-diagnostic (ND); Category 2: Non-neoplastic (NN); Category 3: Atypia of undetermined significance (AUS); Category 4a: Neoplasm: benign (NB), Category 4b: Neoplasm: salivary gland neoplasm of uncertain malignant potential (SUMP);Category 5:suspicious of malignancy (SM);and Category 6:Malignant (M). Results:A total of 54 cases of salivary gland aspirates were classified using the Milan system as non-diagnostic 2 cases (3.7%), non-neoplastic 12 (22.22%), atypia of undetermined significance 1 (1.85%), neoplasm 32 (59.3%), suspicious for malignancy 1 (1.86%), and malignancy 6 (11.1%).Pleomorphic Adenoma (23 cases;43%) was the most common benign salivary gland lesions and Mucoepidermoid Carcinoma (3 cases; 5.6%) was most common malignant lesion. Parotid gland (38 cases; 70.4%) was the most commonly involved in benign and malignant tumors. Commonly affected age group by benign salivary gland lesion was 31-40 years and those with malignant salivary gland lesion was 21-30 years. Conclusions: The MSRSGC helps pathologists to standardize reporting leading to better clinical and surgical management.