The contributory role of cell blocks in salivary gland neoplasms fine needle aspirations classified by the milan system for reporting salivary gland cytology

Erkka Tommola, David Kalfert, Heli Hakso-Mäkinen, Ivana Kholová

Research output: Contribution to journalArticleScientificpeer-review

Abstract

(1) Background: The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was introduced in 2018, bringing an organ-specific classification system for salivary gland cytopathology. The aim of present study is to evaluate the MSRSGC prospectively, based on a two-year experience in the tertiary care center pathology department, and evaluate the role of routine cell block (CB) preparation in salivary gland cytopathological diagnostics. (2) Methods: In our institution, the Department of Pathology, Fimlab Laboratories, Tampere, Finland, the MSRSGC has been implemented in salivary gland cytopathology since January 2018 and, over a two-year period (January 2018–December 2019), there were 365 fine-needle aspirations, of which 164 had a surgical follow-up. The CB methods used were Plasma-thrombin, the collection of visible fragments, and the Shandon and in-house methods. (3) Results: The MSRSGC diagnostic figures were as follows: accuracy 87.5%, sensitivity 45.8% and specificity 98.9%. For diagnostic categories of MSRSGC (non-neoplastic, benign neoplasm and malignant neoplasm) (n = 63) diagnostic accuracy was 98.4%, and for undetermined categories (atypia of undetermined significance, salivary gland neoplasm of uncertain malignant potential and suspicious for malignancy) (n = 49) diagnostic accuracy was 73.5%. Non-contributory cell blocks resulted more often in a false negative diagnosis (25%, 3/12) than a true negative diagnosis (10%, 7/73, p < 0.001), and is, most likely, an insufficient cytological diagnosis (86%, 18/21, p < 0.001). (4) Conclusion: The application of MSRSGC and CBs are beneficial in salivary gland cytological diagnosis, increasing diagnostic accuracy and, thus, patients’ management and treatment.

Original languageEnglish
Article number1778
JournalDiagnostics
Volume11
Issue number10
DOIs
Publication statusPublished - 2021
Publication typeA1 Journal article-refereed

Keywords

  • Cell block
  • FNA
  • Salivary glands
  • The Milan System for Reporting Salivary Gland Cytopathology

Publication forum classification

  • Publication forum level 1

ASJC Scopus subject areas

  • Clinical Biochemistry

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