Derek B Allison1, Alexander P Smith1, Daniel An2, James Adam Miller3, Khurram Shafique4, Sharon Song4, Kartik Viswanathan5, Elizabeth Eykman6, Rema A Rao7, Austin Wiles8, Güliz A Barkan9, Ritu Nayar10, Guido Fadda11, Celeste N Powers8, Esther Diana Rossi11, Momin T Siddiqui5, Syed Z Ali2, Ivana Kholová12,13, Lester J Layfield14, Andrew Field6, Zubair Baloch4, Zahra Maleki2. 1. Department of Pathology and Laboratory Medicine, University of Kentucky College of Medicine, Lexington, Kentucky. 2. Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland. 3. Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin. 4. Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania. 5. Department of Pathology and Laboratory Medicine, NewYork-Presbyterian, Weill Cornell Medicine, New York, New York. 6. Department of Pathology, St. Vincent Hospital, Sydney, New South Wales, Australia. 7. Department of Pathology, Montefiore Medical Center, Bronx, New York. 8. Department of Pathology, Virginia Commonwealth University, Richmond, Virginia. 9. Department of Pathology, Loyola University Medical Center, Maywood, Illinois. 10. Department of Pathology, Northwestern University, Chicago, Illinois. 11. Department of Anatomic Pathology and Histology, Agostino Gemelli School of Medicine, Catholic University of the Sacred Heart, Rome, Italy. 12. Department of Pathology, Fimlab Laboratories, Tampere, Finland. 13. Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. 14. Department of Pathology, University of Missouri School of Medicine, Columbia, Missouri.
Abstract
BACKGROUND: The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) has established distinct diagnostic categories for reporting cytopathological findings, and each is associated with a defined risk of malignancy (ROM). However, the ROM is applied at the overall category level and is not specific for particular morphological entities within a category. Here, the diagnostic performance of the MSRSGC for pleomorphic adenoma (PA) and Warthin tumor (WT) is reported. METHODS: The pathology archives of 11 institutions from 4 countries were retrospectively searched to identify all salivary gland fine-needle aspiration (FNA) biopsies with a differential or definitive diagnosis of PA or WT and all resection specimens with a diagnosis of PA or WT; only paired cases were included. All FNA diagnoses were retrospectively classified according to the MSRSGC. RESULTS: A total of 1250 cases met the inclusion criteria, and they included 898 PA cases and 352 WT cases. The ROM in the benign neoplasm category was 3.0% and 1.3% for cases with a differential or definitive diagnosis of PA and WT, respectively. The ROM in the salivary gland neoplasm with uncertain malignant potential (SUMP) category was 2.7% and 18.8% for PA and WT, respectively (P = .0277). The diagnostic accuracy for PA and WT was 95.1% and 96.1%, respectively. CONCLUSIONS: The diagnostic accuracy for PA and WT on FNA is high. Furthermore, these findings highlight the difference in the ROMs associated with 2 specific differential diagnoses in the SUMP category: basaloid neoplasms and oncocytoid neoplasms.
BACKGROUND: The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) has established distinct diagnostic categories for reporting cytopathological findings, and each is associated with a defined risk of malignancy (ROM). However, the ROM is applied at the overall category level and is not specific for particular morphological entities within a category. Here, the diagnostic performance of the MSRSGC for pleomorphic adenoma (PA) and Warthin tumor (WT) is reported. METHODS: The pathology archives of 11 institutions from 4 countries were retrospectively searched to identify all salivary gland fine-needle aspiration (FNA) biopsies with a differential or definitive diagnosis of PA or WT and all resection specimens with a diagnosis of PA or WT; only paired cases were included. All FNA diagnoses were retrospectively classified according to the MSRSGC. RESULTS: A total of 1250 cases met the inclusion criteria, and they included 898 PA cases and 352 WT cases. The ROM in the benign neoplasm category was 3.0% and 1.3% for cases with a differential or definitive diagnosis of PA and WT, respectively. The ROM in the salivary gland neoplasm with uncertain malignant potential (SUMP) category was 2.7% and 18.8% for PA and WT, respectively (P = .0277). The diagnostic accuracy for PA and WT was 95.1% and 96.1%, respectively. CONCLUSIONS: The diagnostic accuracy for PA and WT on FNA is high. Furthermore, these findings highlight the difference in the ROMs associated with 2 specific differential diagnoses in the SUMP category: basaloid neoplasms and oncocytoid neoplasms.
Keywords:
Milan System for Reporting Salivary Gland Cytopathology; Warthin tumor; cytology; cytopathology; fine-needle aspiration (FNA); head and neck pathology; pleomorphic adenoma; salivary gland
Authors: Miquel Quer; Juan C Hernandez-Prera; Carl E Silver; Maria Casasayas; Ricard Simo; Vincent Vander Poorten; Orlando Guntinas-Lichius; Patrick J Bradley; Wai Tong-Ng; Juan P Rodrigo; Antti A Mäkitie; Alessandra Rinaldo; Luiz P Kowalski; Alvaro Sanabria; Remco de Bree; Robert P Takes; Fernando López; Kerry D Olsen; Ashok R Shaha; Alfio Ferlito Journal: Diagnostics (Basel) Date: 2021-08-13
Authors: Austin B Wiles; Matthew Gabrielson; Zubair W Baloch; William C Faquin; Vickie Y Jo; Fabiano Callegari; Ivana Kholova; Sharon Song; Barbara A Centeno; Syed Z Ali; Satu Tommola; Guido Fadda; Gianluigi Petrone; He Wang; Esther D Rossi; Liron Pantanowitz; Zahra Maleki Journal: Cancer Cytopathol Date: 2022-04-06 Impact factor: 4.264