The Milan System for Reporting Salivary Gland Cytopathology-Proposed modifications to improve clinical utility

Background Fine-needle aspiration of a salivary gland lesion is a well-established diagnostic procedure that aids management decisions. Recently, the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) classification has been proposed in order to improve the reproducibility and communication in the management of salivary gland lesions. Methods A total of 375 patient's cytological reports collected between January 2010 and December 2017 were reviewed and reclassified according to MSRSGC and a risk of malignancy was calculated for each of the category. Results The rate of malignancy in MSRSGC classification was 19.0%, 11.8%, 25.0%, 5.5%, 50.0%, 71.4%, and 94.6% for each of the category (I, II, III, IVa, IVb, V, and VI), respectively. Conclusion The MSRSGC classification is a valuable tool in everyday practice. The modified version of MSRSGC aims to improve the surgical relevance and facilitate uniform management.