scholarly journals Milan scoring system in the diagnosis of salivary gland lesions for assessment of risk of malignancy

2021 ◽  
Vol 8 (4) ◽  
pp. 443-446
Author(s):  
Bhavana Grandhi ◽  
B Syamsundara Rao ◽  
N Mohan Rao ◽  
G V Sunandha
Keyword(s):  
Salivary Gland ◽  
Predictive Value ◽  
Histopathological Examination ◽  
False Negative ◽  
Clinical History ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Risk Of Malignancy ◽  
Needle Aspiration Cytology ◽  
A Prospective Study

Salivary gland lesions are one of the most common encounters in clinical practice for the evaluation of which Fine needle aspiration cytology is a well-established technique nowadays. Owing to the heterogenecity and morphological overlap between the various categories of these salivary gland lesions, there was a need for a standardised procedure. The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) provides a standardised evidence based reporting system to assess the risk of malignancy and thus helpful for the management of these lesions. We have undertaken this study for evaluation of salivary gland lesions by this newly introduced grading system for predicting the malignant potential of these lesions.: We have done a prospective study of all the salivary gland lesions received in our department for a period of 3 years from 2016 to 2019. The clinical history, aspiration cytology and histopathological examination was done for all the cases.: We have received 225 salivary gland lesions for aspiration, but histological follow up was done in only 105 lesions, which were thus included in our study. Case distribution into different categories was done in the following way:ND (5.71%), NN (38.01%), AUS (2.57%), NB (33.34%), SUMP (1.9%), SM (2.85%), and M (15%). Overall, ROM reported were 25%, 5%, 20%, 4.4%, 33.3%, 85.7%, and 97.5%, respectively for each category. Overall, sensitivity was 83.34%, specificity was 98.01%, positive predictive value was 94.87%, and negative predictive value was 91.89%. MSRSGC is a six category scheme that was recently proposed that separates the salivary gland FNAC into distinct categories, thus increasing the specificity by limiting the number of false negative and false positive cases.

Effectiveness of the Pattern-Based Approach in the Cytodiagnosis of Salivary Gland Lesions

2016 ◽  
Vol 60 (2) ◽  
pp. 107-117 ◽  
Author(s):  
K. Amita ◽  
S. Vijay Shankar ◽  
M. Sanjay ◽  
B.M. Sarvesh
Keyword(s):  
Salivary Gland ◽  
False Negative ◽  
Needle Aspiration ◽  
Cross Sectional Study ◽  
Cytological Diagnosis ◽  
Aspiration Cytology ◽  
Cross Sectional ◽  
Prior Informed Consent ◽  
Needle Aspiration Cytology ◽  
Sensitivity Specificity

Objective: The aim of this study is to investigate, primarily, the effectiveness of the application of pattern-based analysis in the diagnosis of salivary gland (SG) lesions. Secondarily, an attempt was made to study the cytomorphology of the various lesions in detail and discuss the pitfalls and solutions involved in the challenging conditions at cytology. Materials and Methods: This was a prospective, cross-sectional study. All SG lesions over 2 years were subjected to fine-needle aspiration cytology with patients' prior informed consent. The lesions were classified based on the predominant pattern, and a provisional diagnosis was made. The secondary pattern and other features, such as background, were then taken note of, and a combined cytological diagnosis was rendered. The entire spectrum of lesions was divided into 6 morphological categories. Results: We had a total of 72 SG lesions. The most commonly affected gland was the parotid gland in 79.16% (57/72) of the cases. Surgery was performed in 26 cases (36.11%). A concordant diagnosis was obtained in 22 cases. The sensitivity, specificity and diagnostic accuracy by the pattern-based approach was 75, 100 and 88.46%, respectively. There were no false-positive cases, but 2 false-negative cases were recorded. Conclusion: The precise cytological preoperative diagnosis of SG lesions is important for the management of patients. The pattern-based approach can be used routinely in the cytological diagnosis of SG lesions.

scholarly journals Diagnostic Accuracy of Fine Needle Aspiration Cytology of Thyroid Pathologies

2020 ◽  
Vol 19 (2) ◽  
pp. 84-89
Author(s):  
Shova Kunwar ◽  
Barsha Bajracharya ◽  
Kavita Karmacharya ◽  
Amar Narayan Shrestha
Keyword(s):  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Fine Needle Aspiration Cytology ◽  
False Negative ◽  
False Negative Rate ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Thyroid Lesion ◽  
Fine Needle ◽  
Needle Aspiration Cytology

Introduction: Fine needle aspiration cytology is considered as the gold standard for the diagnosis of thyroid nodules. This study aimed to evaluate and compare the accuracy of fine-needle aspiration cytology in the diagnosis of thyroid lesion by comparing it with the corresponding histopathologic diagnosis after thyroidectomy. Methods: This is a retrospective study conducted over five years at a teaching hospital in Kathmandu. Eighty-nine cases of FNAC of thyroid nodule with subsequent histopathological reports were reviewed. The corresponding reports were compared and the accuracy of FNAC diagnosis was evaluated. Results: 87% of the cases were females and the majority of cases were in the age group 41 to 50 years. Among 89 cases, 55 were reported as benign on cytology and 34 were reported as malignant. On histopathological examination, out of 55 cases diagnosed as benign on cytology, 47 cases were diagnosed as benign whereas eight cases were diagnosed as malignant. HPE of 34 cases diagnosed as malignant on cytology showed that 29 were malignant and five were benign. The false-positive rate was 9.6% and the false-negative rate was 21.6%. The sensitivity was 78.3% and specificity was 90.3%. The positive predictive value and negative predictive value were 85.2% and 85.4% respectively. The accuracy of FNAC in differentiating benign from malignant thyroid lesions was 85.3%. Conclusions: The findings of this study showed that FNAC is a sensitive method for the diagnosis of a solid thyroid lesion

Fine needle aspiration cytology of salivary gland lesions reported immediately in a head and neck clinic

1993 ◽  
Vol 107 (11) ◽  
pp. 1025-1028 ◽  
Author(s):  
N. J. Roland ◽  
A. W. Caslin ◽  
P. A. Smith ◽  
L. S. Turnbull ◽  
A. Panarese ◽  
...  
Keyword(s):  
Salivary Gland ◽  
Head And Neck ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
False Negative ◽  
Neck Surgery ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Needle Aspiration Cytology

AbstractThis paper describes the application of fine needle aspiration cytology (FNAC) performed on92 patients with salivary gland lesions in a Head and Neck Surgery Clinic. The aspirates were immediately reported by a cytopathologist and the reports conveyed to the surgeon during the same clinic visit. FNAC results were then compared with histology in those patients who underwent surgery and with the clinical course of the disease at subsequent clinic visits in patients where surgery was not performed. The cytological diagnosis was incorrect in five cases, one of which was a false negative result. There were no false positive results. The sensitivity was 90.9 per cent and the specificity 100 per cent. This rapid report system of fine needle aspiration cytology has been found to be safe, free of complications, and helpful in the planning of treatment.

scholarly journals Role of Fine Needle Aspiration Cytology in Evaluation of Bony Lesions

2021 ◽  
Author(s):  
Arpita Singhvi ◽  
SR Negi ◽  
Hemant Jain ◽  
Meeta Dewal ◽  
Rajnee Joshi ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Fine Needle Aspiration Cytology ◽  
False Negative ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Bony Lesions ◽  
Needle Aspiration Cytology ◽  
Standard Techniques

Introduction: Fine Needle Aspiration Cytology (FNAC) is increasingly being recognised for its diagnostic utility in evaluation of bone tumours. Though open surgical biopsy is the procedure of choice for diagnosis of bony tumours. Aim: To evaluate the efficacy and reliability of FNAC in diagnosis of bony tumours. Materials and Methods: This cross-sectional study included 40 patients with bony lesions from July 2018 to December 2019 in tertiary level centre of Rajasthan. The FNAC was performed after clinical and radiological assessment. The smears were stained using standard techniques. Also, open biopsy was performed in the patients who presented with bony lesions of patients and slides prepared for histopathological examination using standard techniques. The data was entered in Excel sheets and the results were evaluated using Statistical Package for Social Sciences (SPSS) software version 20.0. Results: Adequate material was obtained in FNAC in 29 (72.5%) cases. Out of 29 cases, FNAC results were accurate in 96.5% cases. False Negative report was obtained in one case with no false positives. Sensitivity of FNAC in diagnosing bony lesions comes to be 90% and Specificity was 100%. The Positive Predictive Value (PPV) was 100% and the Negative Predictive Value (NPV) 95.4%. Conclusion: The FNAC is invaluable tool in primary diagnosis of bony lesions. The technique of obtaining sufficient material though needs to be mastered and will definitely improve with more experience and radiologic correlation.

scholarly journals A large malignant oncocytoma of parotid gland: a case report

2020 ◽  
Vol 6 (12) ◽  
pp. 2310
Author(s):  
Nidhi S. Mohan ◽  
Sunita S. Vernekar ◽  
Mohammed M. Abus Samee ◽  
Manjunath D.
Keyword(s):  
Salivary Gland ◽  
Parotid Gland ◽  
Fine Needle Aspiration ◽  
Facial Palsy ◽  
Fine Needle Aspiration Cytology ◽  
Histopathological Examination ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Needle Aspiration Cytology

<p class="abstract">Malignant oncocytoma is an extremely rare neoplasm of the salivary gland accounting for 0.5% of epithelial salivary gland malignancies and 0.18% of epithelial salivary gland tumors. We report a case of malignant oncocytoma of left parotid gland in a 61-year old female patient. Patient presented with a 6-year history of painless swelling in the left parotid region. Fine needle aspiration cytology of the swelling was suggestive of pleomorphic adenoma. A computed tomography scan performed did not reveal any features suggestive of malignancy. Patient underwent left superficial parotidectomy. However, histopathological examination of the specimen turned out to be malignant oncocytoma. Malignant oncocytoma of salivary glands have rare incidence and may have similar morphologic features with other neoplasms. Despite the tumor being large and malignant in this case, there was no facial palsy preoperatively. As histopathology is often diagnostic, the possibility of malignancy always must be kept in mind preoperatively even when there is no facial palsy or fine needle aspiration cytology not showing up malignancy.</p>

scholarly journals Milan System for Reporting Salivary Gland Cytopathology - A Two Years’ Experience in a Referral Centre of Western Odisha

2021 ◽  
Vol 8 (17) ◽  
pp. 1146-1151
Author(s):  
Bijayalaxmi Sahoo ◽  
Sunanda Nayak ◽  
Gitimadhuri Dutta ◽  
Shailaja Prabhala ◽  
Kulwant Lakra
Keyword(s):  
Salivary Gland ◽  
Fine Needle Aspiration ◽  
Classical System ◽  
Needle Aspiration ◽  
Medical Sciences ◽  
Aspiration Cytology ◽  
Original Diagnosis ◽  
Fine Needle ◽  
Risk Of Malignancy ◽  
Needle Aspiration Cytology

BACKGROUND Neoplasms of salivary gland account for 2 - 6.5 % of all head and neck neoplasms. Fine needle aspiration cytology (FNAC) is sufficiently sensitive and relevant to the diagnosis and treatment of salivary gland pathologies for salivary gland lesions. The Milan system for reporting salivary gland cytopathology (MSRSGC) represents a stage for a structured, evidence-based international reporting system for salivary gland fine-needle aspiration (FNA). This system provides a guidance for diagnosis and management according to the risk of malignancy (ROM) in different categories. We wanted to study the various cytomorphological lesions of salivary gland and their cytological categorisation based on the MILAN system of reporting. METHODS A 2-year record-based study (January 2018 to December 2019) was conducted on FNAC of salivary gland lesions in the Department of Pathology, VSSIMSAR (Veer Surendra Sai Institute of Medical Sciences and Research), Burla, Odisha. Based on the classical system, all smears were studied and re-categorized into six groups according to the MILAN classification. Histological correlation was carried out in the available cases. RESULTS A total of 103 FNA cases were examined and 20 different categories were there in the original diagnosis. As per the categorisation based on MILAN System there were six categories, maximum cases were non-neoplastic 34 (33.0 %) followed by benign neoplasms 22 (21.35 %), malignant 14 (13.5 %), non-diagnostic 10 (9.7 %), atypia of undetermined significance 9 (8.7 %), suspicious for malignancy 8 (7.7 %) and neoplasms of uncertain malignant potential 6 (5.8 %). 43 cases (80.4 %) were found to be concordant out of 54 histopathology correlated cases. CONCLUSIONS The Milan system of reporting salivary gland cytopathology provided a uniform system of reporting salivary gland cytomorphology that may increase the effectiveness. KEYWORDS Milan System, Salivary Gland Lesions, FNAC, Risk of Malignancy (ROM)

scholarly journals Diagnostic utility of fine needle aspiration cytology in salivary gland lesions: a teaching institutional experience

2019 ◽  
Vol 6 (11) ◽  
pp. 3955 ◽  
Author(s):  
Shilpa M. Shetty ◽  
Kusuma K. N.
Keyword(s):  
Salivary Gland ◽  
Diagnostic Accuracy ◽  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Fine Needle Aspiration Cytology ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Needle Aspiration Cytology ◽  
Sensitivity Specificity

Background: Fine needle aspiration cytology (FNAC) is being widely used for pre-operative diagnosis of salivary gland lesions. It is a simple, cost effective and safe procedure that provides valuable information for planning appropriate management. The aim was to study cytohistopathological correlation of salivary gland lesions; to examine sensitivity, specificity and diagnostic accuracy of fine needle aspiration cytology of salivary gland lesions.Methods: A 4 year 8 months study was conducted from January 2015 to August 2019. Salivary gland lesion FNAC performed in the Department of Pathology, SIMS, Shimoga who were followed up with corresponding biopsy specimen were included in the study.Results: Total of 42 cases was included in the study. Pleomorphic adenoma was the commonest lesion encountered. The overall sensitivity, specificity, diagnostic accuracy, positive predictive value and negative predictive value was 50%, 97.22%, 90.47%, 75% and 92.10%. Diagnostic pit falls occurred because of sampling error and overlapping morphological features.Conclusions: Fine needle aspiration (FNA) though poses diagnostic dilemma in some cases, it still forms an easy and less invasive procedure that can assess therapeutic management of salivary gland lesions.

scholarly journals A Study to Evaluate the Size of Thyroid Nodules as an Indicator for Malignancy

2020 ◽  
Vol 3 (1) ◽  
pp. 16-20
Author(s):  
Ajay Kumar Jha ◽  
Ajit Kumar Sinha
Keyword(s):  
Thyroid Nodules ◽  
Current Practice ◽  
False Negative ◽  
False Negative Rate ◽  
Needle Aspiration ◽  
Indication For Surgery ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Risk Of Malignancy ◽  
Needle Aspiration Cytology

Background: Several authors have questioned the accuracy of fine- needle aspiration cytology (FNAC) in large thyroid nodules. It’s the current practice to provide thyroidectomy to patient with thyroid nodules 4 cm or larger regardless of the FNAC results. The aim of the study is to answer two questions: is the size of nodule associated with higher risk of malignancy and is the size indication for surgery. Subjects and Methods: This study included 20 patients who underwent thyroidectomy. We compared all thyroid nodules with benign FNAC and their final histopathology reports. Patients were divided into two groups based on the size of the nodule (< 4cm or >4cm) and indication of surgery. Results: 20 patients with thyroid nodule underwent thyroid surgery. 13 patients had nodule <4cm and 7 patients were 4 cm. For patients with nodules <4 cm, 3 patients had a malignancy, and for those with nodules 4 cm, 1 patients had a malignancy. For benign cases FNAC and histopathology reports are showing same results, (p<0.05). Conclusion: Thyroid nodules 4 cm are not risk factor of malignancy. Thyroid nodules 4 cm with benign FNAC should not undergo thyroidectomy as false negative rate is low. Therefore, the decision for surgery ought not to be taken based on the size of the nodule.

scholarly journals Cytomorphological Spectrum of Salivary Gland Lesions by Fine Needle Aspiration Cytology

2021 ◽  
Vol 8 (7) ◽  
pp. 397-401
Author(s):  
Mayur Ambekar ◽  
Rachana Binayke
Keyword(s):  
Salivary Gland ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Minor Salivary Gland ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Neoplastic Lesions ◽  
Needle Aspiration Cytology ◽  
A Prospective Study

Introduction: Salivary gland lesions encompass a baffling subset of lesions with overlapping morphologies on cytomorphology, due to their heterogenous histologies and rare enough to sometimes bewilder even the most knowledgeable cytopathologists. The technique of fine needle aspiration (FNA) cytology in the evaluation of salivary gland lesion is simple to perform, saves time, reliable, safe and inexpensive. FNA is highly accurate when used in proper clinical setting and supported by appropriate clinical and relevant diagnostic data. Rapidity of obtaining a pathological diagnosis allows more intelligent therapeutic approach. Materials and Methods: It was a prospective study carried out in the cytology section of pathology department for a period of two years using fine needle aspiration as a diagnostic tool as per standard protocol. The clinical and radiological data were obtained from the patient’s case papers and collaboration with the operating surgeon, the lesions were analysed on cytology. Haematoxylin & Eosin, Papanicolaou stain and Giemsa were used as standard stains. Results: A total of 66 cases of salivary gland lesions were aspirated for a period of two years. Majority of cases were in the age group of 21-30 years with 36 male patients (55%) and 30 female patients (45%). About 44(66.7%), 19(28.8%), 1(1.5%) and 2(3.0%) cases occurred in parotid gland, submandibular gland, sublingual gland and minor salivary gland respectively. There were 21(32%) cases of non-neoplastic lesions and 45(68%) cases of neoplastic lesions. Histopathological specimens were available in 11 out of 66 cases and showed correlation with cytological findings. Conclusion: Fine needle aspiration cytology of salivary gland lesions has high diagnostic accuracy, helps in appropriate therapeutic management and is useful as a diagnostic procedure because of the availability of earlier diagnosis in comparison with the histopathology. Keywords: Salivary gland lesions, fine needle aspiration cytology, neoplastic, non-neoplastic.

scholarly journals Does Tumor Size Influence the Diagnostic Accuracy of Ultrasound-Guided Fine-Needle Aspiration Cytology for Thyroid Nodules?

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Do Hoon Koo ◽  
KwangSeop Song ◽  
Hyungju Kwon ◽  
Dong Sik Bae ◽  
Ji-hoon Kim ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Fine Needle Aspiration Cytology ◽  
Thyroid Nodules ◽  
False Negative ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Needle Aspiration Cytology ◽  
Accuracy Rates

Background. Fine-needle aspiration cytology (FNAC) is diagnostic standard for thyroid nodules. However, the influence of size on FNAC accuracy remains unclear especially in too small or too large thyroid nodules. The objective of this retrospective cohort study was to investigate the effect of nodule size on FNAC accuracy. Methods. All consecutive patients who underwent thyroidectomy for nodules in 2010 were enrolled. FNAC results (according to the Bethesda system) were compared to pathological diagnosis. The nodules were categorized into groups A–E on the basis of maximal diameter on ultrasound (≤0.5, >0.5–1, >1-2, >2–4, and >4 cm, resp.). Results. There were 502 cases with 690 nodules. Overall FNAC sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 95.4%, 98.2%, 99.4%, 86.4%, and 96.0%, respectively. False-negative rates (FNRs) of groups A–E were 3.2%, 5.1%, 1.3%, 13.3%, and 50%, respectively. Accuracy rates of groups A–E were 96.8%, 94.8%, 99%, 94.7%, and 87.5%, respectively. Conclusion. Although accuracy rates of FNAC in thyroid nodules smaller than 0.5 cm are comparable to the other group, thyroid nodules larger than 4 cm with benign cytology carry a higher risk of malignancy, which suggest that those should be considered for intensive follow-up or repeated biopsy.

Sign in / Sign up

Export Citation Format

Share Document