scholarly journals Milan system in salivary gland lesions: Its diagnostic and clinical relevance

2021 ◽  
Vol 12 (11) ◽  
pp. 45-52
Author(s):  
Smriti Singh ◽  
Parveen Rana ◽  
Swaran Kaur ◽  
Uma Garg ◽  
Deepti Agarwal ◽  
...  
Keyword(s):  
Salivary Gland ◽  
Statistical Analysis ◽  
Standard Deviation ◽  
Pleomorphic Adenoma ◽  
Quantitative Data ◽  
Surgical Excision ◽  
Analysis Data ◽  
Needle Aspiration ◽  
Salivary Gland Neoplasm ◽  
Common Benign Tumor

Background: The salivary gland lesions constitute around 3–6% of all head-and-neck lesions and have always posed a diagnostic riddle for the cytopathologists around the world. Since the majority of these lesions need surgical excision, it is, therefore, important to diagnose these lesions with utmost precision to prevent over or under stage procedures. The recent adaption of Milan system of reporting aims to establish a uniform, accurate, and consensual reporting system which bridges the communication between the pathologists and the clinicians. Aims and Objectives: The current study aims to assess the diagnostic application of Milan system and aims to reclassify the lesions according to it. Materials and Methods: The current study was conducted at our institute during 1 year period. All salivary gland swellings presenting to the fine-needle aspiration cytology (FNAC) section during this period were included in the study. Along with this, records and slides of cases of salivary gland lesions were retrospectively assessed. All relevant data and radiologic findings were retrieved from the case records. FNAC was done using 23 G needle. The slides were stained with both Leishman and Papanicolaou stain wherever possible. Quantitative data were expressed as mean and standard deviation and percentages. All the 83 lesions were reclassified as per the Milan system. Histopathology was available in 42 cases. Inclusion criteria: All the samples of the patient having salivary gland lesion(s) whose FNAC were performed in the department of pathology. Statistical Analysis: Data were be entered into Microsoft Excel spreadsheets. For quantitative data, mean and standard deviation were calculated. For qualitative data, percentage and proportion were calculated. Sensitivity, specificity, and spearman correlation between FNAC and histopathology were calculated. P<0.05 was considered statistically significant. Results: The total of 83 cases was included in our study. The cytological analysis was done and all cases were classified as per Milan system. The age of patients ranged from 4 years to 77 years with a mean age of 43 years. Parotid was the most frequently involved gland in which a total of 51 cases (61.4%) were reported. The most common benign tumor reported on cytology was pleomorphic adenoma and the most common malignant tumor reported was adenoid cystic carcinoma. On recategorization of lesions as per Milan system, the category IVA, that is, benign salivary gland neoplasm had the maximum number of lesions (40) accounting for 48.1% of all the lesions. Histopathology was available in 42 cases. The predominant lesion on histopathology was pleomorphic adenoma (22). On statistical analysis of the data, the sensitivity was 71.4%, specificity was 96.1%, diagnostic accuracy as 62.1%, and positive and negative predictive value as 83.3 and 92.5%, respectively. Conclusion: Risk stratification approach in classifying salivary gland cytology aspirate as per Milan system provides a standardized reporting and better communication to clinician.

scholarly journals Management of salivary gland neoplasm – study of 32 cases

2010 ◽  
Vol 9 (2) ◽  
pp. 87-94 ◽  
Author(s):  
Md Abdullah Hel Kafi ◽  
Md Arif Hossain Bhuyan ◽  
Md Jahangir Hossain Bhuiyan ◽  
MS Khurshid Alam
Keyword(s):  
Salivary Gland ◽  
Pleomorphic Adenoma ◽  
Histopathological Examination ◽  
Medical Science ◽  
Surgical Excision ◽  
Military Hospital ◽  
Salivary Gland Neoplasm ◽  
Salivary Gland Tumours ◽  
Presenting Symptoms ◽  
Parotid Neoplasm

Objective: To study the clinical, radiological and histopathological characteristics along with the management outcome of salivary gland neoplasm. Materials and Methods: This study included thirty two patients (16 male and 16 female) with salivary gland tumours presented at Combined Military Hospital Dhaka, Apollo Hospital Dhaka and Ibn Sina Medical College and Hospital Dhaka from January 2006 to December 2009. The data of each patient included age, sex, presenting symptoms and signs, provisional diagnosis, preoperative investigations, operation notes, histopathological examination and state at follow up. Results: The mean age was 42.5 years. 14 (43.75%) patients presented at 5th decade. Main presenting symptom was swelling (100%) followed by pain (18.75%). All patients underwent fine needle aspiration cytology which was conclusive in 26 patients (81.25%). Thirty one patients underwent surgical excision. 24 cases were parotid neoplasm and 8 cases were submandibular neoplasm. 20 patients (16 parotid and 4 submandibular) were pleomorphic adenoma. Conclusion: There is no substitute for detailed clinical history and examination in the assessment of salivary gland neoplasm. Imaging studies are probably academic but determine the extent of the disease. Early diagnosis, adequate and proper treatment improves the prognosis. Key words: Salivary gland tumour; Pleomorphic adenoma; Warthin's tumour; Adenoid cystic carcinoma; Mucoepidermoid carcinoma. DOI: 10.3329/bjms.v9i2.5656Bangladesh Journal of Medical Science Vol.09 No.2 Apr 2010 pp.87-94

scholarly journals Uncommon occurrence of pleomorphic adenoma in submandibular salivary gland in old age males: case series

2020 ◽  
Vol 7 (3) ◽  
pp. 900
Author(s):  
M. S. Kalyan Kumar ◽  
R. Shyamsundar ◽  
M. Sabari Girieasen ◽  
R. Kannan ◽  
S. Nedunchezhiyan
Keyword(s):  
Salivary Gland ◽  
Parotid Gland ◽  
Pleomorphic Adenoma ◽  
Benign Lesion ◽  
Case Series ◽  
Surgical Excision ◽  
Needle Aspiration ◽  
Submandibular Salivary Gland ◽  
Biopsy Report ◽  
Needle Aspiration Cytology

Pleomorphic adenoma is the most common tumor of the benign salivary gland neoplasms, the submandibular gland is the second most common site of PA after the parotid gland. Authors present 3 series case of pleomorphic adenoma in submandibular salivary gland in institution which were admitted in institution within a month interval. Fine needle aspiration cytology (FNAC) of all 3 cases proved to be benign lesion arising from submandibular salivary gland. All 3 cases underwent excision in to and the postoperative period was uneventful. DT removed on 3rd POD and discharged in POD 10. Biopsy report proved to be pleomorphic adenoma in all cases. past studies showed pleomorphic adenoma most commonly occurs in the parotid gland and its occurrence in the submandibular salivary gland is uncommon. Also, age occurrence involves 30s-50s and is more common in females. But all this case was male and occurred in older age group. Early intervention with surgical excision in toto after definite confirmation with FNAC is the treatment of choice in preventing its malignant transformation.

scholarly journals Pleomorphic adenoma of submandibular gland: not so common occurrence

2018 ◽  
Vol 5 (2) ◽  
pp. 657
Author(s):  
Ashok S. Gajbhiye ◽  
Mukteshwar N. Deshmukh ◽  
Parag K. Jaipuriya ◽  
Kishor B. Jeughale ◽  
Abhinav A. Kumar ◽  
...  
Keyword(s):  
Salivary Gland ◽  
Salivary Glands ◽  
Submandibular Gland ◽  
Pleomorphic Adenoma ◽  
Surgical Excision ◽  
Needle Aspiration ◽  
Submandibular Salivary Gland ◽  
Radical Excision ◽  
Submandibular Region ◽  
Female Ratio

Background: The salivary glands tumour are relatively rare, yet they represent a wide variety of both benign and malignant histologic subtypes. Several studies have been conducted on the tumors of the parotid and minor salivary glands, but very few reports in the literature have focused on submandibular gland tumors as they are rare and are usually grouped with other salivary glands. Approximately 70% of the salivary gland tumors affect parotid gland with the submandibular gland being affected in 5-10% of the cases, sublingual gland in 1% and minor glands in 5-15% of the cases. So, we describe a series of 50 patients of pleomorphic adenoma affecting submandibular gland.Methods: The prospective study was conducted at Department of General Surgery, Indira Gandhi Government Medical College, Nagpur between January 2008 to December 2017.Results: Out of the 50 patients, 10 were male and 40 were female. Thus, male to female ratio is 1:4. Most of the 42 (84%) patients presented with painless swelling in submandibular region. Clinically the tumour has the texture of cartilage and has an irregular and bosselated surface observed in all the patients. The size of tumour was 3 to 6 cm in 32 (64%) patients observed in the present study. Fine needle aspiration cytology was performed in all the patients. All patients were managed by surgical excision.  Recurrence occurred in a single patient who was managed with radical excision including a neck dissection with postoperative radiotherapy.Conclusions: Submandibular gland pleomorphic adenoma being common benign tumor, occurring commonly between the 3rd and 5th decade of life and presenting as slow growing asymptomatic swelling with female preponderance. The precise surgical excision along with whole submandibular salivary gland and postoperative radical radiotherapy required for recurrence as the accepted mode of management. However, further long-term studies involving submandibular gland have to be carried out to know the pattern of tumor recurrence.

scholarly journals Pleomorphic adenoma of the upper lip: a case report and review of literature

2016 ◽  
Vol 4 (1) ◽  
pp. 8
Author(s):  
Rashmi Metgud ◽  
Bhardwaj Tina Neelesh ◽  
Saurabh Goel ◽  
Smitha Nail ◽  
Shrikant Patel ◽  
...  
Keyword(s):  
Salivary Gland ◽  
Pleomorphic Adenoma ◽  
Unusual Case ◽  
Needle Aspiration ◽  
Myoepithelial Cells ◽  
Upper Lip ◽  
Epithelial Tumor ◽  
Needle Aspiration Cytology ◽  
Benign Mixed Tumor ◽  
Morphological Patterns

<p>Pleomorphic Adenoma is a benign epithelial tumor arising from the salivary gland. It is a benign mixed tumor composed of epithelial and myoepithelial cells arranged with various morphological patterns, demarcated from surrounding tissues by fibrous capsule. In this article, we report an unusual case of 30 year, male with a single, nodular swelling evident in the upper lip which was discovered during a routine dental procedure. Fine Needle Aspiration Cytology (FNAC) was planned for the patient, where a of cytological diagnosis of Pleomorphic Adenoma was rendered, which was confirmed by biopsy. Hence, this highlights, FNAC makes up an important diagnosing tool as the first line of investigation to distinguish between benign and malignant salivary gland neoplasms.</p>

scholarly journals An unusual pleomorphic adenoma

2014 ◽  
Vol 62 (3) ◽  
pp. 319-324
Author(s):  
Christiano Sampaio QUEIROZ ◽  
Roberto Almeida de AZEVEDO ◽  
Antonio Irineu TRINDADE NETO ◽  
Caetano Guilherme Carvalho PONTES ◽  
Rafael de Queiroz MOURA
Keyword(s):  
Salivary Gland ◽  
Salivary Glands ◽  
Pleomorphic Adenoma ◽  
Histopathological Examination ◽  
Minor Salivary Gland ◽  
Surgical Excision ◽  
Biological Behavior ◽  
Surgical Removal ◽  
Minor Salivary Glands ◽  
Recommended Treatment

Pleomorphic adenoma is the most common neoplasm in major and minor salivary glands. It constitutes approximately 90% of all benign salivary gland lesions and the parotid is the most affected location. When the minor salivary glands are affected, it mostly occurs at the junction of the hard and soft palates. The diagnosis is complex because of the great histological variety and biological behavior of this tumor, a histopathological examination being essential. The recommended treatment is surgical excision. For lesions located superficially in the parotid gland, superficial parotidectomy - identifying and preserving the facial nerve - is necessary. Lesions in the palate or gums sometimes demand a margin of safety, being excised below the periosteum, including the overlying mucosa. With correct surgical removal, the prognosis is excellent. The aim of this study is to report a case of an unusual minor salivary gland pleomorphic adenoma in the hard palate, describing the most important aspects of this pathology.

Application of the Milan System for Reporting Salivary Gland Cytopathology: A 10-Year Experience in a Single Japanese Institution

2020 ◽  
pp. 1-9
Author(s):  
Yukiya Hirata ◽  
Kayoko Higuchi ◽  
Koichi Tamashiro ◽  
Keisuke Koja ◽  
Yuiko Yasutomi ◽  
...  
Keyword(s):  
Salivary Gland ◽  
Predictive Value ◽  
Diagnostic Category ◽  
Needle Aspiration ◽  
Salivary Gland Neoplasm ◽  
Published Evidence ◽  
Risk Of Malignancy ◽  
Categorization System ◽  
Sensitivity Specificity

<b><i>Objective:</i></b> The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) is a recently published evidence-based categorization system for salivary gland fine-needle aspiration (FNA). We applied MSRSGC to Japanese cases and evaluated its utility. <b><i>Study Design:</i></b> A total of 480 FNA cases were reviewed. We recategorized each case into one of the MSRSGC categories. The risk of neoplasm (RON) and the risk of malignancy (ROM) for each diagnostic category in MSRSGC, and the sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) for malignancy and for neoplasms were calculated for cases with histological follow-up. In addition, the overall ROM (O-ROM) was calculated for all FNA cases. <b><i>Results:</i></b> RON, ROM, and O-ROM rates were as follows – non-diagnostic: 51.3, 5.1, and 1.0%; non-neoplastic: 0, 0, and 0%; atypia of undetermined significance: 83.9, 12.9, and 7.3%; neoplasm, benign: 100, 0, and 0%; salivary gland neoplasm of uncertain malignant potential: 100, 32.1, and 23.7%; suspicious for malignancy: 100, 85.7, and 60%; and malignant: 100, 100, 81.8%. The sensitivity, specificity, and accuracy with (without) indeterminate cases for malignancy were 65 (100), 99 (99), 92% (99%) and PPV and NPV were 96 and 100%, respectively, and those for neoplasms were 84 (100), 100 (100), 85% (100%), and PPV and NPV were 100 and 100%, respectively. <b><i>Conclusions:</i></b> The MSRSGC is useful for stratification of ROM and for promoting the performance of salivary gland FNA. The MSRSGC could be easily introduced in Japan and may improve the Japanese salivary gland FNA status.

scholarly journals Review of Salivary Gland Neoplasms

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Victor Shing Howe To ◽  
Jimmy Yu Wai Chan ◽  
Raymond K. Y. Tsang ◽  
William I. Wei
Keyword(s):  
Salivary Gland ◽  
Regional Lymph Node ◽  
Postoperative Radiotherapy ◽  
Surgical Excision ◽  
Needle Aspiration ◽  
Low Grade ◽  
Malignant Tumours ◽  
Parotid Glands ◽  
Salivary Gland Tumours ◽  
Mri Scans

Salivary gland tumours most often present as painless enlarging masses. Most are located in the parotid glands and most are benign. The principal hurdle in their management lies in the difficulty in distinguishing benign from malignant tumours. Investigations such as fine needle aspiration cytology and MRI scans provide some useful information, but most cases will require surgical excision as a means of coming to a definitive diagnosis. Benign tumours and early low-grade malignancies can be adequately treated with surgery alone, while more advanced and high-grade tumours with regional lymph node metastasis will require postoperative radiotherapy. The role of chemotherapy remains largely palliative. This paper highlights some of the more important aspects in the management of salivary gland tumours.

scholarly journals Investigation of Salivary Gland Pathology

2017 ◽  
pp. 29
Author(s):  
M. Zulfath Nihara ◽  
K. Udhaya Chandrika ◽  
R. Vijaya Sundari ◽  
Tan Shi Yi ◽  
Maya Ramesh
Keyword(s):  
Salivary Gland ◽  
Regional Lymph Node ◽  
Surgical Excision ◽  
Needle Aspiration ◽  
Low Grade ◽  
Malignant Tumours ◽  
Parotid Glands ◽  
Salivary Gland Tumours ◽  
Mri Scans ◽  
Salivary Gland Pathology

Salivary gland pathology is diverse in nature and mainly inflammatory or neoplastic. Salivary gland tumours present as painless enlarging masses. Most of the tumours are located in parotid glands and many of them are benign. The management of these tumours is difficult just like the diagnosis of benign and malignant tumours. Fine Needle Aspiration Cytology (FNAC) and Magnetic Resonance Imaging (MRI) scans provide some useful information in diagnosis, but most of the tumours will require surgical excision as a means of coming to a definitive diagnosis. Surgical approach is adequate for benign tumours and early low grade malignancies whereas post operative radiotherapy is needed for more advanced and high grade tumours with regional lymph node metastasis. The role of chemotherapy remains largely palliative. This article throws light on some of the more important aspects in the investigations of salivary gland pathologies.

Sign in / Sign up

Export Citation Format

Share Document