Effectiveness of Milan Classification in Salivary Gland Aspirations

Abstract

Objective: To determine the effectiveness of Milan system for the evaluation of aspiration cytology to salivary gland lesions classification. Study Design: Cross-sectional observational study. Place and Duration of Study: Department of Pathology, Tertier Centre, University of Health Sciences, Adana City Education and Research Hospital, Adana, Turkey from January 2014 to December 2020. Methodology: Salivary gland aspiration cytology of the last six years was recategorised, according to Milan classification. Risk of malignancy (ROM) and risk of neoplasm (RON) were determined among the subgroups in the cytological materials of 233 patients, who had undergone excisional biopsy. Results: Forty hundred and eighty salivary gland aspiration cytologies were available, in which 250 (52.1%) cases were males and 230 (47.1%) were females. The mean age was 52.36 ± 16.05 years. When aspiration cytology of 233 patients with resection were evaluated, according to Milan classification, ROM in non-diagnostic category was 9.5%, ROM in non-neoplastic category was 19.2%, and ROM in neoplasm-benign category was 8.2%. ROM were found 100% in the suspected malignancy and malignancy categories. There were no patients in the atypia category of undeterminate significance. Conclusion: In aspiration cytology of salivary gland lesions, Milan system provides useful information in classifying patients for clinical follow-up and treatment. However, it can be said that it is difficult to distinguish between the atypia of uncertain significance and neoplasm categories.