Assessing the diagnostic accuracy for pleomorphic adenoma and warthin tumor by employing the Milan System for Reporting Salivary Gland Cytopathology: An international, multi-institutional study

Derek B. Allison, Alexander P. Smith, Daniel An, James Adam Miller, Khurram Shafique, Sharon Song, Kartik Viswanathan, Elizabeth Eykman, Rema A. Rao, Austin Wiles, Güliz A. Barkan, Ritu Nayar, Guido Fadda, Celeste N. Powers, Esther Diana Rossi, Momin T. Siddiqui, Syed Z. Ali, Ivana Kholová, Lester J. Layfield, Andrew FieldZubair Baloch, Zahra Maleki

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
JournalCancer Cytopathology
DOIs
StateAccepted/In press - 2020

Keywords

  • cytology
  • cytopathology
  • fine-needle aspiration (FNA)
  • head and neck pathology
  • Milan System for Reporting Salivary Gland Cytopathology
  • pleomorphic adenoma
  • salivary gland
  • Warthin tumor

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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