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Updated: Jan 22, 2026
07:01
Impression Cytology of the Lid Wiper Area
Published on: August 9, 2016
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Enhancing the Milan System for Reporting Salivary Gland Cytology Through Ancillary Testing Using Liquid-Based
Akihiko Kawahara1, Hideyuki Abe1, Ryou Makino1
1Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan.
Summary
Ancillary tests, especially immunocytochemistry (ICC), improve the diagnostic accuracy of the Milan System for Reporting Salivary Gland Cytology (MSRSGC). Their use enhances the reliability of fine-needle aspiration cytology (FNAC) for salivary gland lesions.
Area of Science:
- Cytopathology
- Surgical Pathology
- Oncology
Background:
- Fine-needle aspiration cytology (FNAC) is crucial for salivary gland lesion diagnosis.
- The Milan System for Reporting Salivary Gland Cytology (MSRSGC) standardizes reporting and malignancy risk assessment.
- Ancillary tests, including immunocytochemistry (ICC), are recommended but underutilized and their effectiveness needs evaluation, especially with liquid-based cytology.
Purpose of the Study:
- To investigate the utilization rate of ancillary tests within MSRSGC categories.
- To assess the effectiveness of ancillary tests, particularly ICC, in improving diagnostic accuracy.
- To evaluate the role of ancillary tests in liquid-based cytology for salivary gland lesions.
Main Methods:
- Retrospective review of salivary gland FNAC cases evaluated by MSRSGC at Kurume University Hospital (2020-2024).
- Analysis of ancillary test utilization, FNAC sensitivity, specificity, and risk of malignancy (ROM) in cases with histopathological follow-up.
- Calculation of ROM for each MSRSGC category.
Main Results:
- Ancillary tests were used in 22.1% of 131 cases with follow-up, most frequently in SUMP, Suspicious for Malignancy, and Malignant categories.
- ICC provided definitive (37.9%) or suggestive (27.6%) diagnoses.
- FNAC sensitivity and specificity were high (97.3% and 98.2%, respectively), with ROM varying significantly across MSRSGC categories.
Conclusions:
- Ancillary testing, particularly ICC, significantly enhances the reliability of the MSRSGC classification.
- The integration of ancillary tests improves overall diagnostic accuracy for salivary gland lesions.
- Further studies should explore optimal integration of ancillary tests in liquid-based cytology.
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