2. CYTOPATHOLOGICAL STUDY OF SALIVARY
GLAND LESIONS
AND CATEGORIZATION BASED ON
MILAN SYSTEM OF REPORTING
DR.RAMYASHREE R
DISSERTATION FOR THE COURSE OF MD. PATHOLOGY
GUIDE: DR.HEMALATA M
PROFESSOR, DEPARTMENT OF PATHOLOGY
KEMPEGOWDA INSTITUTE OF MEDICAL SCIENCES,BENGALURU
3. INTRODUCTION
• Salivary glands are unique amongst the secretory glands, with most
heterogenous group of lesions and tumors.
• They exhibit greatest cytological and histological diversities.
• In the management of salivary gland lesions, fine-needle aspiration (FNA)
has gained widespread acceptance as an effective first-line diagnostic tool.
• FNA is a simple, rapid, inexpensive technique
• It provides the clinician a definite preoperative diagnosis and thus
facilitates further management.
4. • It can distinguish between neoplastic and non-neoplastic lesions.
• FNA can diagnose many common benign and malignant tumors.
• Based on FNAC ,lesions can be categorized into inflammatory,
reactive, benign and malignant lesions which aids in appropriate
management.
5. NEED FOR THE STUDY
• Wide variety of lesions with overlapping cytomorphological features occur
in the salivary glands.
• In these cases it is difficult to provide a definitive diagnosis on fine-needle
aspiration cytology (FNAC) alone.
• Hence the need for simplified, standardized and uniform reporting format
that helps in better communication between pathologists and clinicians.
• The newly suggested Milan System for Reporting Salivary Gland
Cytopathology (MSRSGC) offers such a categorization system based on risk
of malignancy (ROM) for each diagnostic category.
• The objective of MSRSGC is to increase the efficacy of reporting by offering a
standardized method which leads to better communication between
institutions and better patient management.
6. AIMS AND OBJECTIVES
• To evaluate various cytopathological features of salivary gland lesions
and categorize them according to Milan system of reporting.
• To correlate cytology with histopathological diagnosis where
available.
7. SUBJECT OR MATERIAL
• STUDY DURATION- 18 months
• STUDY DESIGN- Cross sectional study
• SAMPLE SIZE- 60
• SAMPLING METHOD- Purposive sampling
• INCLUSION CRITERIA- all patients with salivary gland swellings
• EXCLUSION CRITERIA- non co operative patients,
patients who do not consent for FNAC
8. METHODS AND PROCEDURES
• The study will be conducted in Central laboratory ,Department of
Pathology ,KIMS Hospital.
• All salivary gland lesions are included in the study.
• Patient’s clinical history and relevant investigations will be
documented.
• FNAC will be performed using 23-24gauge needle and 10 ml syringe
applying negative pressure either direct or under USG guidance.
• Air dried smears are stained by May Grunwald-Giemsa stain and wet
fixed smears are stained by Papanicolaou and Hematoxylin-Eosin
stains.
9. APPROACH TO ETHICAL ASPECTS
• Patient’s informed consent will be taken.
• Patient’s confidentiality will be maintained.
• Extra financial expenses will not be imposed on the patient.
