1) The document discusses the Milan System for Reporting Salivary Gland Cytopathology, which aims to standardize the reporting of salivary gland fine needle aspiration results.
2) It establishes six diagnostic categories: Non-Diagnostic, Non-Neoplastic, Atypia of Undetermined Significance, Neoplastic (Benign and Uncertain Malignant Potential), Suspicious for Malignancy, and Malignant.
3) The system provides clear criteria and examples for each category to improve consistency in reporting, aid clinical management, and allow for collaborative research.
Atlas on bethesda system for reporting cervical cytologyAshish Jawarkar
This is an atlas with more nearly 100 images, authentic taken from NCI web atlas. Useful to understand and report pap smears. The subject has been presented in a way which will help students reproduce in exams.
This is a presentation on the topic of cytology of the breast, prepared by Dr Ashish Jawarkar, he is MD in pathology and a teacher at Parul institute of Medical sciences and research Vadodara.
Atlas on bethesda system for reporting cervical cytologyAshish Jawarkar
This is an atlas with more nearly 100 images, authentic taken from NCI web atlas. Useful to understand and report pap smears. The subject has been presented in a way which will help students reproduce in exams.
This is a presentation on the topic of cytology of the breast, prepared by Dr Ashish Jawarkar, he is MD in pathology and a teacher at Parul institute of Medical sciences and research Vadodara.
An array of presentation of lymphoma spillover in the peripheral smear and bone marrow. All types of lymphomas are discussed along with a bouquet of HPE pictures
There are several important changes in the WHO 5th edition hemato-lymphoid with a paradigm shift towards genetic diagnosis along with morphological aspects. Precursor lesions of Clonal hematopoiesis, CHIP and CCUS are formally included, Changes include those in AML, MPN, JMML is now a part of MPN, MDS-MPN, ALAL etc.
An array of presentation of lymphoma spillover in the peripheral smear and bone marrow. All types of lymphomas are discussed along with a bouquet of HPE pictures
There are several important changes in the WHO 5th edition hemato-lymphoid with a paradigm shift towards genetic diagnosis along with morphological aspects. Precursor lesions of Clonal hematopoiesis, CHIP and CCUS are formally included, Changes include those in AML, MPN, JMML is now a part of MPN, MDS-MPN, ALAL etc.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
Milan system TUMS (1).pdf
1.
2. The Milan System for Reporting
Salivary Gland Cytopathology
Dr Fereshteh Ameli
Department of Pathology
Tehran University of Medical Sciences
3. Some Salivary Gland Facts
Tumors:
• 0.4-13.5 per 100,000 people (uncommon)
• Older adults, females, parotid gland
• Approx. 75% are benign
• Risk of malignancy is inversely proportional to the
size of the gland
- 20-25% in parotid
- 40-50% submandibular gland
- 50-81% in minor salivary gland
4.
5. Salivary gland tumors are one of
the most heterogenous groups of
neoplasms. So what role is there
for FNA?
6. Effectiveness of Cytomorphology alone:
• Sensitivity:86-100%
• Accuracy:
• High for neoplastic vs. non-neoplastic lesions
• High for Benign/low grade vs HGmalignant: 90-100%
Part of the reason for the high accuracy:
• Majority of benign SG neoplasms are PA & WT
Salivary Gland FNA
7. Role of Salivary gland FNA
Is it neoplastic?
Is it malignant?
Is it hematopoietic?
Is it metastatic?
Is it high grade?
9. Current reporting confusion:
– Diversity of diagnostic categories
– Descriptive reports (no categories)
– Surgical pathology terminology
Why do we need a new reporting
system for salivary gland cytology?
10. The Benefits Of An Uniform Reporting System
For Salivary Gland Cytopathology
Improve communication between pathologists and
clinicians
Improve patient care
Facilitate cytologic-histologic correlation
Promote research into the epidemiology, molecular
biology, pathology, and diagnosis
Foster sharing of data from different laboratories for
collaborative studies
12. The Milan System for Reporting Salivary
Gland Cytopathology(SGC)
Core Group
Co-Chairs: Bill Faquin & Esther
D.Rossi
• Zubair Baloch
• Guliz Barkan
• Maria Pia Foschini
• Daniel Kurtycz
• Marc Pusztaszeri
• Philippe Vielh
13. The Milan System for Reporting SGC
Sponsored by the ASC and the IAC
Practical classification system that will be user-friendly
and internationally accepted
Evidence-based system with a useful format for clinicians
The classification system and ROM for the diagnostic
categories was further refined according to literature
14. Even if you do not adopt the Milan System
in your practice, reviewing the structure of a
reporting system will provide insight to
salivary gland FNA!
Reporting System for SGC
15.
16. 1) Non-Diagnostic
2) Non-Neoplastic
3) Atypia of undetermined significance
4) Neoplastic:
a) Benign
b) Uncertain malignant potential
5) Suspicious for Malignancy
6) Malignant
The Milan System for Reporting SGC
Diagnostic Categories
19. Rare or absent cells ; less than 60 lesional cells
Non-neoplastic (normal) salivary gland elements in the
setting of a clinically or radiologically defined mass
Non-mucinous cyst fluid without an epithelial component
should be subcategorized as “Non-Diagnostic, cystic fluid
only”
Poorly prepared slides with artifacts that preclude the
evaluation of the cellular component
Non-Diagnostic
Cytologic Criteria
22. DDX: Ductal cyst, pseudocyst, cystic neoplasm
Non-Diagnostic:
Absence of an epithelial component
Non-mucinous cyst contents
23. Mucinous cyst fluid contents without an epithelial
component should be interpreted as “Atypia of
Undetermined Significance (AUS)” instead of “Non-
Diagnostic” .
Exceptions:
Non-Diagnostic:
24. In the absence of
neoplastic cells, the
presence of a matrix
component suggestive
of a neoplasm should
not be classified as
“Non-Diagnostic ”.
Exceptions:
Non-Diagnostic:
25. The presence of abundant inflammatory cells without
an epithelial component can be interpreted as adequate.
Any salivary gland aspirate with significant cytologic
atypia cannot be classified as “Non-Diagnostic”
Exceptions …con’t
Non-Diagnostic:
30. 1) Non-Diagnostic
2) Non-Neoplastic
3) Atypia of undetermined significance
4) Neoplastic:
a) Benign
b) Uncertain malignant potential
5) Suspicious for Malignancy
6) Malignant
The Milan System for Reporting SGC
Diagnostic Categories
31. Non-Neoplastic
Specimens lacking evidence of a neoplastic process &
show benign non-neoplastic changes:
• Inflammatory, metaplastic, and reactive
• Reactive lymph nodes (flow cytometry is needed)
Clinico-radiological correlation is essential to ensure
that the specimen is representative of the lesion.
33. Caution is recommended, particularly when evaluating
aspirates of lymph nodes in the elderly, lymph nodes larger
than 3 cm, and multiple enlarged or matted lymph nodes.
Patients with autoimmune disease such as Sjögren’s
syndrome are at increased risk of developing primary parotid
gland lymphomas.
Non-Neoplastic:
Reactive Lymph Node
34. Non-Neoplastic:
Reactive Lymph Node
A subset of lymphomas can yield an aspirate with a
heterogeneous appearance mimicking reactive lymphoid
hyperplasia, namely extranodal marginal zone lymphoma as
well as others such as Hodgkin lymphoma, some T-cell
lymphomas, and T-cell rich B-cell lymphoma.
35. For any case of a salivary gland lymph node aspirate
where lymphoma is in the differential diagnosis, flow
cytometry using an aliquot of unfixed material is highly
recommended.
Non-Neoplastic:
Reactive Lymph Node
36. For negative lymph nodes, caution is warranted:
• A note suggesting repeat FNA or tissue biopsy if
lymphadenopathy persists
Non-Neoplastic:
Reactive Lymph Node
37. Benign Lymphoepithelial Lesion(LESA)
Cytologic Criteria
Cellular aspirate
Lymphoepithelial lesions
Mixed population of lymphocytes,
with predominance of small mature
lymphocytes
Non-Neoplastic:
39. Non-Neoplastic:
Acute Sialadenitis
Aspiration of any residual mass should be performed after
resolution of the inflammatory process since tumor diathesis in
high-grade cancers can mimic acute sialadenitis
47. 1) Non-Diagnostic
2) Non-Neoplastic
3) Atypia of undetermined significance
4) Neoplastic:
a) Benign
b) Uncertain malignant potential
5) Suspicious for Malignancy
6) Malignant
The Milan System for Reporting SGC
Diagnostic Categories
48. SG FNA that lacks either qualitative or quantitative
cytomorphologic features to be diagnosed with
confidence as non-neoplastic or neoplastic(can not
entirely exclude a neoplasm).
Atypia of Undetermined Significance
(AUS)
49. A majority will be reactive atypia or poorly sampledneoplasms.
Specimens are often compromised (eg, air-drying, blood clot).
Should be used rarely (<10 % of all salivary gland FNAs).
The ROM is 20%.
Atypia of Undetermined Significance
(AUS)
50. Low cellularity specimens suggestive of, but not
diagnostic of a neoplasm
Squamous, oncocytic, or other metaplastic changes
indefinite for a neoplasm
Atypia of Undetermined Significance
Cytologic Criteria
51. Mucinous cystic lesions with an absent or very
scant epithelial component
Salivary gland lymph nodes or lymphoid lesions
that are indefinite for a lymphoproliferative disorder
Atypia of Undetermined Significance
Cytologic Criteria …con’t
53. Atypia of Undetermined Significance :
Mixed population of lymphocytes with increased
numbers of larger lymphocytes. A lymphoma
cannot be excluded, particularly in the absence of
flow cytometry.
Indefinite for a
lymphoproliferative
disorder
54. Atypia of Undetermined Significance :
Low cellularity specimens
suggestive of, but not
diagnostic of a neoplasm
Groups of basaloid appearing epithelium
that are indefinite for a neoplastic process
59. 1) Non-Diagnostic
2) Non-Neoplastic
3) Atypia of undetermined significance
4) Neoplastic:
a) Benign
b) Uncertain malignant potential
5) Suspicious for Malignancy
6) Malignant
The Milan System for Reporting SGC
Diagnostic Categories
60. Neoplasm
Benign Neoplasm:
• Reserved for clear-cut benign neoplasms
• This category will include classic cases of PA, WT,…
• The ROM is < 5%
Salivary Gland Neoplasm of Uncertain
Malignant Potential:
• Diagnostic of a neoplasm; however, a diagnosis of a
specific entity cannot be made. A malignant neoplasm
cannot be excluded.
• Most malignant tumors included in this diagnostic category
will be low-grade carcinomas.
63. Neoplastic: Benign
Warthin Tumor
Oncocytes, chronic inflammation, and cystic debris
WT occurs almost
exclusively in the
parotid gland and
the tripartite
appearance is
essentially
diagnostic.
65. SUMP is a diagnostic category reserved for FNA
specimens that are diagnostic of a neoplasm; however, a
definitive diagnosis of a specific entity cannot be made.
This diagnosis should be used for cases in which a
malignant neoplasm cannot be excluded.
The ROM is 35%
Salivary Gland Neoplasm of Uncertain
Malignant Potential (SUMP)
66. A majority of these cases will include neoplasms
with monomorphic lesional cells :
• Basaloid neoplasms
• Oncocytic/oncocytoid neoplasms
• Neoplasms with clear cell features
Neoplasms with atypical features
Salivary Gland Neoplasm of Uncertain
Malignant Potential (SUMP)
67. Cellular aspirate
Neoplastic cells with oncocytic or oncocytoid features
that cannot be classified further
Neoplastic cells lack high-grade cellular features such as
marked nuclear atypia, high mitotic activity, and necrosis.
Neoplastic: SUMP
oncocytic/oncocytoid subcategry
70. Neoplastic: SUMP
Basaloid Neoplasm
DDX basal cell adenoma, cellular PA, AdCC
On histologic follow-up this case was diagnosed as solid variant
of adenoid cystic carcinoma
75. 1) Non-Diagnostic
2) Non-Neoplastic
3) Atypia of undetermined significance
4) Neoplastic:
a) Benign
b) Uncertain malignant potential
5) Suspicious for Malignancy
6) Malignant
The Milan System for Reporting SGC
Diagnostic Categories
76. Suspicious for Malignancy
Aspirates which are highly suggestive of
malignancy but not definitive.
Often high grade carcinomas with limited
sampling or other limitation
The ROM is 60%.
77. Markedly atypical cells with poor smear
preparation, poor cell preservation, fixation
artifact, or obscuring inflammation and blood
Presence of limited cytologic features of a
specific malignant lesion (e.g., ACC or MEC) in
an otherwise sparsely cellular aspirate
Suspicious for Malignancy
79. Suspicious for Malignancy
Hypocellular but contains occasional small groups of markedly atypical
cells suspicious for carcinoma. The corresponding resection showed
a high-grade MEC
84. 1) Non-Diagnostic
2) Non-Neoplastic
3) Atypia of undetermined significance
4) Neoplastic:
a) Benign
b) Uncertain malignant potential
5) Suspicious for Malignancy
6) Malignant
The Milan System for Reporting SGC
Diagnostic Categories
85. Malignant
Aspirates which are diagnostic of malignancy
Sub-classify into specific types and grades of carcinoma:
e.g. low grade vs high grade.
"Other" malignancies such as lymphomas, sarcomas and
metastases are also included in this category and should
be specifically designated.
86. Malignant
Acinic cell carcinoma
Cytologic Criteria:
• Cellular smears
• Monotonous population of epithelial cells
• Loosely cohesive groups
• Low nuclear–cytoplasmic (N:C) ratio
• Abundant delicate vacuolated cytoplasm
• Cells adherent to a delicate capillary meshwork
• No mitotic activity or necrosis
• Stripped nuclei
Low-Grade Carcinomas
96. Immunocytochemistry
LBP
Smears
Cell block
FISH
RT-PCR
Next Generation Sequencing
Ancillary Studies to Improve the FNA
Diagnosis of Head and Neck Tumors
97.
98.
99.
100.
101.
102.
103. Salivary gland cytology presents many diagnostic
challenges.
The Milan System for Reporting Salivary Gland
Cytoplathology will help to produce a more uniform
diagnostic structure.
Availability of IHC and molecular markers can greatly
improve the accuracy of salivary gland FNA!
SUMMARY