{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T04:40:01Z","timestamp":1776314401278,"version":"3.50.1"},"reference-count":54,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,5,3]],"date-time":"2019-05-03T00:00:00Z","timestamp":1556841600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Cytopathology"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) is a 6\u2010tier diagnostic category system with associated risks of malignancy (ROMs) and management recommendations. Submandibular gland fine\u2010needle aspiration (FNA) is uncommon with a higher frequency of inflammatory lesions and a higher relative proportion of malignancy, and this may affect the ROM and subsequent management. This study evaluated the application of the MSRSGC and the ROM for each diagnostic category for 734 submandibular gland FNAs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Submandibular gland FNA cytology specimens from 15 international institutions (2013\u20102017) were retrospectively assigned to an MSRSGC diagnostic category as follows: nondiagnostic, nonneoplastic, atypia of undetermined significance (AUS), benign neoplasm, salivary gland neoplasm of uncertain malignant potential (SUMP), suspicious for malignancy (SM), or malignant. A correlation with the available histopathologic follow\u2010up was performed, and the ROM was calculated for each MSRSGC diagnostic category.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The case cohort of 734 aspirates was reclassified according to the MSRSGC as follows: nondiagnostic, 21.4% (0%\u201050%); nonneoplastic, 24.2% (9.1%\u201053.6%); AUS, 6.7% (0%\u201014.3%); benign neoplasm, 18.3% (0%\u201052.5%); SUMP, 12% (0%\u201037.7%); SM, 3.5% (0%\u201012.5%); and malignant, 13.9% (2%\u201031.3%). The histopathologic follow\u2010up was available for 333 cases (45.4%). The ROMs were as follows: nondiagnostic, 10.6%; nonneoplastic, 7.5%; AUS, 27.6%; benign neoplasm, 3.2%; SUMP, 41.9%; SM, 82.3%; and malignant, 93.6%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This multi\u2010institutional study shows that the ROM of each MSRSGC category for submandibular gland FNA is similar to that reported for parotid gland FNA, although the reported rates for the different MSRSGC categories were variable across institutions. Thus, the MSRSGC can be reliably applied to submandibular gland FNA.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncy.22135","type":"journal-article","created":{"date-parts":[[2019,5,3]],"date-time":"2019-05-03T07:39:11Z","timestamp":1556869151000},"page":"306-315","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":56,"title":["Application of the Milan System for Reporting Submandibular Gland Cytopathology: An international, multi\u2010institutional study"],"prefix":"10.1002","volume":"127","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3273-4802","authenticated-orcid":false,"given":"Zahra","family":"Maleki","sequence":"first","affiliation":[{"name":"Department of Pathology The Johns Hopkins Hospital Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zubair","family":"Baloch","sequence":"additional","affiliation":[{"name":"Department of Pathology Hospital of the University of Pennsylvania 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