{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T12:57:15Z","timestamp":1785589035547,"version":"3.56.0"},"reference-count":21,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diagnostic Cytopathology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) provides a standardized framework for interpreting salivary gland fine\u2010needle aspiration cytology (FNAC) samples and estimating the associated risk of malignancy (ROM). This study aimed to retrospectively reclassify parotid gland fine\u2010needle aspiration (FNA) samples from our institution according to the MSRSGC, evaluate the correlation between preoperative cytological and postoperative histopathological findings, and determine the ROM for each diagnostic category.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>A total of 277 parotid gland FNAC cases with subsequent surgical excision between 2010 and 2024 were included. Cytological smears were independently reviewed and reclassified according to MSRSGC by two blinded pathologists. Cytology\u2013histology concordance was assessed, and diagnostic performance metrics, including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy, were calculated. ROM for each Milan category was derived from the final histopathology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 612 patients who underwent FNAC, 277 (45.3%) had available histopathological follow\u2010up. The mean age was 49.6\u2009\u00b1\u200915.67\u2009years, with a male\u2010to\u2010female ratio of 1.2:1. Benign neoplasm (Category IVa) was the most frequent cytological diagnosis (71.1%). Histopathology revealed 235 benign and 42 malignant lesions. FNAC demonstrated a sensitivity of 85.2%, specificity of 99%, PPV of 92%, NPV of 98%, and an overall diagnostic accuracy of 97.4%. ROM values were 16% for nondiagnostic, 20% for nonneoplastic, 11% for atypia of undetermined significance (AUS), 1.5% for benign neoplasm, 47% for salivary gland neoplasm of uncertain malignant potential (SUMP), 100% for suspicious for malignancy (SFM), and 90% for malignant cases. False\u2010negative results were primarily associated with lymphoma, acinic cell carcinoma, and secretory carcinoma. The combined ROM for indeterminate categories (AUS, SUMP, and SFM) was 46%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>FNAC is a highly accurate and minimally invasive diagnostic method for parotid gland lesions. The Milan System offers valuable guidance for risk stratification and clinical management, although indeterminate categories continue to pose diagnostic difficulties. Multidisciplinary assessment and larger multicenter studies are needed to improve diagnostic precision.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dc.70158","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T07:39:47Z","timestamp":1781509187000},"page":"672-679","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Histopathological Correlation and Determination of Malignancy Risk in Reporting Parotid Gland Masses According to the Milan System"],"prefix":"10.1002","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9508-0469","authenticated-orcid":false,"given":"Ahmet Adnan","family":"C\u0131r\u0131k","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology Umraniye Training and Research Hospital  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyma","family":"Akgun Bostanci","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Umraniye Training and Research Hospital  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4887-4677","authenticated-orcid":false,"given":"Yasar Kemal","family":"Duymaz","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Sultan Abdulhamidhan Training and Research Hospital  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3099-5307","authenticated-orcid":false,"given":"Onur","family":"Sahin","sequence":"additional","affiliation":[{"name":"Department of Pathology Umraniye Training and Research Hospital  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20142"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2015-0222-RA"},{"issue":"3","key":"e_1_2_9_4_1","first-page":"163","article-title":"Malignancy Risk for the \u2018Atypia of Undetermined Significance\u2019 Category in Salivary Gland Fine\u2010Needle Aspiration: A Retrospective Analysis of the Milan System for Reporting Salivary Gland Cytopathology","volume":"126","author":"Viswanathan K.","year":"2018","journal-title":"Cancer Cytopathology"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.2840070311"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jasc.2018.02.002"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jasc.2023.08.004"},{"issue":"1","key":"e_1_2_9_8_1","first-page":"6","article-title":"Malignancy Risk and Diagnostic Accuracy of the Milan System for Reporting Salivary Gland Cytopathology","volume":"48","author":"Hoda R. S.","year":"2020","journal-title":"Diagnostic Cytopathology"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.21710"},{"issue":"1","key":"e_1_2_9_10_1","first-page":"60","article-title":"Risk of Malignancy in Milan System Categories: Analysis of 309 Salivary Gland FNACs in a Tertiary Care Centre","volume":"50","author":"Chand P.","year":"2022","journal-title":"Diagnostic Cytopathology"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.23826"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/00015458.2016.1262491"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.4103\/ams.ams_179_18"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1590\/1678-775720160214"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1159\/000525263"},{"issue":"8","key":"e_1_2_9_16_1","first-page":"684","article-title":"Salivary Gland Fine\u2010Needle Aspiration Cytology With the Application of the Milan System: A Retrospective 6\u2010Year Study","volume":"48","author":"Rivera Rolon M.","year":"2020","journal-title":"Diagnostic Cytopathology"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.23716"},{"issue":"5","key":"e_1_2_9_18_1","first-page":"427","article-title":"Diagnostic Accuracy of Fine Needle Aspiration Cytology in Parotid Gland Lesions: A Tertiary Care Center Experience","volume":"40","author":"Farahani S. J.","year":"2020","journal-title":"Annals of Saudi Medicine"},{"issue":"2","key":"e_1_2_9_19_1","first-page":"180","article-title":"Evaluation of Salivary Gland Fine Needle Aspiration Cytology Using the Milan System","volume":"49","author":"Altin F.","year":"2021","journal-title":"Diagnostic Cytopathology"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.22574"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1159\/000538069"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.23601"}],"container-title":["Diagnostic Cytopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dc.70158","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/dc.70158","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dc.70158","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T12:08:07Z","timestamp":1785586087000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/dc.70158"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,15]]},"references-count":21,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/dc.70158"],"URL":"https:\/\/doi.org\/10.1002\/dc.70158","archive":["Portico"],"relation":{},"ISSN":["8755-1039","1097-0339"],"issn-type":[{"value":"8755-1039","type":"print"},{"value":"1097-0339","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,15]]},"assertion":[{"value":"2025-11-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}