Department of Pathology, Jewish General Hospital, McGill University, Montréal, QC, Canada.
Division of Anatomic Pathology and Histology, Agostino Gemelli School of Medicine, Catholic University of the Sacred Heart, Rome, Italy.
Adv Anat Pathol. 2019 Mar;26(2):84-92. doi: 10.1097/PAP.0000000000000224.
Fine needle aspiration (FNA) is a well-established procedure for the diagnosis and management of salivary gland lesions despite challenges imposed by their diversity, complexity, and cytomorphologic overlap. Until recently, the reporting of salivary gland FNA specimens was inconsistent among different institutions throughout the world, leading to diagnostic confusion among pathologists and clinicians. In 2015, an international group of pathologists initiated the development of an evidence-based tiered classification system for reporting salivary gland FNA specimens designated the "Milan System for Reporting Salivary Gland Cytopathology" (MSRSGC) that culminated with the publication of the MSRSGC Atlas in February 2018. The MSRSGC consists of 6 diagnostic categories, which incorporate the morphologic heterogeneity and overlap among various non-neoplastic, benign, and malignant lesions of the salivary glands. In addition, each diagnostic category is associated with a risk of malignancy and management recommendations. The main goal of the MSRSGC is to improve communication between cytopathologists and treating clinicians, while also facilitating cytologic-histologic correlation, sharing of data from different laboratories for quality control, and research. Herein, we review the current status of salivary gland cytology and the role of MSRSGC in providing a framework for reporting salivary gland lesions.
细针抽吸（FNA）是一种成熟的诊断和管理唾液腺病变的方法，尽管其多样性、复杂性和细胞形态学重叠带来了挑战。直到最近，世界各地不同机构的唾液腺 FNA 标本报告仍不一致，导致病理学家和临床医生之间存在诊断混淆。2015 年，一组国际病理学家发起了一项基于证据的分层分类系统的开发，用于报告唾液腺 FNA 标本，该系统被指定为“米兰唾液腺细胞病理学报告系统”（MSRSGC），最终于 2018 年 2 月出版了 MSRSGC 图谱。MSRSGC 由 6 个诊断类别组成，其中包含了各种非肿瘤性、良性和恶性唾液腺病变的形态异质性和重叠。此外，每个诊断类别都与恶性风险和管理建议相关联。MSRSGC 的主要目标是改善细胞病理学家和治疗临床医生之间的沟通，同时促进细胞学-组织学相关性、不同实验室数据的共享以进行质量控制和研究。本文综述了目前唾液腺细胞学的状况以及 MSRSGC 在提供报告唾液腺病变的框架方面的作用。
