Probe • Vol LXII • No. 3 • May–Aug 2023 • 37 Pathology Reliability of the Milan System for Reporting Salivary Gland Cytopathology in Parotid Gland FNAC This study tested the validity of the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) and assessed the possible differences in the sensitivity and specificity of parotid gland fine‐needle aspiration cytology (FNAC), between dedicated head and neck (H and N) centers. The H and N centers were subdivided into head and neck oncology centers (HNOCs), head and neck oncology affiliated centers (HNOACs), and general hospitals (GHs). The authors searched the Dutch Pathology Registry (PALGA) database for data of patients who had undergone a salivary gland resection between January 1, 2006, and January 1, 2017, and had preoperative FNAC reports. The FNAC reports were retrospectively assigned to MSRSGC categories. The risk of malignancy (ROM) was calculated for each category. The sensitivity and specificity for diagnosing malignancy were calculated and compared among HNOCs, HNOACs, and GHs. In all, 12,898 FNAC aspirates were evaluated. The ROMs for each category were as follows: 12.5% in MSRSGC I, 10.3% in MSRSGC II, 29% in MSRSGC III, 2.3% in MSRSGC IVa, 28.6% in MSRSGC IVb, 83% in MSRSGC V, and 99.3% in MSRSGC VI. The sensitivity of FNAC was the highest in HNOCs (88.1%), followed by HNOACs (79.7%) and GHs (75.0%). The MSRSGC is a valid tool for reporting parotid gland FNAC; therefore, these results strongly advocate its use. On the basis of the higher sensitivity of FNAC in dedicated H and N centers, the authors recommend that GHs use the presented management strategies to help minimize the chances of a preoperative misdiagnosis. Source: Reerds STH, et al. Cancer Cytopathol. 2021;129(9):719–728. Clinical Significance of Endometrial Cells in Pap Smear This retrospective study investigated the histopathologic follow-up results in women diagnosed with endometrial cells in the Papanicolaou (Pap) test. From the hospital electronic database (Zeynep Kamil Training and Research Hospital, Istanbul, Turkey), the data of women with endometrial cells on the Pap test (between January 2013 and December 2018) were searched. The data of those patients who underwent further histopathologic evaluation and who were followed up for at least 1 year were considered for the study, while the data of women who had a Pap test result other than endometrial cells, were lost during follow-up, or had missing information were excluded. Of 91,142 Pap smears, 121 (0.1%) cytologically had endometrial cells, and of those, 65 cases were eligible for the final analysis. The mean age of patients with premalignant/malignant lesions (57.7 ± 2.9 y) was higher than those with benign lesions (50.1 ± 0.7 y), with 77% of them in the postmenopausal period. Gynecologic premalignant/malignant lesions were detected in 9 (17.7%) patients, including endometrial hyperplasia in 2 (3.1%) patients and endometrial cancer in 7 (10.8%) patients. The menopausal status and being 50 years and older were significantly associated with preneoplastic or neoplastic changes in patients with endometrial cells. The presence of endometrial cells in Pap tests may be a harbinger of endometrial pathologies, especially at the age of 50 years and older. The menopausal status is another possible determinant in detecting endometrial carcinoma. Further investigation may be suggested in women aged ≥ 50 years and who are postmenopausal in the event of endometrial cell detection. Source: Keles E, et al. Turk Patoloji Derg. 2022;38(3):235–239. Abstracts From Literature
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