Determination of Rates of Malignancy on Archival Salivary Gland Fine-Needle Aspiration Biopsy after Application of the Milan System for Reporting Salivary Gland Cytopathology in the Philippine General Hospital

A 1-Year Retrospective Study




cytopathology, fine needle aspiration biopsy, FNAB, Milan System, salivary gland, rates of malignancy


Background. The Milan System for Reporting Salivary Gland Cytopathology (MSRGC) aims to increase the overall effectiveness of salivary gland FNAB by defining six general diagnostic categories with corresponding Rates of Malignancies (ROM). This study aims to use this system to categorize salivary gland FNAB in the Philippine General Hospital and stratify ROM per category.

Methodology. In this study a total of 326 cases have been collected and reviewed, of which 154 (47.2%) had either surgical or clinical follow-up. The cases were assigned a Milan category by 3 cytopathologists blinded from the original diagnoses and from each other’s readings.

Results. The overall sensitivity, specificity, PPV, and NPV in detecting neoplasm is at 71.6%, 90.9%, 88.3%, and 76.9%, respectively. On the other hand, the sensitivity, specificity, PPV, and NPV in detecting malignancy is at 52%, 92.9%, 59.1%, and 90.7%, respectively. The computed ROM is as follows: Category I 7.89%, Category II 9.43%, Category III 20%, Category IVa 10.53%, Category IVb 60%, Category V 75%, and Category VI 100%.

Conclusion. The overall diagnostic utility of salivary gland FNAB, as well as the computed ROM per diagnostic category are comparable to internationally published literature. This study also validates the MSRSGC as a valuable tool in stratifying ROM in salivary gland lesions.


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Author Biographies

Nikko Paolo Cablao, Philippine General Hospital

Department of Laboratories

Pauleen de Grano, Philippine General Hospital

Medical Officer III, Department of Otorhinolaryngology

Agustina Abelardo, Philippine General Hospital


Department of Laboratories

Dahlia Teresa Argamosa, Philippine General Hospital

Department of Laboratories


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How to Cite

Cablao, N. P., de Grano, P. ., Abelardo, A., Avila, J. M., & Argamosa, D. T. (2022). Determination of Rates of Malignancy on Archival Salivary Gland Fine-Needle Aspiration Biopsy after Application of the Milan System for Reporting Salivary Gland Cytopathology in the Philippine General Hospital: A 1-Year Retrospective Study. PJP, 7(1), 31–37.



Original Articles