Abstract：
BACKGROUND: The Milan System for Reporting Salivary Gland Cytopathology is an effective reporting system for salivary gland fine needle aspirations with well-established risks of malignancy. Salivary gland neoplasm of uncertain malignant potential (SUMP) comprises a heterogenous group of lesions which have features that can be recognized as at least neoplastic but preclude further classification into benign or malignant. In this study, we reviewed the cytomorphologic features of salivary gland fine needle aspirations diagnosed as SUMP at our institution (over the past 6 years) and correlated those with the final diagnosis on surgical follow up.
METHODS: A retrospective search was performed to identify cases classified as SUMP at our institution from January 2018 to February 2024. Cytology slides were reviewed, and cases were subclassified based on key cytomorphologic features into the following categories: (1) basaloid, (2) oncocytic, (3) with clear cell features and (4) mixed features (myoepithelial/oncocytoid/squamoid features). Histologic diagnosis was recorded if available.
RESULTS: A total of 36 cases of SUMP were identified; 31/36 had surgical follow up; final diagnosis included 22 benign lesions (2 non-neoplastic and 20 benign neoplasms), and nine malignant lesions. The overall risk of neoplasm and risk of malignancy were 93.5% and 29% respectively, with the oncocytic sub-category recording the highest ROM (42.8%). Mucoepidermoid carcinoma was the most common malignant diagnosis and pleomorphic adenoma the most common benign diagnoses.
CONCLUSIONS: Our study supports the subclassification of SUMP lesions based on key cytomorphologic features, thereby aiding in refining this ambiguous entity and providing a precise risk assessment.
METHODS: A retrospective search was performed to identify cases classified as SUMP at our institution from January 2018 to February 2024. Cytology slides were reviewed, and cases were subclassified based on key cytomorphologic features into the following categories: (1) basaloid, (2) oncocytic, (3) with clear cell features and (4) mixed features (myoepithelial/oncocytoid/squamoid features). Histologic diagnosis was recorded if available.
RESULTS: A total of 36 cases of SUMP were identified; 31/36 had surgical follow up; final diagnosis included 22 benign lesions (2 non-neoplastic and 20 benign neoplasms), and nine malignant lesions. The overall risk of neoplasm and risk of malignancy were 93.5% and 29% respectively, with the oncocytic sub-category recording the highest ROM (42.8%). Mucoepidermoid carcinoma was the most common malignant diagnosis and pleomorphic adenoma the most common benign diagnoses.
CONCLUSIONS: Our study supports the subclassification of SUMP lesions based on key cytomorphologic features, thereby aiding in refining this ambiguous entity and providing a precise risk assessment.
摘要：
背景：米兰唾液腺细胞病理学报告系统是一种有效的唾液腺细针穿刺报告系统，具有明确的恶性肿瘤风险。不确定恶性潜能的唾液腺肿瘤（SUMP）包括一组异质性病变，这些病变的特征至少可以被识别为肿瘤，但无法进一步分类为良性或恶性。在这项研究中,我们回顾了在我们机构(过去6年)诊断为SUMP的唾液腺细针穿刺的细胞形态学特征,并将这些特征与手术随访的最终诊断相关联.
方法：我们进行了回顾性搜索，以确定2018年1月至2024年2月在我们机构分类为SUMP的病例。细胞学幻灯片进行了审查，根据关键细胞形态学特征将病例细分为以下类别：（1）基底细胞，(2)嗜酸性细胞，（3）具有清晰的细胞特征和（4）混合特征（肌上皮/癌细胞样/鳞状细胞特征）。如果可用，记录组织学诊断。
结果：共确诊SUMP36例，31/36例手术随访，最终诊断良性病变22例（非肿瘤性2例，良性肿瘤20例），和9个恶性病变.肿瘤和恶性肿瘤的总体风险分别为93.5%和29%。嗜酸细胞性子类别记录最高的ROM(42.8%)。粘液表皮样癌是最常见的恶性诊断，多形性腺瘤是最常见的良性诊断。
结论：我们的研究支持基于关键细胞形态学特征的SUMP病变亚分类，从而帮助完善这个模棱两可的实体并提供精确的风险评估。
方法：我们进行了回顾性搜索，以确定2018年1月至2024年2月在我们机构分类为SUMP的病例。细胞学幻灯片进行了审查，根据关键细胞形态学特征将病例细分为以下类别：（1）基底细胞，(2)嗜酸性细胞，（3）具有清晰的细胞特征和（4）混合特征（肌上皮/癌细胞样/鳞状细胞特征）。如果可用，记录组织学诊断。
结果：共确诊SUMP36例，31/36例手术随访，最终诊断良性病变22例（非肿瘤性2例，良性肿瘤20例），和9个恶性病变.肿瘤和恶性肿瘤的总体风险分别为93.5%和29%。嗜酸细胞性子类别记录最高的ROM(42.8%)。粘液表皮样癌是最常见的恶性诊断，多形性腺瘤是最常见的良性诊断。
结论：我们的研究支持基于关键细胞形态学特征的SUMP病变亚分类，从而帮助完善这个模棱两可的实体并提供精确的风险评估。
