RESUMO
BACKGROUND: Fine-needle aspiration cytology (FNAC) for salivary gland tumors can be challenging to due to the diversity of lesions and cytomorphological convergence between the tumors. The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was hence developed and introduced to provide enhanced communication in salivary gland cytopathology. To evaluate the diagnostic utility and validity of MSRSGC in combination with ancillary radiological investigations, we aim to find correlation between Milan system and the radiological impression comparing with final histopathological diagnosis. AIMS AND OBJECTIVE: Correlate the Milan category with the radiological and final histopathological diagnosis of salivary gland lesions. Review the FNAC diagnosis of salivary gland lesions and identify cytomorphological predictors of malignancy. Correlate the FNAC and the radiological diagnosis with final diagnosis in histopathology. MATERIAL AND METHODS: A five year retrospective study, comprising fifty four cases of salivary gland FNAC were included in the study. RESULTS: Majority of the cases belong to Milan VI-Malignant followed by Milan IVa-Benign and rest of cases were among other categories. The sensitivity, specificity, positive predictive value, and negative predictive value of adjuvant radiological diagnosis in differentiating benign and malignant salivary gland lesions was found to be 80%, 62.5%, 72.7%, and 71.4%, respectively. We could observe that the concurrent radiological assessment along with Milan system of reporting in salivary gland FNAC especially under suspicious categories (Milan Category IVb as well as Milan Category V) is a useful and sensitive predictor of malignancy. CONCLUSION: A correlation with any form of ancillary radiological assessment is a helpful adjuvant with Milan system to derive a relatable diagnosis in salivary gland neoplasm especially those in categories describing the suspicious entities.
RESUMO
Background: Rosette formation is an unusual finding in malignant lymphomas. We report a case of a diffuse large B-cell lymphoma (DLBCL) with abundant rosette formation histologically mimicking non lymphoid tumors. Case presentation: A sixty-five-year-old female presented with a complaint of swelling on left side axillary region since a period of six months with no history of fever, fatigue or weight loss or other similar swellings elsewhere. No relevant personal and family history relatable to the present complaint. Subsequent clinical and radiological investigations revealed isolated left axillary lymphadenopathy. The lymph node on further biopsy showed a particular morphology of pseudorosette formation masquerading a metastatic rosette forming malignancies. Subsequent histopathological and immunohistochemical investigations revealed a rare morphological variant of diffuse large B cell lymphoma. The fluorodeoxyglucose positron emission tomography scan showed multiple discreet supra-diphramatic (left lower cervical and left axillary lymph nodes) metabolically active lymph nodes. Conclusion: Diffuse large B cell lymphoma with rosette formation is a rare entity which can mimic other tumors with rosette formation in a metastatic node. Knowledge on the rosette forming lymphoma entity is thus essential for diagnosis and treatment plan. To the best of our knowledge this case report is the sixth known documented case of a diffuse large B cell lymphoma with rosette in literature.