The Milan System for Classifying Salivary Gland Cytopathology

The “Milan System for Reporting Salivary Gland Cytopathology” (MSRSGC) was first published in 2018 and is currently in its second edition. The MSRSGC provides a system for the uniform reporting of salivary gland fine needle aspiration (FNA) results. It consists of six diagnostic categories (Non-diagnostic, Non-neoplastic, AUS, Neoplasm: Benign or SUMP, Suspicious for Malignancy, and Malignant), each associated with a risk of malignancy (ROM) based upon evidence in the published literature. The main goal of the MSRSGC is to improve communication between cytopathologists and treating clinicians, while also facilitating cytologic-histologic correlation, quality improvement, and research. The MSRSGC has gained international acceptance among cytopathologists and ENT clinicians, and it has been endorsed by the 2021 ASCO management guidelines for salivary gland cancer and by the most recent WHO Blue Book for head and neck tumors.