Reappraisal of bone and soft tissue cytopathology classification using the modified Milan system
Background A standardized reporting system for bone and soft tissue tumor cytopathology has not yet been established. The objective of this study was to explore the potential utility of a classification modified from the Milan System for Salivary Gland Cytopathology and compared it with the upcoming...
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| Veröffentlicht in: | Cancer cytopathology 2024-11, Vol.132 (11), p.696-706 |
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| creator | Naka, Masaki Yamamoto, Hidetaka Kohashi, Kenichi Iwasaki, Takeshi Mori, Taro Nogami, Miwako Ookubo, Fumihiko Higuchi, Kayoko Motoi, Toru Oda, Yoshinao |
| description | Background
A standardized reporting system for bone and soft tissue tumor cytopathology has not yet been established. The objective of this study was to explore the potential utility of a classification modified from the Milan System for Salivary Gland Cytopathology and compared it with the upcoming World Health Organization (WHO) system for fine‐needle aspiration of soft tissue lesions.
Methods
The authors reviewed 285 cytology cases of bone/joint (n = 173) and soft tissue (n = 112) lesions, scoring each within diagnostic categories. The results were compared with histologic diagnoses and the risk of malignancy (ROM) for each category, and diagnostic reliability was analyzed.
Results
All 285 cases were successfully classified into one of the following categories: nondiagnostic (6.3%), non‐neoplastic (11.9%), atypia of uncertain significance (11.9%), benign neoplasm (5.6%), bone and soft tissue neoplasm of uncertain malignant potential (25.3%), suspicious for malignancy (1.4%), and malignant (37.5%). The ROM was 44.4% (eight of /18 cases) in nondiagnostic, 0% (zero of 34 cases) in non‐neoplastic, 32.4% (11 of 34 cases) in atypia of uncertain significance, 0% (zero of 16 cases) in benign neoplasm, 16.7% (12 of 72 cases) in bone and soft tissue neoplasm of uncertain malignant potential, 75.0% (three of four cases) in suspicious for malignancy, and 100% (107 of 107 cases) in malignant categories. Using the WHO system, the proportion and ROM of the benign category (non‐neoplastic and benign neoplasm) was 17.5% and 0%, respectively. Among benign and malignant lesions, the diagnostic accuracy, sensitivity, and specificity for detecting malignancy were 99.4%, 100%, and 98.0%, respectively.
Conclusions
The modified Milan system as well as the WHO system may be a useful cytopathologic classification tool for both bone and soft tissue lesions.
The modified Milan system as well as the World Health Organization system may be applicable in both bone and soft tissue cytology for describing the estimated disease and the risk of malignancy. |
| doi_str_mv | 10.1002/cncy.22888 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3086061694</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3123357194</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2468-a495f1c1f1d8100d40947569c970517251a78712a0be83c9f0332f9296cbd4073</originalsourceid><addsrcrecordid>eNp90MtKxDAUBuAgiveNDyABNyLMmEvbJEsZvMGoIAq6ipk0cSJtU3tapG9vxxln4cJVDuHj55wfoSNKxpQQdm4r248Zk1JuoF2qeDLKMi431zN72UF7AB-EUCkY3UY7XBGREJ7sordHZ-q6MQFMgaPHs1g5bKocQ_QtbgNA57Dt21ibdh6L-N5jWxiA4IM1bYgV7iBU77idO1zGfPh2Ob4Lhakw9NC68gBteVOAO1y9--j56vJpcjOaPlzfTi6mI8uSTI5MolJPLfU0l8NReUJUItJMWSVISgVLqRFSUGbIzElulSecM6-YyuxswILvo9Nlbt3Ez85Bq8sA1hXDJi52oDmRGcloppKBnvyhH7FrqmE7zSnjPBX0R50tlW0iQOO8rptQmqbXlOhF73rRu_7pfcDHq8huVrp8TX-LHgBdgq9QuP6fKD25n7wuQ78BPjSM1A</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3123357194</pqid></control><display><type>article</type><title>Reappraisal of bone and soft tissue cytopathology classification using the modified Milan system</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Naka, Masaki ; Yamamoto, Hidetaka ; Kohashi, Kenichi ; Iwasaki, Takeshi ; Mori, Taro ; Nogami, Miwako ; Ookubo, Fumihiko ; Higuchi, Kayoko ; Motoi, Toru ; Oda, Yoshinao</creator><creatorcontrib>Naka, Masaki ; Yamamoto, Hidetaka ; Kohashi, Kenichi ; Iwasaki, Takeshi ; Mori, Taro ; Nogami, Miwako ; Ookubo, Fumihiko ; Higuchi, Kayoko ; Motoi, Toru ; Oda, Yoshinao</creatorcontrib><description>Background
A standardized reporting system for bone and soft tissue tumor cytopathology has not yet been established. The objective of this study was to explore the potential utility of a classification modified from the Milan System for Salivary Gland Cytopathology and compared it with the upcoming World Health Organization (WHO) system for fine‐needle aspiration of soft tissue lesions.
Methods
The authors reviewed 285 cytology cases of bone/joint (n = 173) and soft tissue (n = 112) lesions, scoring each within diagnostic categories. The results were compared with histologic diagnoses and the risk of malignancy (ROM) for each category, and diagnostic reliability was analyzed.
Results
All 285 cases were successfully classified into one of the following categories: nondiagnostic (6.3%), non‐neoplastic (11.9%), atypia of uncertain significance (11.9%), benign neoplasm (5.6%), bone and soft tissue neoplasm of uncertain malignant potential (25.3%), suspicious for malignancy (1.4%), and malignant (37.5%). The ROM was 44.4% (eight of /18 cases) in nondiagnostic, 0% (zero of 34 cases) in non‐neoplastic, 32.4% (11 of 34 cases) in atypia of uncertain significance, 0% (zero of 16 cases) in benign neoplasm, 16.7% (12 of 72 cases) in bone and soft tissue neoplasm of uncertain malignant potential, 75.0% (three of four cases) in suspicious for malignancy, and 100% (107 of 107 cases) in malignant categories. Using the WHO system, the proportion and ROM of the benign category (non‐neoplastic and benign neoplasm) was 17.5% and 0%, respectively. Among benign and malignant lesions, the diagnostic accuracy, sensitivity, and specificity for detecting malignancy were 99.4%, 100%, and 98.0%, respectively.
Conclusions
The modified Milan system as well as the WHO system may be a useful cytopathologic classification tool for both bone and soft tissue lesions.
The modified Milan system as well as the World Health Organization system may be applicable in both bone and soft tissue cytology for describing the estimated disease and the risk of malignancy.</description><identifier>ISSN: 1934-662X</identifier><identifier>ISSN: 1934-6638</identifier><identifier>EISSN: 1934-6638</identifier><identifier>DOI: 10.1002/cncy.22888</identifier><identifier>PMID: 39074034</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>accuracy ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biopsy, Fine-Needle - methods ; bone and soft tissue ; Bone Neoplasms - classification ; Bone Neoplasms - diagnosis ; Bone Neoplasms - pathology ; Child ; Child, Preschool ; Cytodiagnosis - methods ; cytology ; Female ; Humans ; Male ; Middle Aged ; Milan system ; Reproducibility of Results ; Retrospective Studies ; Soft Tissue Neoplasms - classification ; Soft Tissue Neoplasms - diagnosis ; Soft Tissue Neoplasms - pathology ; Tumors ; World Health Organization ; World Health Organization (WHO) system ; Young Adult</subject><ispartof>Cancer cytopathology, 2024-11, Vol.132 (11), p.696-706</ispartof><rights>2024 The Author(s). Cancer Cytopathology published by Wiley Periodicals LLC on behalf of American Cancer Society.</rights><rights>2024. This article is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2468-a495f1c1f1d8100d40947569c970517251a78712a0be83c9f0332f9296cbd4073</cites><orcidid>0000-0001-9148-6445</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fcncy.22888$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fcncy.22888$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,1417,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39074034$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Naka, Masaki</creatorcontrib><creatorcontrib>Yamamoto, Hidetaka</creatorcontrib><creatorcontrib>Kohashi, Kenichi</creatorcontrib><creatorcontrib>Iwasaki, Takeshi</creatorcontrib><creatorcontrib>Mori, Taro</creatorcontrib><creatorcontrib>Nogami, Miwako</creatorcontrib><creatorcontrib>Ookubo, Fumihiko</creatorcontrib><creatorcontrib>Higuchi, Kayoko</creatorcontrib><creatorcontrib>Motoi, Toru</creatorcontrib><creatorcontrib>Oda, Yoshinao</creatorcontrib><title>Reappraisal of bone and soft tissue cytopathology classification using the modified Milan system</title><title>Cancer cytopathology</title><addtitle>Cancer Cytopathol</addtitle><description>Background
A standardized reporting system for bone and soft tissue tumor cytopathology has not yet been established. The objective of this study was to explore the potential utility of a classification modified from the Milan System for Salivary Gland Cytopathology and compared it with the upcoming World Health Organization (WHO) system for fine‐needle aspiration of soft tissue lesions.
Methods
The authors reviewed 285 cytology cases of bone/joint (n = 173) and soft tissue (n = 112) lesions, scoring each within diagnostic categories. The results were compared with histologic diagnoses and the risk of malignancy (ROM) for each category, and diagnostic reliability was analyzed.
Results
All 285 cases were successfully classified into one of the following categories: nondiagnostic (6.3%), non‐neoplastic (11.9%), atypia of uncertain significance (11.9%), benign neoplasm (5.6%), bone and soft tissue neoplasm of uncertain malignant potential (25.3%), suspicious for malignancy (1.4%), and malignant (37.5%). The ROM was 44.4% (eight of /18 cases) in nondiagnostic, 0% (zero of 34 cases) in non‐neoplastic, 32.4% (11 of 34 cases) in atypia of uncertain significance, 0% (zero of 16 cases) in benign neoplasm, 16.7% (12 of 72 cases) in bone and soft tissue neoplasm of uncertain malignant potential, 75.0% (three of four cases) in suspicious for malignancy, and 100% (107 of 107 cases) in malignant categories. Using the WHO system, the proportion and ROM of the benign category (non‐neoplastic and benign neoplasm) was 17.5% and 0%, respectively. Among benign and malignant lesions, the diagnostic accuracy, sensitivity, and specificity for detecting malignancy were 99.4%, 100%, and 98.0%, respectively.
Conclusions
The modified Milan system as well as the WHO system may be a useful cytopathologic classification tool for both bone and soft tissue lesions.
The modified Milan system as well as the World Health Organization system may be applicable in both bone and soft tissue cytology for describing the estimated disease and the risk of malignancy.</description><subject>accuracy</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biopsy, Fine-Needle - methods</subject><subject>bone and soft tissue</subject><subject>Bone Neoplasms - classification</subject><subject>Bone Neoplasms - diagnosis</subject><subject>Bone Neoplasms - pathology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Cytodiagnosis - methods</subject><subject>cytology</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Milan system</subject><subject>Reproducibility of Results</subject><subject>Retrospective Studies</subject><subject>Soft Tissue Neoplasms - classification</subject><subject>Soft Tissue Neoplasms - diagnosis</subject><subject>Soft Tissue Neoplasms - pathology</subject><subject>Tumors</subject><subject>World Health Organization</subject><subject>World Health Organization (WHO) system</subject><subject>Young Adult</subject><issn>1934-662X</issn><issn>1934-6638</issn><issn>1934-6638</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><recordid>eNp90MtKxDAUBuAgiveNDyABNyLMmEvbJEsZvMGoIAq6ipk0cSJtU3tapG9vxxln4cJVDuHj55wfoSNKxpQQdm4r248Zk1JuoF2qeDLKMi431zN72UF7AB-EUCkY3UY7XBGREJ7sordHZ-q6MQFMgaPHs1g5bKocQ_QtbgNA57Dt21ibdh6L-N5jWxiA4IM1bYgV7iBU77idO1zGfPh2Ob4Lhakw9NC68gBteVOAO1y9--j56vJpcjOaPlzfTi6mI8uSTI5MolJPLfU0l8NReUJUItJMWSVISgVLqRFSUGbIzElulSecM6-YyuxswILvo9Nlbt3Ez85Bq8sA1hXDJi52oDmRGcloppKBnvyhH7FrqmE7zSnjPBX0R50tlW0iQOO8rptQmqbXlOhF73rRu_7pfcDHq8huVrp8TX-LHgBdgq9QuP6fKD25n7wuQ78BPjSM1A</recordid><startdate>202411</startdate><enddate>202411</enddate><creator>Naka, Masaki</creator><creator>Yamamoto, Hidetaka</creator><creator>Kohashi, Kenichi</creator><creator>Iwasaki, Takeshi</creator><creator>Mori, Taro</creator><creator>Nogami, Miwako</creator><creator>Ookubo, Fumihiko</creator><creator>Higuchi, Kayoko</creator><creator>Motoi, Toru</creator><creator>Oda, Yoshinao</creator><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9148-6445</orcidid></search><sort><creationdate>202411</creationdate><title>Reappraisal of bone and soft tissue cytopathology classification using the modified Milan system</title><author>Naka, Masaki ; Yamamoto, Hidetaka ; Kohashi, Kenichi ; Iwasaki, Takeshi ; Mori, Taro ; Nogami, Miwako ; Ookubo, Fumihiko ; Higuchi, Kayoko ; Motoi, Toru ; Oda, Yoshinao</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2468-a495f1c1f1d8100d40947569c970517251a78712a0be83c9f0332f9296cbd4073</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>accuracy</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biopsy, Fine-Needle - methods</topic><topic>bone and soft tissue</topic><topic>Bone Neoplasms - classification</topic><topic>Bone Neoplasms - diagnosis</topic><topic>Bone Neoplasms - pathology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Cytodiagnosis - methods</topic><topic>cytology</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Milan system</topic><topic>Reproducibility of Results</topic><topic>Retrospective Studies</topic><topic>Soft Tissue Neoplasms - classification</topic><topic>Soft Tissue Neoplasms - diagnosis</topic><topic>Soft Tissue Neoplasms - pathology</topic><topic>Tumors</topic><topic>World Health Organization</topic><topic>World Health Organization (WHO) system</topic><topic>Young Adult</topic><toplevel>online_resources</toplevel><creatorcontrib>Naka, Masaki</creatorcontrib><creatorcontrib>Yamamoto, Hidetaka</creatorcontrib><creatorcontrib>Kohashi, Kenichi</creatorcontrib><creatorcontrib>Iwasaki, Takeshi</creatorcontrib><creatorcontrib>Mori, Taro</creatorcontrib><creatorcontrib>Nogami, Miwako</creatorcontrib><creatorcontrib>Ookubo, Fumihiko</creatorcontrib><creatorcontrib>Higuchi, Kayoko</creatorcontrib><creatorcontrib>Motoi, Toru</creatorcontrib><creatorcontrib>Oda, Yoshinao</creatorcontrib><collection>Wiley-Blackwell Open Access Titles</collection><collection>Wiley Free Content</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Cancer cytopathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Naka, Masaki</au><au>Yamamoto, Hidetaka</au><au>Kohashi, Kenichi</au><au>Iwasaki, Takeshi</au><au>Mori, Taro</au><au>Nogami, Miwako</au><au>Ookubo, Fumihiko</au><au>Higuchi, Kayoko</au><au>Motoi, Toru</au><au>Oda, Yoshinao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Reappraisal of bone and soft tissue cytopathology classification using the modified Milan system</atitle><jtitle>Cancer cytopathology</jtitle><addtitle>Cancer Cytopathol</addtitle><date>2024-11</date><risdate>2024</risdate><volume>132</volume><issue>11</issue><spage>696</spage><epage>706</epage><pages>696-706</pages><issn>1934-662X</issn><issn>1934-6638</issn><eissn>1934-6638</eissn><abstract>Background
A standardized reporting system for bone and soft tissue tumor cytopathology has not yet been established. The objective of this study was to explore the potential utility of a classification modified from the Milan System for Salivary Gland Cytopathology and compared it with the upcoming World Health Organization (WHO) system for fine‐needle aspiration of soft tissue lesions.
Methods
The authors reviewed 285 cytology cases of bone/joint (n = 173) and soft tissue (n = 112) lesions, scoring each within diagnostic categories. The results were compared with histologic diagnoses and the risk of malignancy (ROM) for each category, and diagnostic reliability was analyzed.
Results
All 285 cases were successfully classified into one of the following categories: nondiagnostic (6.3%), non‐neoplastic (11.9%), atypia of uncertain significance (11.9%), benign neoplasm (5.6%), bone and soft tissue neoplasm of uncertain malignant potential (25.3%), suspicious for malignancy (1.4%), and malignant (37.5%). The ROM was 44.4% (eight of /18 cases) in nondiagnostic, 0% (zero of 34 cases) in non‐neoplastic, 32.4% (11 of 34 cases) in atypia of uncertain significance, 0% (zero of 16 cases) in benign neoplasm, 16.7% (12 of 72 cases) in bone and soft tissue neoplasm of uncertain malignant potential, 75.0% (three of four cases) in suspicious for malignancy, and 100% (107 of 107 cases) in malignant categories. Using the WHO system, the proportion and ROM of the benign category (non‐neoplastic and benign neoplasm) was 17.5% and 0%, respectively. Among benign and malignant lesions, the diagnostic accuracy, sensitivity, and specificity for detecting malignancy were 99.4%, 100%, and 98.0%, respectively.
Conclusions
The modified Milan system as well as the WHO system may be a useful cytopathologic classification tool for both bone and soft tissue lesions.
The modified Milan system as well as the World Health Organization system may be applicable in both bone and soft tissue cytology for describing the estimated disease and the risk of malignancy.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>39074034</pmid><doi>10.1002/cncy.22888</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-9148-6445</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | accuracy Adolescent Adult Aged Aged, 80 and over Biopsy, Fine-Needle - methods bone and soft tissue Bone Neoplasms - classification Bone Neoplasms - diagnosis Bone Neoplasms - pathology Child Child, Preschool Cytodiagnosis - methods cytology Female Humans Male Middle Aged Milan system Reproducibility of Results Retrospective Studies Soft Tissue Neoplasms - classification Soft Tissue Neoplasms - diagnosis Soft Tissue Neoplasms - pathology Tumors World Health Organization World Health Organization (WHO) system Young Adult |
| title | Reappraisal of bone and soft tissue cytopathology classification using the modified Milan system |
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