Cytomorphology of salivary gland neoplasms: select entities and updates on the available ancillary tests and the Milan System of Reporting Salivary Gland Cytopathology

Cytopathologic diagnosis of salivary gland neoplasms (SGN) is uniquely challenging due to its diversity and some shared cytomorphologic features amongst SGN. Despite its challenges, fine-needle aspiration remains a popular screening method for its high sensitivity/specificity, minimally invasive nature, and low rate of complications. There are many recent advances in ancillary studies, which can aid in improving the accuracy of diagnosis. Also, a newly proposed reporting terminology for SGN, the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC), is aimed at categorizing SGN with specific risk of malignancy (ROM) for each category. We review the cytomorphologic features, histology, and available ancillary studies on select common and challenging SGN with focus on the MSRSGC.