Indian Journal of Pathology: Research and Practice

Introduction: FNAC of salivary is simple, easy, cost-effective investigation that can be used to differentiate benign and malignant lesions. Milan system was introduced to improve the communication between cytopathologists and physicians. Objectives: To diagnose the salivary gland swelling using fine needle aspirations by Milan system of reporting and correlate with histopathology. Materials and methods: Total number of 150 cases of salivary gland lesions were studied from September 2020 to August 2021 in SNMC and HSK hospital. Smears were then stained with H&E, Giemsa and PAP stains. Results: A total 150 patients that underwent FNAC, reported using Milan system of reporting and followed up with histopathological correlation. Results revealed that FNAC was effective in differentiating benign and malignant conditions by using Milan system of reporting. Conclusion: FNAC is a safe, reliable and yet economically effective technique in diagnosing salivary gland lesions. Milan system of reporting is essential to improve the communication between cytopathologists and physicians and gives universal approach in diagnosis and management of salivary gland lesions. So FNAC with Milan system can be used as effective pre-operative investigation in patients with salivary gland lesions.

Background & Objectives: Platelet transfusion reduces mortality from hemorrhage in patients with thrombocytopenia. Platelet transfusions are given prophylactically or therapeutically for managing patient with various platelet consumptive or destructive disorders. This study evaluates the effect of platelet transfusion over the count and parameters of platelets. The objective of this study is to compare the Platelet count, Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) before and after platelet transfusion. Materials and Methods: The platelet parameters of 202 samples with thrombocytopenia, demographic variables including gender, clinical details including indication for platelet transfusion, blood group, Platelet count, MPV, PDW before and after transfusion and additional details such as critical illness, transfusion reaction, stay in ICU etc, were noted. Descriptive statistics such as mean were calculated for descriptive variables such as difference in platelet count, MPV, PDW before and after transfusion. Results: The rise in platelet count with one unit of platelets was approximately 40000/µL and that with 12 units was 1,00,000/µL.The rise in MPV with one unit of platelets was approximately 2 fL and that with 12 units was approximately 1 fL. The mean rise in PDW after platelet transfusion ranged from 1.2 to 1.8. Conclusion: Platelet count, MPV and PDW increase after platelet transfusion. The increase in platelet count is disproportionate to the number of units transfused.

Salivary gland lesions are relatively less common but challenging because of their marked variability in cytomorphology, clinical features and biologic behavior. Fine needle aspiration cytology (FNAC) is helpful in evaluating suspicious salivary glands lesions due to its their superficial location, easy accessibility, low cost, minimum morbidity, rapid turnaround time, high specificity and sensitivity. Fine needle aspiration cytology in salivary gland lesions is intriguing for the cytopathologists due to their diverse morphology and overlapping cytological features which lead to the dilemma in diagnosis. Materials and Methods: Present study was a retrospective analytical study in a tertiary care centre over a duration of 3 years. All the salivary gland FNAC cases were retrieved and divided into various categories as per Milan system for reporting salivary gland cytopathology. Histopathological correlation was done wherever possible. Results: A total of 152 were included in the study. The percentage of cases in each category was: nondiagnostic 4.5%, nonneoplastic 51.9%, atypical lesions 0.76%, neoplastic category benign neoplasm 21.37%, salivary lesion of uncertain malignant potential 1.52%, suspicious category 2.29%, and malignant category 17.5%. The risk of malignancy for indivdual category was 6.25% (nonneoplastic), 100% (atypical), 3.3% (neoplastic), 0% (benign), 25% (salivary neoplasm of uncertain neoplastic potential), 100% (suspicious for malignancy), and 100% (malignant) categories. Sensitivity, specificity, positive predictive value, and negative predictive value of FNAC with application of Milan system was 89.4%, 100%, 100%, and 95.74%, respectively. Conclusion: Salivary gland FNAC when classified toa particular category by Milan system helps to overcome the pitfalls due to congruent features of various diagnostic categories yet provide risk stratification and stochastic information for the doubtful cases.