Abstract
The heterogeneity of salivary gland diseases presents unique challenges for the pathologist, radiologist, and treating clinician in their pursuit of optimal patient care. Clinical history, physical exam, and information provided by imaging studies such as ultrasound, contrast-enhanced computed tomography (CT), or magnetic resonance imaging (MRI) with contrast as well as fine needle aspiration (FNA) contribute to the development of a management plan that can range from observation to limited or extensive surgical resection and possible adjuvant therapy. FNA has an established role in salivary gland diagnostics because it can provide valuable information regarding the nature of the salivary gland lesion. It is also quick and well tolerated, with very few complications, lending itself to rapid onsite evaluation (ROSE) when used in conjunction with clinical assessment and imaging studies. The clinical utility to surgical specialists of the Milan System for Reporting Salivary Gland Cytopathology can be summarized in clarity of communication, correlation, stratification of risk of malignancy (ROM), and definition of a management algorithm.