Shafique K, Zhang PJ, Montone KT, et al. - Investigators examined clinicopathologic features of mucoepidermoid carcinoma (MEC) utilizing a 3-tier grading system and retrospectively categorized cytologic diagnoses according to the Milan System for Reporting Salivary Gland Cytology (MSRSGC). Sixty-nine cases of MEC were distinguished, most were detected in the parotid gland. Compared with the intermediate and low-grade MEC, aggressive clinical behavior was found in the high-grade MEC. The MAML2 rearrangements were seen in 78% of cases by FISH analysis. It was indicated that the MSRSGC subcategorized the majority (63.8%)of MEC as SUMP, suspicious for malignancy or malignant. The results showed that clustering intermediate with low-grade cases did not significantly affect clinical behavior. Moreover, both high grade and oncocytic mucoepidermoid carcinoma can be MAML2 FISH negative.