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Background: Primitive neuroectodermal tumor (PNET) is a malignant small round cell tumor that exhibits neuroepithelial differentiation, most often presenting as a bone or soft tissue mass in the trunk or axial skeleton in adolescents and young adults. Isolated cases of PNET have been observed at visceral sites, such as the ovary, testis, uterus, bladder and pancreas. We present a case of PNET in the kidney initially diagnosed by fine needle aspiration (FNA)., Case: A 21-year-old woman presented with microhematuria. Urine cytology was negative for malignant cells. Physical examination was without abnormal findings. Computerized tomography revealed a partially cystic tumor in the left kidney. FNA showed monotonous-appearing small round tumor cells with occasional rosette formation. The differential diagnoses include other primitive small round cell tumors. The tumor cells were immunoreactive for neuron specific enolase and O13 (CD99). A cytologic diagnosis of PNET was suggested and subsequently confirmed on histopathology., Conclusion: To our knowledge, this is the first description of PNET of the kidney initially diagnosed by FNA. This nerve tumor must be included in the differential diagnosis of small cell malignant tumors of the kidney and adjacent organs.

Background: Intraparotid schwannoma of the salivary gland is a rare entity. Review of the literature revealed one previous report describing its cytologic features., Case: A 22-year-old man had a slowly growing, painless mass in the left parotid gland. Fine needle aspiration biopsy, performed prior to surgical excision, showed several tissue fragments consisting of uniform, spindle-shaped neoplastic cells with cigar-shaped nuclei and scant, ill-defined cytoplasm. Some of the neoplastic cells were clustered in typical arrangements of Verocay bodies. In addition, lymphocytes and foamy histiocytes were found. A diagnosis of schwannoma was made. Pathologic evaluation of the resected parotid mass supported the diagnosis., Conclusion: The diagnosis of intraparotid schwannoma can be made by examining cytologic material containing the characteristic Verocay bodies. The correct cytologic diagnosis of this entity helps to rule out morphologically similar primary salivary gland neoplasms and thereby permits the appropriate surgical procedure to ensue.

We describe a mutation in the FGFR2 gene in affected members of a large family with inherited autosomal dominant craniosynostosis. The mutation is a G1044A transition at codon 344 of exon B of the gene and results in abnormal splicing of the FGFR2 transcript. The phenotypic effect of the mutation varies greatly. It ranges from minor anomalies such as slight hypertelorism and maxillary hypoplasia to severe manifestations such as brachycephaly and dolichocephaly. The severe cases required surgery because of increased intracranial pressure. The patients cannot be assigned clinically to one of the known craniosynostotic syndromes with mutations in FGFR2, e.g., Crouzon, Pfeiffer, or Jackson-Weiss. This study demonstrates that FGFR2 mutations can result in a spectrum of craniofacial abnormalities even within one family. The known eponymic syndromes of Crouzon, Pfeiffer, or Jackson-Weiss only describe phenotypic extremes of this spectrum. Therefore, the clinical classification should be abandoned and replaced by a molecular one such as "FGFR-associated craniosynostosis syndromes."

A case of upper gastrointestinal bleeding as the first and only manifestation of giant cell carcinoma of the pancreas invading the duodenum is described. The polypoid tumor was visualized during endoscopy. The diagnosis was made by a cytologic brush and confirmed by endoscopic biopsy. The rather uncommon presentation of pancreatic carcinoma and the possibility of establishing the diagnosis by a cytologic brush is discussed.

Starch glove powder may contaminate the environment and material removed from patients. When such material is not fixed immediately, starch granules may be ingested by viable phagocytes, possibly giving rise to the mistaken impression that phagocytosis took place in the body of the patient. The presence of phagocytosed material in cytologic preparations should not automatically lead to the conclusion that intravital phagocytosis has taken place.

Even with the most painstaking techniques, cornstarch granules used as surgical glove powder are deposited in the abdominal cavity during laparotomy. In tubal reconstructive surgery, aimed at the elimination of fibrous adhesions, this deposition may have undesirable consequences. After a successful operation, starch particles introduced in the abdominal cavity may result in the formation of new adhesions. It is therefore desirable to develop an alternative, completely nonreactive, glove powder.

A major problem in tubal reconstructive surgery is the recurrence of peritubal and periovarian adhesions which negate the surgical endeavors. In many cases the etiology of these adhesions is obscure. Histologic re-evaluation with polarized light of 49 resected adhesions revealed residual cornstarch glove powder and suture material in seven specimens. It is concluded that cornstarch powder may be an active agent, and may not be as innocuous as its widespread use indicates.