Polyomavirus BK (BKV) has ebeen identified as the main cause of polyomavirus-associated nephropathy, a major cause of renal allograft failure. Although BKV-associated nephropathy develops in only 2% to 5% of renal transplant recipients, its prognosis when present is very poor, with irreversible graft failure developing in 45% of affected patients. While the use of urine cytology for the detection of decoy cells has been in use for decades, other diagnostic modalities to detect BKV have emerged, including tissue biopsy, polymerase chain reaction, viral culture, and serology. Currently, there is no consensus regarding the laboratory technique best suited for clinical monitoring. This review article will discuss essential and clinical features of polyomavirus, followed by a discussion pertaining to the various diagnostic modalities that contribute to detecting polyomavirus-associated nephropathy.

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Although schwannomas are frequently found in the head and neck region, sinonasal tract involvement is extremely rare, especially those of the frontal sinus. We report a patient with an incidentally found right frontal sinus lesion. The patient underwent resection of the tumor via a right craniotomy. The histological diagnosis was consistent with a schwannoma. There has been no radiographic recurrence on 2-year follow-up.

Extranodal lymphomas can be challenging for a practicing cytopathologist, especially in the fine needle aspiration clinic setting. These lymphomas can vary in type from one extranodal site to another. A variety of these lymphomas have very specific clinicopathologic features. They also may be associated with underlying autoimmune diseases, immunodeficiency syndromes, infection, or be noted in unique ethnic communities. This article reviews some of the commonly encountered lymphomas in extranodal sites with an emphasis on clinicopathologic and cytologic features.

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IntroductionPrimary leiomyoma of the lung is a rare benign tumor that usually presents as a solitary lesion predominantly in young females. Fewer than 100 cases have been reported. Common symptoms include fever, chronic cough, hemoptysis, chest pain, shortness of breath, and pneumonias.Case presentationA 34-year-old, non-smoker female who presented with recurrent pneumonias. She was found to have a primary leiomyoma of the right middle lobe. This was treated by right middle lobectomy. 6-month follow up showed patient doing well without evidence of residual disease on computerized tomography.ConclusionPrimary pulmonary leiomyoma is a rare tumor distinct from benign metastasizing leiomyoma. Histologic features include absence of mitotic count, low cellularity, lack of cytologic atypia and pleomorphism. Treatment is by conservative surgical resection and carries a favorable prognosis.

Spindle cell rhabdomyosarcoma is a rare variant of embryonal rhabdomyosarcoma that was first described in 1992 in the pediatric population by the German-Italian Cooperative Sarcoma study. 1 In children and young adults, it occurs predominately in the paratesticular region and has a good prognosis when compared with the other classic forms of rhabdomyosarcoma. In 1998, Rubin et al. reported the first examples of spindle cell rhabdomyosarcoma in adults. 2 These tumors show a more aggressive clinical course with the two patients dying of the disease shortly after diagnosis. The largest review to date of this entity was performed by Nascimento and Fletcher who over an 18-year period, found 16 cases of adult spindle cell rhabdomyosarcoma (age 18-years and older) which showed a male predominance (2.2:1), median age of 32 years, and a predilection for the head and neck area. The remaining cases occurred in the retroperitoneum, thigh, leg, subscapular area, hand, vulva, and paratesticular region. Sixty-four percent of these patients had either localized tumor or metastases post-therapy and 17% died soon after diagnosis. 3 The cytologic features of spindle cell rhabdomyosarcoma are sparse in the literature with only one previously published case report in the literature to date in a 13year-old child with paratesticular disease. 4 This brief communication describes the cytologic features on crush preparations of two additional cases of spindle cell rhabdomyosarcoma occurring in two adult patients.The first patient, a 27-year-old male, presented to the orthopedic oncologist with a painful disabling left calf

In this report, we describe the fine-needle aspiration findings of a case of adrenocortical carcinoma (ACC) that spread to the peritoneal cavity in an 80-year-old female. Cytologically, the peritoneal fluid exhibited clusters and single, small uniform cells with round nuclei and a fine chromatin pattern, which in conjunction with the immunohistochemical stains was diagnostic of ACC. Although ACC is the most common malignant neoplasm of the adrenal gland, its metastatic spread to the peritoneal cavity is exceptionally unusual.