Background. Papillary renal tumors lack alterations of chromosome 3 and show trisomy of chromosomes 7 and 17, genotypic features distinct from nonpapillary carcinomas. Methods. The authors examined 39 papillary renal neoplasms to identify morphologic features allowing distinction of high grade from low grade tumors. Twenty‐nine papillary tumors and 13 nonpapillary tumors were examined for the presence of trisomy of chromosome 7 using fluorescence in situ hybridization. Data recorded included tumor size, stage, grade, architectural pattern, and the presence of glycogen, foam cells, and iron. Results. Nineteen tumors were classified as low grade and 20 as high grade. The high grade tumors more often formed tall papillae with solid and tubular areas and had more intracellular glycogen, whereas the low grade tumors were more often trabecular. There was no significant difference in tumor size or iron deposition. High grade tumors were of higher stage. Foam cells more commonly were noted in low grade tumors. Sixty‐seven percent of low grade, 43% of high grade, and none of the non‐papillary tumors showed trisomy of chromosome 7. Metastases developed only in patients with high grade papillary tumors (10/19, 7 within 2 years of diagnosis), all of whom died of disease. Conclusions. Papillary renal carcinomas with high nuclear grade are more likely to behave in an aggressive fashion, whereas those with low nuclear grade may be associated with longer disease free survival. Furthermore, trisomy of chromosome 7 can be identified by fluorescence in situ hybridization and is useful in differentiating true papillary from nonpapillary renal neoplasms. Cancer 1995; 76:669–73.

Pancreatoblastoma is a rare pancreatic neoplasm seen most commonly in the pediatric age group. We report on the aspiration cytology and immunohistochemical findings of a pancreatoblastoma in a 16-yr-old male.

Small-cell carcinomas arise uncommonly in extrapulmonary sites and are rare primary neoplasms in the salivary glands. We report on the aspiration cytology and immunohistochemical findings of a small-cell carcinoma of the parotid gland in an 81-yr-old man.

Myelolipomas are benign soft‐tissue tumors predominantly found in the adrenal gland. Extra‐adrenal myelolipomas are rare, with about 30 previous cases reported. Approximately half of the reported cases were located in the presacral region. These were usually found at autopsy or during the workup of vague abdominal symptoms. Histologically, these lesions show bone marrow elements, with adipose tissue and scattered lymphoid aggregates. Radiologically‐guided fine‐needle aspiration (FNA) is helpful in establishing the diagnosis, thus obviating resection in some patients. We report on a case of an incidental presacral myelolipoma that underwent examination by computer tomography, magnetic resonance imaging, FNA, and immunohistochemical staining. This lesion was also analyzed by flow cytometry. To our knowledge, the use of the latter technique in the characterization of such tumors has not been previously reported. Diagn. Cytopathol. 1999;20:47–51. © 1999 Wiley‐Liss, Inc.

Displacement of phenytoin (90% bound to albumin) by other highly albumin-bound drugs like salicylate has been well documented. Other widely used nonsteroidal antiinflammatory drugs like tolmetin, ibuprofen, and naproxen are also strongly bound to albumin and can potentially displace phenytoin. However, phenytoin-ibuprofen interaction has been poorly studied in the past, and interaction of phenytoin with tolmetin or naproxen has not been studied before. For normal serum pool (albumin 3.7 g/dl), we observed significant increases in free phenytoin concentrations only with antiinflammatory drug concentrations at the upper end of therapeutic or above therapeutic concentrations. However, for the uremic pool (albumin 2.9 g/dl), displacement of phenytoin was significant even at the lower end of therapeutic concentrations of those antiinflammatory drugs. Of the three antiinflammatory drugs we studied, ibuprofen caused the highest displacement of phenytoin.

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Nephrogenic adenoma of the urinary bladder and urethra is an uncommon benign lesion of the urinary epithelium that can cytologically and histologically mimic malignancy. We report on the cytologic findings of a case of nephrogenic adenoma of the urethra that mimicked malignancy in an 84‐yr‐old woman. The differential diagnosis of this problematic lesion is discussed, and the literature describing the cytologic features is reviewed. Diagn. Cytopathol. 2000;22:49–51. © 2000 Wiley‐Liss, Inc.

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