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Concordance for neuroblastoma in monozygotic twins has been reported only rarely, and the cause of the shared pathology has not been established. We describe a case of infant monozygotic twins developing tumours that were morphologically, clinically and molecularly indistinguishable, but with a delay of 6 months between times of presentation. Both tumours were metastatic and had amplification of MYCN and deletion at 1p36. Twin 1, who developed neuroblastoma first, had constitutional karyotype abnormalities in at least 5% of peripheral blood mononuclear cells involving 1p and 3p, and a deletion of 1q44 in 21% of cells. Twin 2 had a normal constitutional karyotype and lacked rearrangement or deletion of these regions. We propose an acquired neuroblastoma predisposition specific for twin 1, and in utero metastatic spread of tumour cells to twin 2 via the shared placental circulation. © 2001 Cancer Research Campaign http://www.bjcancer.com

cytological atypia, augmented with clinical suspicion of malignancy may result in an erroneous diagnosis of neoplasia. Clinical history, the metachromatic nature of any necrotic material and the absence of mitoses helps in establishing a correct diagnosis in such cases.In conclusion, fine needle aspiration cytology is a safe, reliable and quick method in making the diagnosis of a rheumatoid nodule and obviates the need for an invasive procedure like biopsy.