Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease) is a rare benign disease of unknown etiology presenting with massive lymphadenopathy. We report four cases of this disease retrieved from the archives of cytopathology laboratory, BPKIHS, Dharan, Nepal, during the period of January 2002 to October 2007. The cytologic morphology revealed lymphocytes, plasma cells, and single to multinucleated histiocytes with well preserved lymphocytes in their cytoplasm (emperipolesis or lymphophagocytosis). It is concluded that FNAC is a useful and reliable tool for the diagnosis of sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease) and biopsy can be avoided in these patients, thereby reducing patient inconvenience and health care cost.

BACKGROUND Fine-Needle Aspiration Cytology (FNAC) is a rapid, easily available technique for evaluation of nodular lesions of the epididymis and plays a prime role in the diagnosis of tubercular epididymitis and epididymo-orchitis. The aim of the study is to study the cytological findings of epididymal lesions to distinguish the inflammatory and neoplastic lesion, so that specific medical or surgical treatment can be early instituted. MATERIALS AND METHODS Fine-Needle Aspiration (FNA) was performed by 23G needle with 10 mL disposable plastic syringe. Both Papanicolaou and May-Grunwald-Giemsa stained smears were available in all cases and acid-fast stain were done in suspicious cases of tuberculosis and other granulomatous lesions. RESULTS A total of 234 cases attended for FNAC. Out of which, smears of 23 cases were found unsatisfactory and smears of 211 cases were studied for cytological findings. Epididymal cyst, acute epididymitis, chronic nonspecific epididymitis, tubercular epididymitis, filarial epididymitis, spermatocele, spermatic granuloma and adenomatoid tumour were found in 51(24.17%), 8(3.79%), 31(14.69%), 43(20.38%), 13(6.16%), 37(17.54%), 18(8.53%) and 10(4.74%) cases respectively. CONCLUSION FNAC is easier, cost effective, timesaving, minimally invasive, minimally traumatic and reliable first step outdoor or indoor procedure for the diagnosis of epididymal lesions, which guide the clinician for early institution of medical and surgical therapy.

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Background: Multicystic nephroma (MCN) is an uncommon but distinctive benign pediatric renal neoplasm but may present clinically at any age. It is scantily reported in the literature. To the best of our knowledge it has not yet been reported from Nepal. It is characterized by a well circumscribed mass with nodular outer surface that contain multiple fluid filled locals. Microscopy show cystically dilated spaces lined by flattened to columnar epithelium and is separated by fibroblastic stroma. A hobnail pattern is common. Case description: Here we report two cases of multicystic nephroma in a span of seven years. The first case is of a one year old female child who was diagnosed of having huge left sided renal mass clinically and the second case is of a 35-year-old male revealing hydatid cyst in USG, CT scan and IVP. Both of them underwent nephrectomy and their microscopic examination revealed typical characteristics of a multicystic nephroma. Conclusion: Since MCN has a benign behaviour it must be differentiated from focal cystic neoplastic lesions, including cystic partially differentiated nephroblastoma (CPDN), which has a low but distinct capability for local recurrence; from Wilm's tumour with cystic change; and cystic renal cell carcinoma.

Teratomas are neoplasms that arise from pluripotent cells and can differentiate along one or more embryonic germ lines 1 . Renal teratoma is an exceedingly rare condition. The primary involvement site is the gonadal tissue; less frequent primary sites of involvement include the anterior mediastinum, retroperitoneum, sacrococcygeal region, brain and the gastrointestinal tract.. The proximity of the genital ridge to the nephrogenic anlage may partly explain how germ cells could be displaced within the kidney.