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10.4103/cytojournal. cytojournal_31_16 Enlarging right neck mass in 10-year-old boy since 1 month with 5-pound weight loss, new onset cough, and change in voice. Examination of the oral cavity showed 8 cm × 8 cm oropharyngeal mass involving the entire right tonsillar region crossing the midline with deviation of the uvula. Computed tomography studies showed involvement of the parapharyngeal space from skull base to the omohyoid area with encasing of carotid artery. Fine-needle aspiration (FNA) [Figure 1] revealed highly cellular smears composed of small round blue cells with oval nuclei showing mild to marked anisonucleosis, lobulated to irregular nuclear contours, and intense hyperchromasia with occasional bare tumor nuclei and mitotic figures. Occasional loosely cohesive clusters and possible rosette formation were seen. Tumor karyotype was highly abnormal, complex, hyperdiploid with several structural and numerical aberrations, including gains of chromosomes 5, 8, 12 and 13. Fluorescence in situ hybridization (FISH) showed extra copy of the 13q14/ FOXO1-specific signal in 85.7% of interphase nuclei (gain of chromosome 13q) without 13q14 (FOXO1) rearrangement. Published: 27 December 2017 Received: 22 August 2016 CytoJournal 2017, 14:30 Accepted: 11 June 2017 This article is available from: http://www.cytojournal.com/content/14/1/30 © 2017 Chang, et al.; Licensee Cytopathology Foundation Inc.