Cytologic Diagnosis of Mastocytosis by Fine Needle Aspiration Biopsy

Endoscopic ultrasound‐guided fine needle aspiration: a powerful modality in the diagnosis of aggressive systemic mastocytosis

“…To date there are only two other reports documenting the use of FNA for detection of systemic mastocytosis. 8,9 Unlike those reports, which demonstrated many hypergranular mast cells, we show here that ASM may also reveal hypogranular mast cells. After a stable course of disease, this patient, in a short time frame, had progressively developed systemic symptoms affecting the gastrointestinal tract as well as the urinary tract.…”

“…EUS‐FNA in this patient not only helped to determine the systemic nature of the disease, providing evidence for a more aggressive disease, but also ruled out other causes of lymphadenopathy such as malignant lymphoma, mast cell leukemia, mast cell hyperplasia and ANHMD. To date there are only two other reports documenting the use of FNA for detection of systemic mastocytosis 8,9 . Unlike those reports, which demonstrated many hypergranular mast cells, we show here that ASM may also reveal hypogranular mast cells.…”

Lymph node fine needle aspiration cytology in systemic mastocytosis: cytological features with ancillary tests and literature review

“…19 With regard to the presence of eosinophils, these may be observed in lymph nodes in different conditions, i.e. dermatopathic lymphadenopathy, Langerhans cell histiocytosis and Hodgkin lymphoma, but may also be present in SM, as in the present cases and in others reported in the literature; [10][11][12] hence, a different diagnosis may be suggested. However, in addition to the clinical data, our cases, apart from the mast cell features, lacked the specific cytological features of these entities (Langherans cells, Hodgkin and Reed-Sternberg cells), which could therefore be ruled out.…”

“…17,18 FNA combined with ancillary techniques may conveniently be used to diagnose lymph node involvement in SM -as in the few cases described in the literature (Table 1) -mainly because all the suggested diagnostic criteria may be applied on the corresponding samples. [8][9][10][11] Nonetheless, cytological diagnosis may be extremely difficult in cases for which there is still no diagnosis of CM or SM at the time of FNA. This was so in the case described by Tongson-Ignacio and Gu, 10 in which, in the absence of skin lesions, a CT-guided FNA of a retroperitoneal mass was first diagnosed as myeloproliferative disorder.…”

“…5,6 Moreover, the use of ultrasound (US) and the application of immunocytochemistry (ICC) and molecular techniques have increased significantly the sensitivity and accuracy of FNA, 7 and widened the range of detectable pathology. Nonetheless, cytological features of SM have rarely been described, [8][9][10][11][12] and the corresponding cytological diagnostic criteria have not been extensively reported. We describe our experience with the cytological diagnosis of SM with lymph node involvement, and have merged our data with those available in the literature with the aim to better define the diagnostic criteria.…”