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

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.…”

“…Moreover, metachromatic intracytoplasmic granules typical of mast cells, which are easily detected on May-Gr€ unwald-Giemsa or Diff-Quik stain, may be scanty. 11 Therefore, CD117 and CD25/CD2 co-expression is also helpful in the diagnosis of mastocytosis. In particular, CD117 differentiates mast cells from basophils, which may mimic them morphologically as they are both positive for toluidine blue stain; 10 instead, immunoreactivity with CD25/CD2 is generally an aberrant expression limited to neoplastic mast cells in adult mastocytosis.…”

“…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.…”

Endoscopic ultrasound and endobronchial ultrasound-guided fine-needle aspiration of deep-seated lymphadenopathy: Analysis of 1338 cases

“…Nine (52.9%) were diagnosed as small cell carcinoma, four (23.5%) as positive for malignant neoplasm, one as neuroendocrine neoplasm, one as urothelial cell carcinoma, one as poorly differentiated carcinoma, and one as systemic mastocytosis. [16] The last case was reported by our group previously. Of the 17 patients with neoplastic lesions within lymph nodes, 11 were men and six were women with an age range of 36 to 79 years (mean age, 60 years; [Table 8]).…”