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

Abstract

ObjectiveSystemic mastocytosis (SM) may rarely involve the lymph nodes; the corresponding cytological features are variable and have rarely been described. The aim of this study was to define more clearly the corresponding cytological diagnostic criteria. \ud \ud MethodsUltrasound-guided fine needle aspiration (FNA) of the deep-seated lymph nodes of two men, aged 72 and 75years respectively, was performed with rapid on-site evaluation (ROSE). Additional passes were used to prepare alcohol-fixed smears for immunocytochemistry (ICC) and cell suspensions for flow cytometry (FC). \ud \ud ResultsSmears showed medium-sized, roundish or elongated, mast cells with round to oval nuclei, sometimes irregular in shape. Cytoplasm was abundant with coarse granules, magenta-stained on Diff-Quik((R)) smears. Mature lymphocytes, plasma cells, histiocytes and a variable number of eosinophils were present in the background. ICC showed mast cell positivity for CD117 in both cases; FC demonstrated CD2/CD25 co-expression in one case. On the basis of the cytological and phenotypical features, the diagnosis of lymph node involvement in SM was made in both cases. Cytological ICC and FC data were evaluated using information reported in the literature. \ud \ud ConclusionsLymph node involvement in SM may be detected by FNA and ancillary techniques successfully applied to demonstrate the mast cell phenotype. FNA may also be used in a multidisciplinary algorithm for timely and effective SM staging

Mastocytosis in the skin in dogs: A multicentric case series

“…Dog #1 had mast cells identified in an inguinal lymph node, but not in the spleen, liver, or blood. In humans, the involvement of the lymph node is strongly associated with SM but data on nodal involvement in CM are lacking 38,39 . In this dog, advanced SM, as described in humans, 7 is unlikely given the good response to treatment and the good long‐term outcome, but indolent SM or, less likely CM with nodal involvement, is a possibility.…”

“…In humans, the involvement of the lymph node is strongly associated with SM but data on nodal involvement in CM are lacking. 38,39 In this dog, advanced SM, as described in humans, 7 is unlikely given the good response to treatment and the good long-term outcome, but indolent SM or, less likely CM with nodal involvement, is a possibility. Dog #10 had clinical signs, clinicopathological features and an outcome suggestive of MIS associated with SM.…”

Prenatal diagnosis, 3-D virtual rendering and lung sparing surgery by ligasure device in a baby with “CCAM and intralobar pulmonary sequestration”

“…Due to this new classification, Stocker himself proposed a new name of the esion: congenital pulmonary airway malformations CPAM [ 11 - 12 ]. Bronchopulmonary sequestration (BPS) represents 0.15-6.45% of all CTM [ 9 ] and it is a non functioning lung mass which is not connected with the bronchial tree and which is supplied from systemic vessels. Based on its visceral pleura BPS is divided in intralobar (ILS-75%), which shares the pleura with lung and extralobar sequestration (ELS-25%) which has an independent pleura.…”

“…The inpatients stay was 8 days. Histological examination was performed as described elsewhere [ 2 - 9 ] and confirmed the preoperative diagnosis of hybrid lesion (CCAM and intralobar bronchopulmunary sequestration). At follow up (6 months) the patient was completely asymptomatic.…”