Mast cell tumor laboratory findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Laboratory Findings
Diagnostic pathway of mastocytosis
Following flow chart illustrates the diagnostic pathway of mast cell tumor:[1]
Skin lesions or suggestive clinical features | |||||||||||||||||||||||||||||||||||||
Serum Tryptase
Complete blood count Complete metabolic panel | |||||||||||||||||||||||||||||||||||||
Normal complete blood count
Serum tryptase ≤ 100ng/ml | Abnormal complete blood cell count
Serum tryptase > 100 ng/ml | ||||||||||||||||||||||||||||||||||||
Cutaneous mastocytosis
| Bone marrow: biopsy and aspiration
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Negative findings:
Other diagnosis | Positive findings: Systemic mastocytosis | ||||||||||||||||||||||||||||||||||||
Laboratory findings
- Tryptase which is stored almost exclusively within the secretory granules of mast cells is the most widely used marker of mastocytosis.
- In healthy individuals, serum tryptase levels range between <1 and 15 ng/mL; however, mast cell activation causes increased tryptase levels.
- Additionally, tryptase levels in SM are assumed to correlate closely with the cumulative mast cell burden and multiorgan involvement
- Plasma and urinary histamine
- Chronically elevated plasma and urinary histamine levels and its metabolite N-methylhistamine
- Elevated in a blood sample obtained immediately after attack
- Kinetics of blood clotting may be altered due to fibrinogenolytic and anticoagulant activities of tryptase and heparin respectively.[3]
- Molecular testing for Kit D816V mutation
References
- ↑ Ferrante, Giuliana; Scavone, Valeria; Muscia, Maria; Adrignola, Emilia; Corsello, Giovanni; Passalacqua, Giovanni; La Grutta, Stefania (2015). "The care pathway for children with urticaria, angioedema, mastocytosis". World Allergy Organization Journal. 8 (1): 5. doi:10.1186/s40413-014-0052-x. ISSN 1939-4551.
- ↑ Ozdemir, Didem; Dagdelen, Selcuk; Erbas, Tomris; Agbaht, Kemal; Serefhanoglu, Songul; Aksu, Salih; Ersoy-Evans, Sibel (2010). "Hypotension, Syncope, and Fever in Systemic Mastocytosis without Skin Infiltration and Rapid Response to Corticosteroid and Cyclosporin: A Case Report". Case Reports in Medicine. 2010: 1–4. doi:10.1155/2010/782595. ISSN 1687-9627.
- ↑ Koenig, Martial; Morel, Jérôme; Reynaud, Jacqueline; Varvat, Cécile; Cathébras, Pascal (2008). "An unusual cause of spontaneous bleeding in the intensive care unit – mastocytosis: a case report". Cases Journal. 1 (1): 100. doi:10.1186/1757-1626-1-100. ISSN 1757-1626.