Mast cell tumor laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Suveenkrishna Pothuru, M.B,B.S. [2]

Overview

Laboratory tests that may be helpful for diagnosis of mast cell tumor include complete blood count, serum tryptase levels, plasma and urinary histamine levels, and coagulation profile.

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
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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
  • 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]

References

  1. 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.
  2. 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.
  3. 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.

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