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Posted by on Jul 2, 2013 in Uncategorized |

Forum Question

Back in October I was referred for a bone marrow biopsy to a hematologist.

He was the first to admit that he had never had a patient with Mastocytosis, but was willing to do the procedure and learn along with me.  The results came back and he said they were negative. 

The thing that confuses me is this specific wording in my flow cytometry report,

Although there is no immunophenotypic evidence of mast cell neoplasm, note that less than 10 strongly CD117+/CD33+ mast cells were identified by flow cytometry.  Therefore our pending morphologic evaluation of the bone marrow biopsy, including CD117 immunohistochemistry, will be important to further exclude involvement by mastocytosis. 

There is no explansion of the meyloid blasts, but if clinically indicated, more detailed immunophenotypic evaluation of myeloid maturation could be performed. 

Finally, there is no immunophenotypic evidence of a lymphoid neoplasm.

So what are strongly CD117+/CD33+ mast cells? It also indicated,

.09% CD34+ blasts, .1% plasma cells and extremely rare, strongly CD117+ mast cells.  78% Tcells (CD5+) and 3.7% NK cells (CD5-, CD38+, CD56+).

I am just concerned that my doctor missed something.  Is anyone familiar with these results?

The bone marrow biopsy showed only

Mildly hypocellular marrow for age (~30-40%) with maturing trilineage hematopoiesis and no abnormal mast cells identified (see Comments.)”  With the comments saying, “The marrow appears mildly hypocellular for age; however trilineage hematopoiesis is noted with full maturation and no morphologic evidence of dysplasia.  No increase in mast cells is seen morphologically, by immunohistochemistry or by flow cytometry.  Correlation with overall clinical findings, including syrum tryptase levels is recommended.

It also says there are no spindle-cell collections.

Does this mean I can put the notion of Mastocytosis to bed and continue looking elsewhere for an answer?