title: Two cases of concomitant acquired aplastic anemia and systemic mastocytosis.
abstract: Reactive bone marrow mast cells reliably lack the morphologic, immunophenotypic, and molecular features of systemic mastocytosis (SM). We report two unusual cases of acquired aplastic anemia (AA) in which multifocal aggregates of bone marrow mast cells fulfilled morphologic and immunophenotypic criteria for SM according to the World Health Organization 2008 classification. In the absence of clinical symptoms attributable to SM, the patients were treated with immunosuppressive therapy directed towards AA. Clinical follow-up and subsequent bone marrow examination revealed no evidence of overt SM in either patient. These cases represent, to our knowledge, the first reported instances in which criteria for SM have been fulfilled in the presence of AA. However, given the clinical courses followed by our patients, the incidental identification of mast cell lesions consistent with indolent SM may be of uncertain significance in the setting of AA.
authors.affiliation: Department of Pathology, University of New Mexico, Albuquerque, NM 87102, USA.
authors.forename: Natalia
authors.initials: N
authors.lastname: Golardi
authors.affiliation: Department of Pathology, University of New Mexico, Albuquerque, NM 87102, USA; Penrose - St. Francis Hospital, Department of Pathology, Colorado Springs, CO, USA.
authors.forename: Jacob E
authors.initials: JE
authors.lastname: Sramek
authors.affiliation: Penrose - St. Francis Hospital, Department of Pathology, Colorado Springs, CO, USA.
authors.forename: Jerome B
authors.initials: JB
authors.lastname: Myers
authors.affiliation: Analytic Pathology Medical Group, Sharp Grossmont Hospital, La Mesa, CA, USA.
authors.forename: Helene
authors.initials: H
authors.lastname: Saffer
authors.affiliation: Department of Pathology, University of New Mexico, Albuquerque, NM 87102, USA.
authors.forename: Tracy I
authors.initials: TI
authors.lastname: George
authors.affiliation: Department of Pathology, University of New Mexico, Albuquerque, NM 87102, USA. Electronic address: dczuchlewski@salud.unm.edu.
authors.forename: David R
authors.initials: DR
authors.lastname: Czuchlewski
mesh_terms: D000741:Anemia, Aplastic / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D000961:Antilymphocyte Serum / Q000627:therapeutic use; D001854:Bone Marrow Cells / Q000473:pathology; D001856:Bone Marrow Examination; D016572:Cyclosporine / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008407:Mast Cells / Q000473:pathology; D034721:Mastocytosis, Systemic / Q000145:classification* / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use
chemical_list: D000961:Antilymphocyte Serum; D016572:Cyclosporine; D011241:Prednisone
keywords: Aplastic anemia; Mast cell; Systemic mastocytosis