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This case study describes a 38-year-old male with a history of leukemia/lymphoma, presenting with vomiting, diarrhea, and fatigue. Diagnostic findings, including cytospin analysis, immunophenotype, and cytogenetic studies, led to the diagnosis of Mast Cell Sarcoma. Unfortunately, the patient had a rapid downhill course and passed away a month after presentation.
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Mast cell sarcoma Yi-Hua Chen1, Amy Chadburn2, LoAnn Peterson1 1. Northwestern University Feinberg School of Medicine, Chicago. 2. Weil Cornell Medical College, New York
Clinical History and Physical Exam (1) • 38 y/o male with history of gamma delta T lymphoblastic leukemia/lymphoma, status post chemotherapy and HSCT. • Presented with intractable vomiting, diarrhea and fatigue. • CT showed significant bowel thickening, ascites and peritoneal nodularity.
Flow Cytometry – Ascitic Fluid Forward Scatter CD13 CD33 Side Scatter CD117 CD117 CD25 CD2 MPO CD117 CD117 CD117
Immunophenotype summary (Flow & IHC): CD117+, CD34-, CD33+, dim CD13+, MPO-, TdT-, CD123+, CD2+, CD25+, tryptase+, CD68 (KP-1)+ Cytogenetic studies: 78-89,XXXX,del(3)(p12p26),add(9)(p23),del(9) (p12-24), add(21)(p11.2)inc[cp 18] Molecular analysis: Negative for KIT mutation
Diagnosis Mast Cell Sarcoma
Follow up of patient • Rapidly progressive downhill course • Expired one month after presentation