Mastocytosis. Review of the literature and description of clinical cases


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Abstract

The term mastocytosis (MC) encompasses a group of rare diseases characterized by the tumorous proliferation of clonal mast cells and the infiltration of one or several organs. The clinical picture of MC is extremely diverse from skin lesions that can spontaneously regress to the aggressive disease forms associated with organ dysfunction and short survival. Nowadays, the 2008 WHO classification identifies 7 MC subtypes. The disease is diagnosed on the basis of its clinical manifestations and detection of tumorous mast cell infiltrations via morphological, immunohistochemical, immunophenotypic, genetic, and molecular examinations. Abnormal mast cells are characterized by the atypical morphology and pathological expression of CD25 and CD2 antigens. Enhanced serum tryptase activity is a common sign in all MC subtypes. More than 90% of the patients have D816V KIT mutations in the mast cells. This paper reviews the literature. Three cases are described as a clinical example in patients with different MC subtypes.

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Мастоцитоз (обзор литературы и описание клинических случаев). - Аннотация. Термин "мастоцитоз" объединяет группу редких заболеваний, характеризующихся опухолевой пролиферацией клональных тучных клеток (ТК) и инфильтрацией одного или нескольких органов. Клиническая картина мастоцитоза (МЦ) крайне разнородна - от поражений кожи, которые могут спонтанно регрессировать до агрессивных форм заболевания, ассоциированных с органной недостаточностью и короткой продолжительностью жизни. В настоящее время в классификации ВОЗ (версия 2008 г.) выделено 7 подтипов МЦ. Заболевание диагностируется на основании клинических проявлений и выявления инфильтратов опухолевых ТК с использованием морфологического, иммуногистохимического, иммунофенотипического, генетического и молекулярного методов. Аномальные ТК характеризуются атипичной морфологией и аномальной экспрессией антигенов CD25 и CD2. Повышение активности триптазы в сыворотке является общим признаком для всех подтипов МЦ. Более чем у 90% пациентов имеется мутация D816VKIT в ТК. В данной статье представлен обзор литературы. В качестве клинического примера приведены описания 3 клинических случая у пациентов с различными подтипами МЦ.
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