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Gastrointestinal Manifestations in Systemic Mastocytosis: The Need of a Multidisciplinary Approach
SIMPLE SUMMARY: Mastocytosis is a group of neoplastic mast cell disorders ranging from a skin-limited disease to a systemic form with multi-organ involvement, including gut involvement. Clinical manifestations and outcome of systemic mastocytosis are variable. Symptoms may result from either release...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8269078/ https://www.ncbi.nlm.nih.gov/pubmed/34282774 http://dx.doi.org/10.3390/cancers13133316 |
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author | Zanelli, Magda Pizzi, Marco Sanguedolce, Francesca Zizzo, Maurizio Palicelli, Andrea Soriano, Alessandra Bisagni, Alessandra Martino, Giovanni Caprera, Cecilia Moretti, Marina Masia, Francesco De Marco, Loredana Froio, Elisabetta Foroni, Moira Bernardelli, Giuditta Alvarez de Celis, Maria Isabel Giunta, Alessandro Merli, Francesco Ascani, Stefano |
author_facet | Zanelli, Magda Pizzi, Marco Sanguedolce, Francesca Zizzo, Maurizio Palicelli, Andrea Soriano, Alessandra Bisagni, Alessandra Martino, Giovanni Caprera, Cecilia Moretti, Marina Masia, Francesco De Marco, Loredana Froio, Elisabetta Foroni, Moira Bernardelli, Giuditta Alvarez de Celis, Maria Isabel Giunta, Alessandro Merli, Francesco Ascani, Stefano |
author_sort | Zanelli, Magda |
collection | PubMed |
description | SIMPLE SUMMARY: Mastocytosis is a group of neoplastic mast cell disorders ranging from a skin-limited disease to a systemic form with multi-organ involvement, including gut involvement. Clinical manifestations and outcome of systemic mastocytosis are variable. Symptoms may result from either release of mast cell mediators or tissue infiltration by mast cell proliferation. Gastrointestinal symptoms are one of the major causes of morbidity in these patients. The diagnosis of gastrointestinal mastocytosis can be tricky, as symptoms often mimic other more common gastrointestinal diseases; the endoscopic appearance is often unremarkable or nonspecific and the infiltrate can be focal and subtle and easily missed unless special stains are used. This review aims to better define the gastrointestinal involvement in systemic mastocytosis, discussing potential diagnostic pitfalls and pointing out the importance of a multidisciplinary approach for a prompt diagnosis and treatment. ABSTRACT: Mastocytosis represents a heterogeneous group of neoplastic mast cell disorders. The basic classification into a skin-limited disease and a systemic form with multi-organ involvement remains valid. Systemic mastocytosis is a disease often hard to diagnose, characterized by different symptoms originating from either the release of mast cell mediators or organ damage due to mast cell infiltration. Gastrointestinal symptoms represent one of the major causes of morbidity, being present in 60–80% of patients. A high index of suspicion by clinicians and pathologists is required to reach the diagnosis. Gastrointestinal mastocytosis can be a challenging diagnosis, as symptoms simulate other more common gastrointestinal diseases. The endoscopic appearance is generally unremarkable or nonspecific and gastrointestinal mast cell infiltration can be focal and subtle, requiring an adequate sampling with multiple biopsies by the endoscopists. Special stains, such as CD117, tryptase, and CD25, should be performed in order not to miss the gastrointestinal mast cell infiltrate. A proper patient’s workup requires a multidisciplinary approach including gastroenterologists, endoscopists, hematologists, oncologists, and pathologists. The aim of this review is to analyze the clinicopathological features of gastrointestinal involvement in systemic mastocytosis, focusing on the relevance of a multidisciplinary approach. |
format | Online Article Text |
id | pubmed-8269078 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-82690782021-07-10 Gastrointestinal Manifestations in Systemic Mastocytosis: The Need of a Multidisciplinary Approach Zanelli, Magda Pizzi, Marco Sanguedolce, Francesca Zizzo, Maurizio Palicelli, Andrea Soriano, Alessandra Bisagni, Alessandra Martino, Giovanni Caprera, Cecilia Moretti, Marina Masia, Francesco De Marco, Loredana Froio, Elisabetta Foroni, Moira Bernardelli, Giuditta Alvarez de Celis, Maria Isabel Giunta, Alessandro Merli, Francesco Ascani, Stefano Cancers (Basel) Review SIMPLE SUMMARY: Mastocytosis is a group of neoplastic mast cell disorders ranging from a skin-limited disease to a systemic form with multi-organ involvement, including gut involvement. Clinical manifestations and outcome of systemic mastocytosis are variable. Symptoms may result from either release of mast cell mediators or tissue infiltration by mast cell proliferation. Gastrointestinal symptoms are one of the major causes of morbidity in these patients. The diagnosis of gastrointestinal mastocytosis can be tricky, as symptoms often mimic other more common gastrointestinal diseases; the endoscopic appearance is often unremarkable or nonspecific and the infiltrate can be focal and subtle and easily missed unless special stains are used. This review aims to better define the gastrointestinal involvement in systemic mastocytosis, discussing potential diagnostic pitfalls and pointing out the importance of a multidisciplinary approach for a prompt diagnosis and treatment. ABSTRACT: Mastocytosis represents a heterogeneous group of neoplastic mast cell disorders. The basic classification into a skin-limited disease and a systemic form with multi-organ involvement remains valid. Systemic mastocytosis is a disease often hard to diagnose, characterized by different symptoms originating from either the release of mast cell mediators or organ damage due to mast cell infiltration. Gastrointestinal symptoms represent one of the major causes of morbidity, being present in 60–80% of patients. A high index of suspicion by clinicians and pathologists is required to reach the diagnosis. Gastrointestinal mastocytosis can be a challenging diagnosis, as symptoms simulate other more common gastrointestinal diseases. The endoscopic appearance is generally unremarkable or nonspecific and gastrointestinal mast cell infiltration can be focal and subtle, requiring an adequate sampling with multiple biopsies by the endoscopists. Special stains, such as CD117, tryptase, and CD25, should be performed in order not to miss the gastrointestinal mast cell infiltrate. A proper patient’s workup requires a multidisciplinary approach including gastroenterologists, endoscopists, hematologists, oncologists, and pathologists. The aim of this review is to analyze the clinicopathological features of gastrointestinal involvement in systemic mastocytosis, focusing on the relevance of a multidisciplinary approach. MDPI 2021-07-01 /pmc/articles/PMC8269078/ /pubmed/34282774 http://dx.doi.org/10.3390/cancers13133316 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Zanelli, Magda Pizzi, Marco Sanguedolce, Francesca Zizzo, Maurizio Palicelli, Andrea Soriano, Alessandra Bisagni, Alessandra Martino, Giovanni Caprera, Cecilia Moretti, Marina Masia, Francesco De Marco, Loredana Froio, Elisabetta Foroni, Moira Bernardelli, Giuditta Alvarez de Celis, Maria Isabel Giunta, Alessandro Merli, Francesco Ascani, Stefano Gastrointestinal Manifestations in Systemic Mastocytosis: The Need of a Multidisciplinary Approach |
title | Gastrointestinal Manifestations in Systemic Mastocytosis: The Need of a Multidisciplinary Approach |
title_full | Gastrointestinal Manifestations in Systemic Mastocytosis: The Need of a Multidisciplinary Approach |
title_fullStr | Gastrointestinal Manifestations in Systemic Mastocytosis: The Need of a Multidisciplinary Approach |
title_full_unstemmed | Gastrointestinal Manifestations in Systemic Mastocytosis: The Need of a Multidisciplinary Approach |
title_short | Gastrointestinal Manifestations in Systemic Mastocytosis: The Need of a Multidisciplinary Approach |
title_sort | gastrointestinal manifestations in systemic mastocytosis: the need of a multidisciplinary approach |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8269078/ https://www.ncbi.nlm.nih.gov/pubmed/34282774 http://dx.doi.org/10.3390/cancers13133316 |
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