PMC5739150_01
A maculopapular telangiectatic rash on the patient's right breast.
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A 64-year-old woman had an 18-month history of a maculopapular telangiectatic rash on her right breast (Fig 1).
Skin biopsy at initial presentation of affected area on right breast shows mast cells highlighted by immunoperoxidase stain CD117 (c-kit).
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A skin biopsy of the rash was performed and histopathologic findings were consistent with CM (Fig 2), and considering the predominant maculopapular nature of the rash with only minimal telangiectasia, the diagnosis of UP was favored.
Basal serum tryptase increasing over time.
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Her basal serum tryptase increased (Fig 3).
Bone marrow aspirate from patient after symptom progression has clot section with mast cell aggregate admixed with small mature lymphocytes highlighted by immunoperoxidase stain CD117 (c-kit). Some mast cells have atypical spindle-shaped morphology.
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More than 25% of her mast cells were spindle shaped with atypical morphology (Fig 4).