- 50s to 80s
- Bone marrow involvement in 90%
- Often asymptomatic
- Sometimes thoracic and lumbar pain, arthralgia
- Associated with myelodysplastic syndrome, myeloproliferative neoplasia, leukemia, lymphoma
- Findings due to direct effect of mast cells and indirect effect of histamine, heparin, prostaglandins
- Osteolytic and osteosclerotic lesions
- Diffuse or focal
- 4-5 mm lytic lesions with sclerotic rim seen in spine, ribs, skull, pelvis, tubular bones
- Diffuse osteopenia
- Osteosclerosis: trabecular thickening, cortical thickening, reduced marrow space
- MRI signals depend on extent of marrow fibrosis. Usually T1 low and T2 high
- PET/CT shows FDG uptake in bone marrow, lymph nodes and spleen
Avila, Nilo A., et al. “Systemic mastocytosis: CT and US features of abdominal manifestations.” Radiology 202.2 (1997): 367-372.
Fritz, J., et al. “Advanced imaging of skeletal manifestations of systemic mastocytosis.” Skeletal radiology 41.8 (2012): 887-897.