Table 1

WHO classification of mastocytosis

Classification
1. CM 
 a. UP/MPCM 
 b. Diffuse CM 
 c. Solitary mastocytoma of skin 
2. ISM: Meets criteria for SM.* No C findings.* No evidence of associated clonal hematological nonmast cell lineage disease. 
 a. Smoldering SM: As above (ISM) but with 2 or more B findings, and no C findings.* 
 b. Isolated BM mastocytosis: As above (ISM) with BM involvement but without skin involvement. 
3. SM with an associated SM-AHNMD: Meets criteria for SM and criteria for AHNMD as a distinct entity per the WHO classification 
4. ASM: Meets criteria for SM. One or more C findings.* No evidence of mast cell leukemia. 
 a. Lymphadenopathic mastocytosis with eosinophilia 
5. MCL: Meets criteria for SM. BM biopsy shows a diffuse infiltration, usually compact, by atypical immature mast cells. BM aspirate smears show ≥20% mast cells. In typical MCL, mast cells account for ≥10% of peripheral blood white cells. Rare variant: aleukemic MCL. 
6. MCS: Unifocal mast cell tumor. No evidence of SM. Destructive growth pattern. High-grade cytology. 
7. Extracutaneous mastocytoma: Unifocal mast cell tumor. No evidence of SM. No skin lesions. Nondestructive growth pattern. Low-grade cytology. 
Classification
1. CM 
 a. UP/MPCM 
 b. Diffuse CM 
 c. Solitary mastocytoma of skin 
2. ISM: Meets criteria for SM.* No C findings.* No evidence of associated clonal hematological nonmast cell lineage disease. 
 a. Smoldering SM: As above (ISM) but with 2 or more B findings, and no C findings.* 
 b. Isolated BM mastocytosis: As above (ISM) with BM involvement but without skin involvement. 
3. SM with an associated SM-AHNMD: Meets criteria for SM and criteria for AHNMD as a distinct entity per the WHO classification 
4. ASM: Meets criteria for SM. One or more C findings.* No evidence of mast cell leukemia. 
 a. Lymphadenopathic mastocytosis with eosinophilia 
5. MCL: Meets criteria for SM. BM biopsy shows a diffuse infiltration, usually compact, by atypical immature mast cells. BM aspirate smears show ≥20% mast cells. In typical MCL, mast cells account for ≥10% of peripheral blood white cells. Rare variant: aleukemic MCL. 
6. MCS: Unifocal mast cell tumor. No evidence of SM. Destructive growth pattern. High-grade cytology. 
7. Extracutaneous mastocytoma: Unifocal mast cell tumor. No evidence of SM. No skin lesions. Nondestructive growth pattern. Low-grade cytology. 

ASM, aggressive systemic mastocytosis; MCL, mast cell leukemia; MCS, mast cell sarcoma; UP, urticaria pigmentosa; AHNMD, associated clonal hematological nonmast cell lineage disease.

*

See Table 2 for diagnostic criteria for systemic mastocytosis and definition of B and C findings.

Provisional categories.

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