{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T04:28:15Z","timestamp":1782534495176,"version":"3.54.5"},"reference-count":6,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2021,1,7]],"date-time":"2021-01-07T00:00:00Z","timestamp":1609977600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>A 79-year-old woman presented with a long history of peripheral eosinophilia. Previous right hemicolectomy for colonic polyposis was reported. Laboratory tests were notable for mild macrocitic anaemia and eosinophilia. \u03b22 microglobulin and serum tryptase levels were elevated. Serum immunofixation revealed IgA\/kappa monoclonal protein. Bence-Jones protein was positive. Bone marrow (BM) biopsy revealed the coexistence of two neoplastic components. Cohesive clusters of bland-looking, spindle-shaped mast cells, representing 20% of marrow cellularity, were close to aggregates of mature plasma cells occupying 40% of marrow cellularity. Molecular analysis on marrow aspirate demonstrated KIT D816V mutation, TET2 mutation, monoallelic deletion of TP53\/17p13 and trisomy of ATM\/11q23. A bone density study revealed mild osteoporosis. Full skeletal X-rays and magnetic resonance imaging (MRI) of spine and hips showed multiple, small rarefaction areas and an old L1-L2 fracture, both ascribed to osteoporosis. The association of systemic mastocytosis (SM) and multiple myeloma (MM) is very uncommon. The coexistence of SM with MM placed our patient in the SM with associated clonal haematological non-mast-cell lineage disease (SM-AHN) subtype. Midostaurin therapy was started.<\/jats:p>","DOI":"10.3390\/diagnostics11010088","type":"journal-article","created":{"date-parts":[[2021,1,8]],"date-time":"2021-01-08T08:58:34Z","timestamp":1610096314000},"page":"88","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Systemic Mastocytosis Associated with \u201cSmoldering\u201d Multiple Myeloma"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8733-9933","authenticated-orcid":false,"given":"Magda","family":"Zanelli","sequence":"first","affiliation":[{"name":"Pathology Unit, Azienda Unit\u00e0 Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Ricci","sequence":"additional","affiliation":[{"name":"Pathology Unit, Azienda Unit\u00e0 Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9841-7856","authenticated-orcid":false,"given":"Maurizio","family":"Zizzo","sequence":"additional","affiliation":[{"name":"Surgical Oncology Unit, Azienda Unit\u00e0 Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy"},{"name":"Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Sanguedolce","sequence":"additional","affiliation":[{"name":"Pathology Unit, Azienda Ospedaliero-Universitaria-Ospedali Riuniti di Foggia, 71122 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"De Giorgi","sequence":"additional","affiliation":[{"name":"Pathology Unit, Azienda Unit\u00e0 Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy"},{"name":"Pathology Unit, Dipartimento di Medicina e Chirurgia, Universit\u00e0 di Parma, 43125 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2299-5160","authenticated-orcid":false,"given":"Andrea","family":"Palicelli","sequence":"additional","affiliation":[{"name":"Pathology Unit, Azienda Unit\u00e0 Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Martino","sequence":"additional","affiliation":[{"name":"Hematology Unit, CREO, Azienda Ospedaliera di Perugia, University of Perugia, 06129 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Ascani","sequence":"additional","affiliation":[{"name":"Hematology Unit, CREO, Azienda Ospedaliera di Perugia, University of Perugia, 06129 Perugia, Italy"},{"name":"Pathology Unit, Azienda Ospedaliera S. Maria di Terni, University of Perugia, 05100 Terni, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,1,7]]},"reference":[{"key":"ref_1","unstructured":"WHO Classification of Tumours Editorial Board (2017). Tumours of Haematopoietic and Lymphoid Tissues, IARC. [4th ed.]."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e638","DOI":"10.1016\/S2352-3026(19)30166-8","article-title":"International Prognostic Scoring System for Mastocytosis (IPSM): A Retrospective Cohort Study","volume":"6","author":"Sperr","year":"2019","journal-title":"Lancet Haematol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1002\/ajh.25371","article-title":"Systemic Mastocytosis in Adults: 2019 Update on Diagnosis, Risk Stratification and Management","volume":"94","author":"Pardanani","year":"2019","journal-title":"Am. J. Hematol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1016\/j.leukres.2008.11.010","article-title":"Systemic Mastocytosis in Association with Plasma Cell Dyscrasias: Report of a Case and Review of the Literature","volume":"33","author":"Motwani","year":"2009","journal-title":"Leuk. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1007\/s002770050382","article-title":"A Case of Bone Marrow Mastocytosis Associated with Multiple Myeloma","volume":"76","author":"Hagen","year":"1998","journal-title":"Ann. Hematol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2008","DOI":"10.1172\/JCI114392","article-title":"Serum Levels of Interleukin 6, a Potent Myeloma Cell Growth Factor, as a Reflect of Disease Severity in Plasma Cell Dyscrasias","volume":"84","author":"Bataille","year":"1989","journal-title":"J. Clin. 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