Bone scan findings do not always correlate with x-ray or bone marrow biopsy results. Positive bone scans may be seen in patients with negative bone marrow biopsy, and not everyone with a positive bone marrow biopsy has a positive bone scan. X-ray may be normal in areas that show increased activity on a bone scan. While a reaction to the solution is rare, even in patients with mastocytosis, that possibility should always be considered, with epinephrine and other emergency measures immediately available. The diagnosis of systemic mastocytosis cannot be made or excluded on bone scan results alone.
Some physicians suggest that all adult-onset Mastocytosis patients have a bone marrow.
In systemic Mastocytosis, the mast cells are arranged in distinctive lesions. The increase of mast cell numbers in the bone marrow is significantly greater than in other conditions associated with increased bone marrow mast cells. Prior to the collection of the sample, it is important that the pathologist who will prepare and examine the bone marrow be consulted to ensure that it is processed promptly and correctly. Often, the characteristic staining properties of the mast cell granules are lost during routine staining procedures due to the decalcification process. Depending on the expertise of the facility, plastic embedding may not always provide clean results, so a second sample should be processed in paraffin sections to view as a backup.