A 44-year-old woman had neck and lower back pain, watery diarrhea, and episodes of flushing. A 44-year-old woman presented with a one-year history of neck and lower back pain. The neck and back pain had worsened over the previous two months and was associated with new symptoms of drenching night sweats, watery diarrhea, and episodes of flushing. Magnetic resonance imaging (MRI) of the spine revealed abnormal signal in the C6 and T11 vertebral bodies, findings that suggested the possibility of infiltrative or metastatic disease (Panel A, arrows). A biopsy of the C6 vertebral abnormality revealed perivascular spindle cells that stained strongly for tryptase, suggesting a diagnosis of systemic mast-cell disease. The values for serum tryptase.
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