Nichols C R, Hoffman R, Einhorn L H, Williams S D, Wheeler L A, Garnick M B
Ann Intern Med. 1985 May;102(5):603-9. doi: 10.7326/0003-4819-102-5-603.
Three men with primary mediastinal germ-cell tumors subsequently developed a malignant hematologic disorder characterized by pancytopenia and marrow infiltration with hematopoietic blast cells. Two of these patients were classified as having acute megakaryocytic leukemia and the third was believed to have a myelodysplastic syndrome with a prominent megakaryocytic component. Analysis of clinical characteristics of these patients and review of the literature suggest that the proximate association of mediastinal germ-cell tumors with malignant hematologic disorders is neither a coincidence nor a consequence of chemotherapy given for the germ-cell tumor. We believe this association represents the evolution of a neoplastic disorder that initially involves a totipotent germ cell. These germ cells, when located in the mediastinum, apparently acquire hematologic phenotypes and are manifested clinically as a hematologic malignancy.
三名原发性纵隔生殖细胞肿瘤患者随后发生了一种恶性血液系统疾病，其特征为全血细胞减少以及造血母细胞浸润骨髓。其中两名患者被归类为急性巨核细胞白血病，第三名患者被认为患有以显著巨核细胞成分为特征的骨髓增生异常综合征。对这些患者的临床特征分析以及文献回顾表明，纵隔生殖细胞肿瘤与恶性血液系统疾病的密切关联既不是巧合，也不是针对生殖细胞肿瘤进行化疗的结果。我们认为这种关联代表了一种肿瘤性疾病的演变，该疾病最初涉及一个全能生殖细胞。这些生殖细胞位于纵隔时，显然获得了血液学表型，并在临床上表现为血液系统恶性肿瘤。
