Hematopoietic precursor cells within the yolk sac tumor component are the source of secondary hematopoietic malignancies in patients with mediastinal germ cell tumors
✍ Scribed by K. C. Lee; Attilio Orazi; Richard S. Neiman; Thomas M. Ulbright; Craig R. Nichols
- Publisher
- John Wiley and Sons
- Year
- 1994
- Tongue
- English
- Weight
- 229 KB
- Volume
- 73
- Category
- Article
- ISSN
- 0008-543X
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✦ Synopsis
Orazi et al.' reported data on six patients with secondary leukemia who were seen initially with mediastinal germ cell tumor. They hypothesized that the leukemias are derived from pluripotent stem cells found in the yolk sac tumor component. Given the discovery of a marrow stem cell that can give rise to both hematopoietic and mesenchymal elements,* it is conceivable that a single stem cell in the proper environment, such as the mediastinum, can develop along germ cell lines to result in the primary tumor. Subsequently, as a result of changes in the microenvironment, the same stem cell can be enticed into developing along hematopoietic lines to result in a leukemia. If this is true, an alternate interpretation of their data might be that both the mediastinal germ cell tumor and the leukemia result from clonal development from a single stem cell, that is, an example of monophyletic differentiation as the stem cell adapts genetically, in response to two different signals in its environment, to express two distinct phenotypes in the form of a germ cell tumor and a leukemia. In this regard, it is interestirg to note the concordance in i(12p) and p53 in their patients.