Cytologic Studies of Tumors. L. Clonal Proliferation of Four Stemlines in Three Hematopoietic Tissues of a Patient With Reticulosarcoma

A case of reticulosarcoma was found to have four chromosomally different stem-lines in peripheral blood, lymph node and bone marrow. The four lines are recognized to be of monoclonal origin on the basis of the closely allied karyotypes characterized by trisomy for E₁₆, E₁₇ and E₁₅, the loss of one A₁, two F and two to four C elements in addition to M and R markers. The markers characterize three kinds of hematopoietic tissues: an M₁, R₁, R₂ line occurs in lymph node, and an M₁, M₂, M₃, R₁ line in peripheral blood and M₁, M₄ and M₁, M₂, M₃ lines in bone marrow. Cytogenetic variability of malignant cells was highest in peripheralblood. Information was provided to suggest that of the four stemlines, the lymph node line may be original, the peripheral blood line may be a derivative of the lymph node line and, finally, two marrow lines may have originated from the blood line or from one of the mutated cells slightly different from the marrow lines. The M markers were discussed in relation to malignant evolution of hematopoietic cells of this patient. The suggestion was made that the chromosomes of the patients with malignant hematopoietic disorders should be examined in different tissues.