Mediastinal Germ Cell Tumor Associated with the Hemophagocytic Syndrome

The hemophagocytic syndrome is a reactive disorder of the monocyte-macrophage system characterized clinically by an acute onset, fever, lymphadenopathy, hepatosplenomegaly, and pancytopenia (1). The he-mophagocytic syndrome can be differentiated from malignant histiocytosis by a potentially self-limited clinical course and by histologic findings of general-ized monocyte-macrophage proliferation with promi-nent hemophagocytosis but without features of malig-nancy (1, 2). The hemophagocytic syndrome has been reported in association with infections (1) , non-Hodg-kin lymphoma (2) , Hodgkin disease (3) , chronic lym-phocytic leukemia (4) , acute lymphocytic (5) and nonlymphocytic (6) leukemias, and gastric carcinoma (7).