00:02
When the time is right,
we’ll walk through lymphoid
cancer or lymphoid neoplasia.
00:08
The way that we’ll approach
lymphoid neoplasia
is that we will divide
this into, well, at first,
it’s important that we pay
attention to ALL and CLL.
00:18
Let me stop here.
00:20
And I want to make sure that you
understand the significance of this.
00:23
I don’t want you to just
memorize, you know that of me.
00:26
The more you understand this,
the better off you’ll be
so that you cannot get fooled by any
question or case that is thrown your way.
00:34
If your patient develops leukemia,
the youngest of the
leukemias will be ALL.
00:41
And the median age of
70 some will be CLL.
00:46
These are some very
common leukemias.
00:49
"But, Dr. Raj, that says
lymphoid neoplasia."
"Why are you discussing
leukemia under this?"
Let me tell you.
00:57
If it’s a leukemia,
the origin of leukemia
is going to be the bone marrow in
which it spills out into blood.
01:06
-emia means blood.
01:08
At some point,
don’t you think that these leukemic
cells might then enter the lymph node?
Yes, they can.
01:15
So now, you have a leukemia
that has caused what?
A lymphoma.
01:20
Oftentimes, CLL -- and I will
talk about this later on.
01:24
CLL will be associated
always with SLL, won’t it?
The CLL is the leukemic
version of your SLL.
01:32
The SLL is the lymphoma
version of your CLL.
01:36
Hence, we have leukemias that oftentimes
will present with non-tender --
non-tender.
01:42
It doesn’t hurt.
01:43
“Hey, doc, I have a
lump in my neck.”
Does it hurt?
"No."
Lymphomas.
01:49
Technically now, with lymphomas,
meaning to say you have a cancer
that originated in the lymph node,
this then brings us into a
category or categories of
Hodgkin versus non-Hodgkin lymphoma.
02:04
What does Hodgkin mean to you?
You reflexibly should be
thinking histologically
different types of
Reed-Sternberg cell.
02:10
The point being is if you see
Reed-Sternberg, it means Hodgkin.
02:16
If you do not see Reed-Sternberg,
it’s non-Hodgkin.
02:20
If you look at lymphoma, diffuse large
B-cell lymphoma, Burkitt lymphoma
make up a pretty big, big percentage
of our non-Hodgkin’s lymphoma,
you add in there CLL,
you pretty much know all of
your non-Hodgkin’s lymphoma.
02:36
How can you add in your CLL?
Remember, once again, you can have leukemic
cells that go into your lymph node
and present as a lymphoma.
02:44
And do you find
Reed-Sternberg cells in CLL?
Not at all.
02:47
Remember, you’ll find smudge
cells, cracked chromatic,
which you will never
find in Reed-Sternberg.
02:53
What if you did find Reed-Sternberg?
Then you call this a Hodgkin lymphoma.
02:57
You call this a Hodgkin lymphoma.
02:59
And we’ll talk about different types
of Reed-Sternberg including classic,
including monocytic, and
so on and so forth.
03:06
Our topic at this point
is lymph node neoplasia.
03:10
Plasma cell disorders,
especially, let’s say Waldenstrom.
03:15
Waldenstrom is also called
lymphoplasmacytic lymphoma.
03:21
And when the time is right,
we will compare and contrast
multiple myeloma with Waldenstrom.
03:27
Let’s continue.