Lymphadenopathy: Lymphoid Neoplasms – White Blood Cell Pathology

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.