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Lymphadenopathy: Non-Hodgkin Lymphoma (NHL) – White Blood Cell Pathology

by Carlo Raj, MD
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    00:01 Under non-Hodgkin’s lymphoma, in general, most of your non-Hodgkin’s lymphoma will be in B-cell origin.

    00:09 T-cell origin is extremely rare.

    00:13 Usually presents with widespread lymphadenopathy and what we’ll do we’ll compare and contrast non-Hodgkin versus Hodgkin’s lymphoma.

    00:21 You have something called B symptoms that you want to very much be aware of.

    00:25 Your B symptoms include night sweats, weight loss, and fever.

    00:29 Doesn’t this sound like a presentation of tuberculosis? Very much so.

    00:34 However, one has nothing to do with the other.

    00:37 Not only can you find B symptoms with non-Hodgkin’s lymphoma, but you would also find it with Hodgkin’s lymphoma.

    00:43 That has to be kept in mind.

    00:45 And by the way, when you think about lymphoma, apart from non-Hodgkin’s being B-cell, so are Hodgkin’s.

    00:52 Hodgkin’s lymphoma, that Reed-Sternberg cell, is a variant of a B-Cell.

    00:59 I will continue comparing and contrasting NHL, non-Hodgkin’s lymphoma, with Hodgkin’s.

    01:05 In non-Hodgkin’s lymphoma, the spread of your cancer will be non-contiguous.

    01:15 What does that even mean? Meaning to say that the lymph node that are being affected in non-Hodgkin’s lymphoma, maybe cervical lymph node may then spread down to, well, let’s say down in the abdominal, so on and so forth, meaning to say it’s not spreading in sequential order.

    01:31 Whereas if it is going to be Hodgkin’s lymphoma, maybe it will be the cervical and mediastinal involvement and that has contiguous spread.

    01:41 Non-Hodgkin’s, non-contiguous.

    01:45 In non-Hodgkin’s, you would have extranodal involvement to be quite common.

    01:50 In Hodgkin’s lymphoma, the extranodal involvement would be extremely rare.

    01:55 Example for this would be, at some point, we’ll talk about diffuse large B-cell lymphoma, which is a non-Hodgkin lymphoma.

    02:02 And oftentimes is associated with the gut in the GI system.

    02:07 And there will be an extranodal involvement of diffuse large B-cell lymphoma.

    02:10 And, yes, you heard correctly, it’s a B-cell lymphoma in the GI.

    02:18 The non-Hodgkin lymphoma, the CD stands for cluster differentiation.

    02:22 The cell surface markers used in flow, which is something that you are extremely familiar with from immunology.

    02:29 If not, please become familiar.

    02:32 And immunohistochemistry analysis to subtype the lymphoma and leukemia .

    02:36 And so therefore, like flow, you have an X and Y axis and depending as to what that marker might be for example, you definitely want to know 19 and 20 as being B-cell markers.

    02:46 You want to know lower grades of CD as being T-cell markers, especially CD 5, and CD 138 would represent kappa, lambda and kappa much more so and these are your plasma cells markers, welcome to? Good.

    03:01 Multiple myeloma and perhaps Waldenstrom.

    03:05 We’ll talk more about that CD 5 when the time is right so that you can properly rule out certain cancers.


    About the Lecture

    The lecture Lymphadenopathy: Non-Hodgkin Lymphoma (NHL) – White Blood Cell Pathology by Carlo Raj, MD is from the course Lymphadenopathy – White Blood Cell Pathology (WBC).


    Included Quiz Questions

    1. Multiple myeloma
    2. B-cell lymphoma
    3. Acute lymphoblastic leukemia
    4. Chronic myeloid leukemia
    5. Hodgkin’s lymphoma
    1. Fever, night sweats, and weight loss
    2. Night sweats, vertigo, blurred vision
    3. Fever, vomiting, leg cramps
    4. Nausea, vertigo, weight loss
    5. Fever, vertigo, weight loss

    Author of lecture Lymphadenopathy: Non-Hodgkin Lymphoma (NHL) – White Blood Cell Pathology

     Carlo Raj, MD

    Carlo Raj, MD


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