Hey guys, how are things? I'm so excited today to continue our discussion on hematology.

And today, it's time.. for Hodgkin's lymphoma

As you know,

Hematological malignancies are leukemias, lymphomas, or myeloma

Lymphoma: is a solid tumor of the lymphatic system, or lymphoid tissue such as: lymph node, spleen

Mucosa-associated lymphatic tissue,...etc

Lymphoma is divided into Hodgkin's lymphoma, and non-Hodgkins lymphoma. Hodgkin's is less common than non-hodgkin's.

Hodgkins is a local disease, with Reed Sternberg cells.

So, imagine that the genie appeared to you and told you: "you have been cursed by a lymphoma"!

Which one should you choose? -Of course, You should choose...

Hodgkin's lymphoma, because it's less evil than non-Hodgkin's. your chance of

survival with Hodgkins is better than that with non-Hodgkins lymphoma.

Represents 40 percent of adult lymphoma. Commoner in males than females, with the exception of nodular sclerosing subtype.

remember roses for the female (Mnemonic: sclerosis = roses = female)

More common in Caucasian. Has bimodal age distribution;

The first peak is around 15 to 34 years of age and

the second peak; to patients older than 50 years of age.

Patients of Hodgkin's disease are usually younger than those of non-hodgkin's

So Hodgkin's is a disease of the young!

Usually starts in the cervical lymph nodes causing cervical lymph adenopathy, which is painless.

HIV patients have higher risk of Hodgkin's disease and

Hodgkin's is associated with a defect in cell mediated immunity

Did you know that exposure to benzene can lead to Hodgkin's lymphoma?

Exposure to benzene can lead to acute leukemia as well

Hodgkin's disease has a complication of causing acute lymphoblastic leukemia

Hodgkin's is associated with Epstein Barr virus

Hodgkin's is more common in patients with

History of mono because it makes perfect sense since infectious mononucleosis

is

with epstein-barr virus (EBV)

Contiguous spread is

common in Hodgkin's lymphoma.

Which means from this lymph node to this lymph node to the next lymph node to the next one node in the same local area

This is different from non Hodgkin's lymphoma,

Where there is distant spread.

There is lymphadenopathy in Hodgkin's, absolutely. It's localized and it's painless remember painful infection?

painless malignancy

Secondary amyloidosis; the serum amyloid A protein or SAA protein.

Hodgkin's

can be treated youth using

Radiation which will lead to non Hodgkin's so you're trying to treat Hodgkin's using radiation

But now you end up with non-Hodgkin's. Talking about misfortune!!!

The classification of Hodgkin's is nodular lymphocyte predominance or

Classic Hodgkin's. Classic Hodgkin's is more common

Classic Hodgkin's has four subtypes:

Nodular sclerosis is by far the most common; it's commoner in females

roses

lymphocyte rich, mixed cellularity

Lymphocyte depleted: they're the worst subtype. So let's talk more about these subtypes.

You have nodular lymphocyte predominance?

5% of cases and carries good prognosis

nodular sclerosis the most common subtype

Females more than males roses

women and

Children are the typical patients. It's the most common subtype of the classic Hodgkin's

Anterior mediastinal nodes are often involved.

It has an excellent prognosis...the best prognosis all of all of these are the nodules chlorosis.

It has the lacunar type reed Sternberg so which is a reed Sternberg sole variant

Lymphocyte rich, it's rich. So it carries very good prognosis

Lymphocyte depleted on the other hand it's depleted. So it has the poorest survival bad prognosis

it's the most aggressive of one and

Thankfully, it's the least common it's depleted. Okay

Mixed cellularity the name has the answer. It has more than one cell it has if Sinha fills plasma cells

histiocytes

etc a disease of the elderly

Abdominal lymph nodes and spleen are often involved

So remember nodular sclerosis commoner and females good prognosis lymphocyte

Rich, very good prognosis a lymphocyte depleted very bad prognosis mixed cellularity more than one cell

There is a genetic component to Hodgkin's disease

Nuclear factor Kappa light chain. It's is a transcription factor. It will undergo

Activation by epstein-barr virus or other factors now we turn the switch on

Genes that promote proliferation are now on leading to proliferation proliferation proliferation

proliferation which is cancer

Now, let's turn our attention to lymph adenopathy in Hodgkin's disease. It's localized

It's painless

It starts in the cervical nodes the supraclavicular and the interior

Mediastinal are also common. If you do a biopsy to this lymph node, and we use a core needle biopsy

Never use fine needle aspiration. We need a core needle biopsy for lymphoma

Ungrown appearance. You'll have bulging fish flesh appearance rubbery

inconsistency a good pathologist can

feel the lymph node and

Tell this is very rubbery

I can tell it's gonna be Hodgkin's it takes a slice put it under the microscope and Wow

Here we have the Reda Sternberg cell and we confirm the diagnosis of Hodgkin's lymphoma

That's a good pathologist that uses all of his senses to diagnose the disease and instead of just like a lab technician

Just reads rumors all therefore Hodgkiss. No medicine is an art

Microscopic appearance, there is Sternberg. So which are positive for CD 15 and CD 30?

Here's a side note. Did you know causes of mediastinal masses are the famous forties?

Thyroid mass thymoma

Teratoma and terrible lymphoma the terrible lymphoma is Hodgkin's which subtype?

Nodular sclerosis, and usually the patient is a female

Lymphoma in the mediastinum only too short of breath and dry cough. Clinically. We have lymph adenopathy

We have fever the fever comes the fever goes the fever comes the fever goes

Comes and goes in a cyclical manner we call this Pelle Epstein fever

itching is common splenomegaly, but not massive contrast that with

CML that had massive splenomegaly

nephrotic syndrome is common, especially

Minimal change disease think about it minimal change disease is a disease of the young

Hodgkin's disease the disease of the young they go together

Obstructive jaundice of lymph adenopathy involve that porta hepatis, which is the door of the liver

skin, erythema, nodosum

CNS cerebellar degeneration

autoimmune hemolytic anemia

Yes in Hodgkin's disease as well as CLL

Pain and lymph nodes on alcohol consumption is a very specific sign. It's not sensitive

It's not common, but it's very specific Epstein Barr virus can cause

Hodgkin's disease as well as non-hodgkins lymphoma it

commonly causes

non-hodgkins lymphoma even more than Hodgkin's

cancer caused by EBV nasopharyngeal carcinoma

Burkitt's lymphoma Hodgkin's lymphoma primary CNS lymphoma post organ transplant lymphoma the evil Epstein Barr

So today we have finished talking about Hodgkins in the next videos. We will talk about diagnosis and treatment reached cerebrum

So mnemonic about Hodgkins case not only one case but 10 cases

Or 10 questions on Hodgkins then a quick review

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Stay happy and study hard medicos is perfection Alice