Transcription
Hey guys, it's Medicos is Perfection Ellis once again. Today's topic is aggressive versus indolent non-Hodgkin's lymphoma. So let's get started.
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In the previous video, we have talked about non-Hodgkin's lymphoma. So make sure to watch that previous video before this one. Lymphoma, Hodgkin's or non-Hodgkin's, which one is more common? Of course, non-Hodgkin's. Which one is only nodal? Hodgkin's. Non-Hodgkin's has nodal and extra-nodal. It has constitutional symptoms. Could be B-cell or T-cell. Which one is more common? Of course, B-cell. And again, B-cell is either aggressive or indolent.
How about Hodgkin's lymphoma? Hodgkin's lymphoma has the Reed-Sternberg cell. If you don't find the Reed-Sternberg cell, it's non-Hodgkin's. We have risk factors for non-Hodgkin's lymphoma. We have talked about them briefly in the previous video, but today let's just elaborate. We have viruses such as Epstein-Barr virus, can lead to Burkitt's lymphoma, diffuse large B-cell lymphoma, or primary CNS lymphoma. Human T-cell lymphoma virus 1, human T-cell leukemia or lymphoma. We have talked about this in a previous video. Hepatitis C virus can lead to B-cell lymphoma. Or any logical risk factors could be either autoimmune disease or immune deficiency syndrome. Autoimmune such as Sjogren's, salivary lymphoma, GI lymphoma, or Hashimoto leading to thyroid lymphoma. Radiation exposure can lead to non-Hodgkin's lymphoma. By the way, we use radiation to treat Hodgkin's lymphoma, and this radiation therapy can lead to non-Hodgkin's. So you're trying to cure Hodgkin's lymphoma, but now you end up with non-Hodgkin's lymphoma. What a miserable life. H. pylori can lead to gastric lymphoma, it's MALT (mucosa-associated lymphatic tissue) lymphoma or MALToma.
Non-Hodgkin's lymphoma, nodal plus extra-nodal, could be liver or spleen, GI tract, thyroid, testes, can brain, rarely bone. But don't forget bone because non-Hodgkin's lymphoma can have a leukemic phase. Constitutional items or B symptoms such as fever, weight loss, night sweats, again associated with these viruses. Some lymphomas cause compression syndrome. Some lymphomas have IgM leading to hyperviscosity or autoimmune cytopenias. Others have agammaglobulinemia leading to infections. By the way, Hodgkin's lymphoma, there is no extra-nodal spread. Huge difference.
As you know, non-Hodgkin's lymphoma is the second most common cancer in AIDS patients. Again, it's a late manifestation. Non-Hodgkin's lymphoma can take place after organ transplant, immunosuppressed patients, or in congenital immunodeficiency. What's common here is decreased immunity. Median age is 50 years old, and the older you get, the higher risk of developing non-Hodgkin's lymphoma.
Now contrast that with Hodgkin's lymphoma, because Hodgkin's lymphoma, the patients are younger, usually young adults. Non-Hodgkin's lymphoma again has an overt leukemic phase because it can involve the bone marrow. It's a terrible bone marrow here, and cancer cells can be seen in the blood. Contrast that with Hodgkin's lymphoma, as Hodgkin's lymphoma has no leukemic phase whatsoever. Why is that? Because Hodgkin's lymphoma doesn't have extra-nodal involvement. It doesn't spread to the bone marrow.
Now, non-Hodgkin's lymphoma can be either intermediate or high grade, also known as aggressive, or low grade, also known as indolent, lazy, slow. Let's first start with the aggressive intermediate to high-grade lymphoma. A Shannara usually younger, they have more B symptoms such as fever, weight loss, night sweats, very sensitive to chemo, and we treat with the intention to cure. Does that mean that we cure all the cases? Of course not. It's an aggressive lymphoma. The median survival rate is short, probably one to two years, and then the patient unfortunately will die. Low-grade lymphoma patients are older, fewer B symptoms, higher stages presentation, sensitive to chemo, but not curable lesions by chemo. The median survival rate is long, seven to ten years, okay? And they can change or upgrade into the other type called the aggressive non-Hodgkin's lymphoma.
And here are the specific subtypes. Aggressive such as diffuse large B-cell, Burkitt's lymphoma, mantle cell lymphoma, precursor T lymphoblastic, and B lymphoblastic. The indolent are follicular, marginal zone, CLL or SLL, hairy cell leukemia lymphoma, Waldenstrom macroglobulinemia, and mycosis fungoides. Of the aggressive lymphomas, which one is the most common? And the answer is diffuse large B-cell lymphoma. We can write it like this: diffuse large B-cell lymphoma, in short. From the indolent, which one is more common? The answer is follicular lymphoma.
Let's just imagine for the sake of imagination that Aladdin's Genie has appeared to you and told you that you have been cursed by gods and you'll get a lymphoma. Which one of them will you choose? Follicular, diffuse large B-cell lymphoma, or Burkitt's lymphoma? Of course, you should choose follicular lymphoma. Why? It's indolent. Does that mean it's a good thing to have? Of course not. It's a terrible thing to have, but compared to diffuse large B-cell and Burkitt's, it's the least evil choice. Thank you, Genie.
And that's it for today. Again, don't forget non-Hodgkin's lymphoma could be either the aggressive subtypes or the indolent subtypes. These are bad, these are less bad. They grow very fast. The median survival rate is low here. The median survival rate is higher here. The most common one is diffuse large B-cell lymphoma, and the most common indolent is the follicular lymphoma. Don't ever forget that. That's it for today. Thank you so much for watching. This is me, the coaster perfection Alice. As always, be safe, stay happy, and study hard until next time.