today we are starting a series of lectures on lymphomas and leukemias right we are going to talk about lymphomas and leukemias and Yuki Mia's right so before we really go into detail we should know what's the difference between lymphoma and leukemias anyone who has a clear concept what's the difference in between them for mine leukemia yes right so she's saying lymphoma start from lymphoid tissue and leukemia start from bone marrow anyone has a better definition anyone has a better definition what is the difference in them for mine leukemia yes there's a very big difference she has not mentioned what is the real big mega big difference between lymphoma and leukemia anyone please yes you want to say something or you are just scratching your head okay he is coming with another definition he's saying lymphomas are going to be B cells or T cells you think live for mother made of lymphocyte and what about leukemia according to your concept neutrophils another self okay I remember this is wrong right why I put this question because I want to make clear in your mind very clear crystal clear what is the difference in lymphoma and leukemia before we delve into detail of this topic lymphomas are lymphomas are solid cohesive tumors of immune system what are lymphomas them for mother solid cohesive tumors of immune system is that right these are solid cohesive neoplasms of immune system right now lymphomas originate classically from lymphoid tissue but rarely they may originate from even central nervous system in HIV infection patient with AIDS you develop them form and central nervous system is that right so what I'm saying that lymphomas are basically solid cohesive neoplasms our immune system classically are typically they originate from lymphoid tissue what are leukemias leukemias are malignancies of Hamato poetic precursor cells leukemias are malignancies of natto poetic this is bone marrow house leukemias are malignancies of hematopoietic yes rata body precursor cells which very often spill into circulation that's very important they're from bone marrow house leukemias start leukemia start from bone marrow house what really happens you know that in bone marrow and metabolic cells they undergo proliferation and differentiation right somewhere during proliferative process and differentiated process some cells are arrested in there further differentiation right and they just keep on proliferating proliferating and eventually spilling to fall into circulation right so leukemic cells classically start from the bone marrow they are milling in neoplasms of metabiotic precursor cells and the don't make make cohesive says they are not having so many adhesion molecules as lymphoma has right so don't they don't stick to each other the way lymphomas take that is the very difference due to that reason eventually they spill into circulation right and due to this reason leukemic cells we start from bone marrow eventually increase total might not cell count on the blood peripheral circulation you have lot of leukemic cells now this is this was the original concept about lymphomas and leukemias and then I have a medical student doctors were very start that they knew the differences in lymphomas and leukemias and they always treated them as separate category but very recently in medical sciences most of the things are getting clear but these two things are getting blood as they studied the behavior of lymphomas they came to know some of the lymphoma can go into leukemic phase what I mean by this let's suppose a lymphoma start from a lymph node right limb for miles suppose this is lymphoma and this lymphoma start from a lymph node for many years it keep on proliferating in lymphoid tissue and keep on making us solid mass sometimes as you know during uncle Genesis more and more mutations may occur in neoplastic cells so sometimes in limbs for myself due to more accumulated mutations they lose the ability to remain cohesive and light leukemia even lymphoma cells may spill into circulation the doctor said okay some of the lymphomas at some advanced stage may go into leukemic phase they may go into leukemic phase right this was one reading and other reading which they made was that sometimes suddenly ukhimath cells may go into a lymph node or lymphoid tissue Lu Kim itself started from the bone marrow went to the circulation metastasized into many tissue as leukemic cells but sometimes leukemic cells enter into lymphoid tissue and underwent some further transformation and they became sticky to each other started making of solid masses so they thought okay sometimes it is quite possible that lymph leukemic cells sometimes not always may enter into some lymphoid tissue and there they may live for Metis mass and due to this reason modern oncology we say that concept about distinction in lymphoma and leukemia is not very clear lymphomas may go into leukemic phase and leukemias may go into some pain lymphoma does change in some tissue right and now after telling you this thing I will tell you the most important thing about limb from modern leukemias especially when we talk about lymphoid tissues lymphoid neoplasms come back now for mother of course always with a limb fired because immune system is a limb fired but leukemias may be lymphoid or very my light let's start with the pluripotent stem cell this is pluripotent stem cell right it will go into two stem cells which are lymphoid stem cell and yes myeloid stem cell you know lymphoid stem cells will eventually go into yes these cells through the thymus yes t-cells what else please lymphoid stem cells what else they make these cells B cells and natural killer cells is that right now my light cells made which products my light cells made which product here set red blood cells platelets and all other white cells except lymphocytes this is that right now it means the malignancies from the myeloid side right we start from the bone marrow and eventually spill into circulation they will be called my light leukemias is that right but those malignancy which start with the bone marrow and originate originally from lymphoid stem cell and eventually spill into circulation they will be called lymphoid leukemias lymphoid leukemias what I want to put in your mind that leukemias can be my light or lymphoid right but lymphomas are always lymphocytes related just not right now again further going into detail the latest latest tendency is not to diagnose that a particular cancer cell of lymphoma or leukemia is present in which tissue no there's something more important than that again old concept was that we should know that lymphoma or leukemia cells they are infiltrating which tissues and according to that we were trying to differentiate them and treat them modern trend is not that one modern trend is that we don't bother much that particular leukemic all lymphoma Tercel is present in which tissue no the most important thing from prognosis viewpoint from treatment viewpoint and clinical presentation viewpoint the most important thing is that the cell tumor cell either it is a lymphoma or leukemia either it is lymphoma leukemia a specific tumor cell what it is is it B cell or T cell right because these cells tumors behave differently T cells tumors bear differently then they have to see what are the underlying karyotype ik changes right within the neoplastic cell what are the chromosomal abnormalities founded that different tumors with different kgo typique abnormalities respond better to different drugs right so those days are gone when main specific interests was is ritalin for more leukemia these days the real interest is in these malignancy what are these cells are the T cells are the B cells if they are B cell are the precursor the precursor B cells or are the mature B cells or are they immuno blasts or are the central blast is the right so that is very important then we have to see what are the translocation in that and we have to identify the tumor not only at the site in the body we have to identify the tumor cell with its region and with its phenotype and of course with its karyotyping and molecular abnormalities that determines the prognosis and that determines the treatment am i clear okay after this basic thing now we start about lymphoid tumor right violet tomb of the another tumors we'll talk later lymphoid tumors there is a there was a classification which was called real classification of tumors real stands for what yes real classification real stands really for what revised European American lymphomas classification is that right this was the original classification and with little more modification with little more modification now they are calling this the latest name of this classification is World Health Organization classification of lymphomas or lymphoid tumors again old classification was the real classification revised European American lymphoid tumors classification with some more modification now then ended up with the latest classification is called World Health Organization classification now let me tell you according to that classification lymphoid tumor broadly categorized into four categories lymphoid tumors number one non-hodgkin's lymphomas then there are Hodgkin's lymphoma lymphoid tumors non-hodgkin lymphomas of course these are solid cohesive masses Hodgkin's lymphoma they are also solid cohesive masses what else anyone what else lymphoid tumors tumors originating from the immune system please tell me another category why don't you tell me those lymphocytes which spill into circulations look these are tumors which are cohesive these are also cohesive but there can be lymphoid tumors which are not cohesive and they spill into circulation and sir neoplastic cells circulate and raise the white blood cell count can they be lymphoma they cannot be now now they should be called leukemias now they should be called leukemia so why don't you put it lymphocytic leukemia lymphoma Dukey Mia's so there are lymphomas hot Hodgkins and non-hodgkin's lymphomas which are solid cohesive message and they are lymphocytic leukemia which are also derived from lymphocytes but they are spilling into circulation is the right and one more last category of tumors derived from lymphoid tissue yes plasma cell plasma cells are also immune cells isn't it so plasma cell dyscrasia plasma cell new places are dis crazy ins right so again white blood cell tumors are divided into white blood cell tumors are divided into lymphoid tumors my light tumors and history of scitech tumors we are now concentrating on lymphoid tumors nymphet Yuma's may be non Hodgkin's lymphoma and Hodgkin's lymphoma as they are cohesive methods and fatigue leukemia which spill into circulation but again remember sometimes even some of these lymphomas may also enter into leukemic phase and then of course plasma cell dyscrasia is that right now now we will go into detail of no non-hodgkins lymphoma then Hodgkin's lymphoma lymphomas are cohesive solid tumor goth immune system now we are going into detail of Hodgkin's lymphoma and comparing from past as a group with norm kills lymphomas yes