Diffuse Large B-Cell Lymphoma (DLBCL) - Aggressive B-Cell Neoplasm - Non-Hodgkin’s Lymphoma
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- Опубліковано 15 жов 2024
- Diffuse Large B-Cell Lymphoma (DLBCL) - Aggressive B-Cell Neoplasm - Non-Hodgkin’s Lymphoma
Hematological malignancies are subdivided into leukemias, lymphomas, and multiple myeloma.
Lymphoma can be Hodgkin or Non-Hodgin's (such as DLBCL).
Diffuse Large B-cell lymphoma (DLBCL) is an aggressive Non-Hodgkin's lymphoma (NHL)...It's the most common NHL
To diagnose, you need a core needle biopsy or an excisional biopsy of the lymph node
Uric acid levels can be high---Give allopurinol (Xanthine oxidase inhibitor).
Staging of cancer is important (Ann-Arbor classification based on history, physical exam and CT scan)
Treatment: Combination Chemotherapy (R-CHOP) regimen.
Tumor lysis syndrome can ensue.
PET scan is helpful.
The lymph node is a bean-shaped body (not a gland) that interrupts the flow of lymph through the lymphatic vessels.
Afferent lymphatics go towards the lymph node, while efferent exits the node. The lymph node has cortex (which contains the follicle, germinal center, mantle, and margin).
Lymphocyte activation and differentiation occur in the lymph node.
Lymph is a colorless fluid that floats in the lymphatic vessels (lymphatics) of your lymphatic systems.
Formed from the interstitial fluid (extracellular fluid) and returns back to the big veins (Superior vena cava) through the thoracic duct and Right lymphatic duct.
Lymph slows down when it passes in lymph nodes.
Lacteals are a special type of lymph, they are milky because they contain chylomicrons.
Lymph node enlargement can happen in cases of lymphoma (painless lymphadenopathy) or infection (painful).
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I am an 83 yr male- I had DLBCL when I was 61yrs old , had my spleen out and CHOP chem. -it was back 12 yrs later and I had RCHOP - back 7 yrs later more RCHOP - back again 3yrs and I am still fighting!
keep fighting!! I am going into radiation oncology in a few years. My dad is a Hodgkins survivor. Cancer patients are some of the strongest and best patients to look after.
@@janiamunozmelendez6451 Thanks to everyone I will face whatever comes!
keep fighting . we all support you
Wow , you are exemplary brave!!!
Keep on! Hope you're doing well now!
This is a very good explanation! Thank you! My mother is 93 and was just diagnosed with DLBCL. Her left foot was swelling up. Numerous doctors visits and then 1 night her entire left swelled up. I took her to the ER and they found a mass encasing her iliac arteries and urterer. Biopsy took 1 week to get results. She had Rituxan and 2 days later chemo. She was sent home. Swelling is starting to go down finally. She also had a nephrostomy to help her left kidney drain into a bag. At 1st doctors were very grim. When they asked me her activity level and I told them she walks 4 miles a day, runs and dances twice a week, they decided try treatments to see if her body would tolerate them. So far so good!
How is ur mother now
hi, i find your lectures really useful. Most of the lectures tell the difference in individual topic and do not differentiate from the outline and tell u where is the disease in the general part, which is absolutely confusing. Thanks for your uploading and sharing!
My pleasure 😇
Thank you so much for watching!
Stage 3a : more than one group of lymph node is affected and it is below and above the diaphragm
How are now bro
my girlfriend who is 20y/o was diagnosed a few months ago with large b cell lymphoma. she just finished treatment today!
I wish her a speedy recovery!
How is she now pls answer
@@aparichittheunknown3398 shes doing very well! she’s back at college taking classes now. her heart rate is heavily increased during physical activity but that’s about it.
How is she, 3 months in now?
@@rcat230 Heart rate is still slightly elevated at resting rates, and goes up rapidly when walking/except using. Other than that pretty great! Thanks for asking
Both side off diaphram one lymph node from mediastinum and other from inguinal and illiac lymph node involment stage 3
i have been watching ur hematology and oncology playlist for few days, i'm a second year medical student, these videos really help a lot and they are very amazing. also, a request- i have pathology as my subject in 2nd year so it would be nice if u also add morphology of cells in all of your videos. :)
Ruby, you’re awesome!
Thank you so much for your kind words!
I can’t add morphology to my videos for now, because many of them are protected under copyright ©
39yrs old, fem. In beginning of 2024 got diagnosed as well. Im in middle of 6 rounds of my R Chop chemotherapy. Have stage 2 High Grade Diffuse large B-cell Lymphoma. Aggressive type. It was in my inguinal area/inner right thigh. Was so uncomfortable, it was hard to sit or walk & another small one on the left. This video has helped my husband & I to fully understand when I was first diagnosed.🙏❤
Hello Amanda. My grandpa has been diagnosed with diffuse large b cell lymphoma and has almost the same site of cancer as yours.
Can I ask how effective the treatment has been? What side effects are you facing?
My grandpa is around 70 years old too, so that adds to my fear.😢
stage IV because the mass is in the mediastinum, and you have multiple l.n in the inguinal and iliac (so we supose it's disseminated).
Dont how ur doing but still want to let u know ur very brave...god bless u.
@@mom5219 She just answered the quiz at the end of the video hahaha
For there was both side lymphadenopathy of diaphragm, but not involving extranodal area, stage III was indicated.
Exactly...You nailed it!
Medicosis Perfectionalis
Why stage 3?
Both sides of the diaphragm
What about the mass in mediastinum isn't it extranodal.?
Maryam saeed It’s a mediastinal lymphadenopathy. An enlarged lymph node.
Thank you l have large diffuse B cell non hodgekins lymphoma and I’m doing 6 rounds of R-CHOP chemotherapy. All of my blood tests are normal. I’m 35 and was just diagnosed. Mine is in my right lung and localized to my chest. I have an enlarged lymph node in my chest as well. My oncologist has me on allopurinol for uric acid.
DLBCL starts at 2:40
What is some of the causes of this disease? What is the cause of the imbalances of the T cells and B cells? Why are these cells not communicating with each other?
My father 63 yrs, diagnosed with dlbcl stage 3 in 2014,, treated with RCHOP , remission in 2015, relapsed in oct 2021 ,, now doc is treating with RGDP ,, but this time its getting very tough for him to cope ,chemo has made him too weak 😔
I'm sorry! I pray for your father's cure and well being 😔
How is your dad?
How is ur dad
@@Sandeep-ls7hd it's back again in2024 after 2 years in remission..this time immunotherapy only as condition is not good for chemo. He is fighting it for last 10 years . doctor say cancer has changed from DLBCL(aggressive type ) to follicular (slow growing) type .
Stage3: 2 or more lymph node on opposite side of diaphragm.
Hi,
Loving your videos! I find them very helpful.
But at 4:02 you say that a performance status less or equal than 2 is a unfavourbale prognostic factor. Should't it be the opposite?
Love the way you teach it's very helpful. Thank you so much!!!
I think the answer should be stage IIIb?
Excuse me, Prof! Your Arbor staging in the video is lacking other points
I AM 73 AND HAVEN'T BEEN TO AN ONCOLOGIST SINCE 2010 AFTER HAVING R-CHOP AND IN REMISSION. I STOPPED GOING TO THE DR. THINKING I DIDN'T NEED TO. SHOULD I SEE AN ONCOLOGIST AFTER THIS LONG? I REALIZE NOW THAT IT CAN COME BACK.
If I were you, I would consult an oncologist.
A patient diagnosed with Peripheral T cell NHL in the year 2014. Location of the infected lymph node was Right Gorin, which enlarged to lower abdomen. Peripheral T cell NHL digonosed after excision biopsy. She got 7 Cycle CHOP and Radiotherapy. In September 2020 a PET-CT Scan done after she notice sever itching problem. PET scan showed an 70x51x70mm sized Anterior Mediastinal Mass with SUV max 11. Thoracic surgeon refused to operate the mass. A core biopsy and histochemestry done few days ago. Which shows an Intermediate grade Diffuse large B cell Lymphoma. CD20, BCL6 & MUM1 are positive. BCL2, CD3, CD5 & CD10 Negative. Bone marrow aspiration suggesting "Reactive marrow with myeloid hyperplasia and excess of lymphocytes". Before all these diagnosis the patient only faced itching problem. First symptom noticed on the beginning of August 2020. Last 24-26th October the patient suddenly faced swallowing face. An echocardiogram of the heart on 27th October showing small amount of fluid buildup around her heart. LDH lifted to 366. Her oncologists immediately suggest chemotherapy. The new chemo protocol is R-GCEOP. 1st Cycle started on 27th October and splited into 3 days. Rithuximab, Cyclophosphamide, Gemcitabine, Etopside, Vincristine, prednisone given. After 1st cycle chemo, face swallowing and itching removed significantly. Do you think the new protocol of chemotherapy is good for the patient? And is it possible that, a patient treated previously with T cell Lymphoma will affected newly by DLBCL? Is chemotherapy alone is good option to remove the DLBCL? If remove with chemo further Stem cell transplantation is necessary? Her current age 32 years.
I think it will be stage (lll b)
Bcz pt have symptoms of cough and pain as sir told us ....that in subtype B symptoms appears
a lady aged 24 is suffering from DLBCL, stage-2. now she is been given her first chemo with R-CHOP regimen. can she live long, is it curable????
of course, I had diagnosed DLBCL, stage-2 at my 18. treatment with 3 R-CHOP and a total of 6 CHOP. I am 30 years old now with 2 children. Giving birth at my 23 yo & 26 yo.
stage 3 due to both side of the diaphragm involvement and with only lymph node involvement
I wanna say may God bless you a long live, life to be a great gift for the poor knowledged medical xtudents ,,,
is it not performance status score >2 instead of below at 4:00
ive been in remission since june i had non hogkins lymphoma in my groin judt got wait see if it will return im 51 had r chop chemo
Kindly mention the IHC markers for diagnosing DLBCL
On your slide for unfavorable prognosticators, I think you meant to include PS >= 2, not
Ok I'm just going to throw this out there. Wrt large B cell lymphoma. The normal function of B cells is to proliferate during an infection. Swollen lymph nodes are normal in infection. There is nothing that stands out in the definition of 'cancerous lymphoma' B cells that is functionally different from the repertoire of normal B cells. It seems diagnosis is by biopsying cell size. Well guess what, b cells can grow in size. Macrophages are good at taking up iron, making them larger, and iron is also a growth factor. Coincidentally, blood transfusions - a main cause of iron overload - are associated with lymphoma, something I feel is being downplayed.
So in my mind, it's possible that 'large b cell lymphoma' is nothing more than a temporary expansion of b cells because of being inundated in iron (and say some infection). Temporary because eventually the iron would be deposited in the liver.
Between 3,4 stage
Can I ask you what you believe causes it ?
52 year old man
Non Hodkings Lymphoma large B cell stage IVB, CD20 positive high Ki67 index
R-CHOP done
Cancer has Relapsed
Lost a lot of weight and muscles
Is this cureable ?
What are the treatment options available ?
How to apply for clinical trials ?
Thanks for Helping
Sir year 49 male dlbcl lymphoma but doctor low grade lymphoma treated how to next sir pls help sir
you are such a great teacher thank you so much
My pleasure 😇
21 year female
Plasma blastic lymphoma cure rate ?
nasoparangel tumer remove
Chop cheemo 6 cycle
Cure rate plz tel me??
Stage III because of inguinal and iliac lymph node involvement which is already on both sides of diaphragm
There's 1 correction..performance status (ECOG) more than /equals to 2
Why we use the diaphram ? Do we have any specific reasons?
upper and lower abdomen
Case answer: stage IIIa
What's the correct answer
My dother was diagnostic with linfom difuz cu celule B mari,NOS germinal center 😢😢😢😢😢
She has 20 yers,she is student of medicine 2 year...my soul is break😢😢😢😢i dont have Power 😢😢😢....
Thank you
You're most welcome!
Would you please help me by sharing?
@@MedicosisPerfectionalis I did a massive research on the DBLCL. I am the patient. I would not know who to share. I had my first treatment of MTX via ommaya tube.
Can someone help me to find the Pathophysiology of Primary Breast Lymphoma? Please.
Stage III because they are all above and below the diaphragm and is one side only which is involved.
I love your videos ❤️❤️
Thank you so much 😊
I think it's stage III. Bc there are more than 2 L.N.s on both sides of diaphragm.
Thank you 🙏
My pleasure 😇
stage 2 sir, because lymph nodes involved on same side of diaphragm..
That should be an ECOG performance status MORE than 2. 0 is healthy all the way down to 4 which is bedridden.
love the videos, thanks so much :)
My pleasure 😇
My father diagnosed high grade b cell lemphoma. What is the life expetency of this type?is it curable?
What type of high-grade B-cell?
High grade B-cell lymphoma has a worse prognosis than normal DLBCL. I think 40% are alive within 2 years. It's great unmet medical need for high grade. Regular DLBCL 60% respond to RCHOP but high grade is refractory to RCHOP. Unsure if your father is HGBCL with Myc/bcl2/blc6 (DH/TH) or HGBCL-NOS but he might be treated with DA-EPOCH-R instead of R-CHOP.
Definitely consider finding a clinical trial for your dad. There are quite a few in the DLBCL and also high grade BCL disease with more hope. Some of the CAR-T's are curative but I'm not sure if any are tested in high grade.
I will also add FDA allows expanded or emergency use of drugs not even approved for emergency situations, if it is especially urgent.
I'm sorry to hear of your dad's diagnosis but do some research, read a lot, on available trials and current therapies and get a good doctor, there's hope out there, wish him well.
My Father is Diagnosed with Stage 3 DLBCL and he is getting treatment in Sacramento California USA....
@ Dr Saira Bibi ... Hows your Father doing now ? As i can see this comment is 1 year ago
Unfortunately died last year after diagnosis he lived 8 months and was also on chemotherapy
stage III b (stage IV?)
Good information 👍
Thank you 🙏
The beautiful intro
Thank you 🙏
Love from Pakistan
Thank you!
answer is 3
Excellent!
I would say it could be III or IV, definitely at least III, but maybe we will discover more organs involved.
The answer is in the next videos.
³?
Yup! That’s true!
Stage 4
Is it possible in lympoma to have dialysis even if your kidney is not failed
What do you mean?
@@MedicosisPerfectionalis my brother has lympoma and after first chemo he is weakening and now after 21 day when he will receive 2 chemo urine is not coming doctor has kept him on dialysis for 4 days but they said his kidney is not failed but can't work properly which is normal in this case.
So is it normal
Please answer as soon as possible
Stage 4 diffuse dissemination , inguinal and iliac lymphadenopathy
4 years ago? I hope this oitdated as shit. Just diagnosed. 36 M. Found lump on back of head almost overnight, removed. Boom Large B Cell lymphoma.
Doctor said rarest but most treatable. Said stage 1 has 90% success. Only 3 rounds of chemo.
But you know internet and my dumbass finds this video that says 1-2 years... bro..i got a 10 month old. I CANT die...he wont remember me. My wife cant handle it.
Damn UA-cam killing me. Lol
3
Indeed...You’re the first one to answer this question...Congratulations!
Can't describe how grateful for your efforts making those brilliant videos. GO ON please.
I sure will...I am so grateful to have chat with a nice person like you...All the best!
Stage 3a
Stage-3a ...
It's stage III
Stage three both sides of Diapham
Excellent 👍👍
Stage 3B
Common en Hodgkin's lymphoma the médian survival rate either teatment in oliemans After century not back case of oliemans this is horrible cup
Done
Nice
Stage IIIb
Sir high grade lymphoma
stage 4
Great
Thank you so much 😊
I think answer is stage 4 ...
IV stage
B cell 4 stage
Stage IV
Stage3
STAGE IV I Think .
Stage -IVa
Stage IV A :D
Stage4
Stage 4a
👏👍
I was told my DLBCL was rare and more rare than Hodgkin? I'm 23. 21 when I was diagnosed.
Stage 2BE was in my face. Eye socket, sinus, mouth. All one huge tumor.
I am so sorry to hear that... How are you now?
It’s rare because of your young age
Stage 3b
Why?
Grade 4
Have a massive tumor under my armpit that is first getting treated with Radiation soon
Stay strong, and never give up!
@@MedicosisPerfectionalis thank you
Stage 2
Nope...Please try again!
@@MedicosisPerfectionalis stage 3B
I watched this because I wanted to know wha this is
Thank you for watching!
Dumbfounded
III
Smh
👀
Stage 3
Stage 3a
Stage IV
3
Yes! That’s correct!
stage 3
Indeed 👍
Stage 3