B-cell lymphoma refers to a group of cancers that attack the immune system. It is the most common type of non-Hodgkin’s lymphoma.
The cancer grows in the B cells, also called B lymphocytes, which make antibodies to attack invading pathogens.
There are different types of B-cell lymphoma based on where the cancer begins. Symptoms can depend on the type but may include pain at the site of the lymphoma, swollen lymph nodes, and more.
Read on to learn more about the types and symptoms of B-cell lymphoma. This article also looks at causes and risk factors, staging, outlook, and more.
A note about sex and gender
Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.
B-cell lymphoma is a type of non-Hodgkin’s lymphoma. Non-Hodgkin’s lymphoma is the name for a group of cancers that attack the white blood cells of the immune system, specifically lymphocytes. Doctors distinguish non-Hodgkin’s lymphoma from Hodgkin lymphoma by checking for Reed-Sternberg cancer cells, which are a hallmark of the latter.
B-cell lymphoma usually begins in the lymph nodes but can also appear in other parts of the immune system, such as the spleen or bone marrow.
Doctors usually detect lymphoma in the lymph system, which includes the lymph nodes and lymph fluid. However, the cancer can also travel outside of this system.
B-cell lymphoma attacks the B cells, which are part of the immune system. There are many different subtypes that vary in terms of where the cancer begins.
There are numerous types of B-cell lymphoma. Some include:
- Cutaneous B-cell lymphoma: This is lymphoma in the skin. When cutaneous B-cell lymphoma is primary — meaning that it originated in the skin rather than developing elsewhere before spreading to the skin — it usually grows very slowly.
- Diffuse large B-cell lymphoma: This form usually begins as a rapidly growing lymph node,
often in the neck, armpit, or chest. It grows quickly and can be aggressive, but about 75% of people have no signs of cancer after treatment. The average age at the time of diagnosis is mid-60s. Primary mediastinal B-cell lymphoma is a subtype that typically develops in young females. - Follicular lymphoma: Also more common among older people, this type of lymphoma usually grows more slowly and is typically less aggressive than other B-cell lymphomas. Although treatment can slow its growth, curing it is challenging. It can sometimes develop into a fast-growing form of diffuse large B-cell lymphoma.
- Chronic lymphocytic leukemia and small lymphocytic lymphoma (CLL/SLL): These cancers are so similar that doctors may treat them as the same condition. They are slow-growing and usually originate in the bone marrow or blood. Treatment cannot cure these cancers, but it is possible to live a very long time with them.
- Mantle cell lymphoma: This cancer accounts for around 5% of lymphomas. It is much more common in males than in females, and it primarily affects people over the age of 60 years. By the time a doctor discovers it, it may be in several places in the body, including the lymph nodes and spleen. It is more challenging to treat than many other B-cell lymphomas.
- Burkitt lymphoma: This rare lymphoma is more common in children than adults. In the United States, this lymphoma usually begins in the abdomen, from where it may spread to the central nervous system. It grows quickly, but more than half of those who develop it respond well to treatment.
- Marginal zone lymphoma: This accounts for around 5–10% of lymphomas. It is typically slow-growing. Subtypes include mucosa-associated lymphoid tissue (MALT) lymphoma, nodal marginal zone B-cell lymphoma, and splenic marginal zone B-cell lymphoma.
- Lymphoplasmacytic lymphoma (Waldenstrom macroglobulinemia): This type of lymphoma accounts for around 1–2% of lymphomas. The small lymphoma cells typically occur in the spleen, bone marrow, and lymph nodes.
Learn more about types of non-Hodgkin’s lymphoma.
The symptoms of B-cell lymphoma vary a lot depending on the type. Many people with lymphoma have no symptoms at all. Those who do
- Pain: Some people have pain at the site of the lymphoma. For example, a person with lymphoma beginning in the chest may have chest pain.
- Swollen lymph nodes: Lymphoma often begins as a swollen or painful lymph node. It is important to inform a doctor about any lymph node that does not return to its usual size after an infection.
- Infection symptoms: Some people have symptoms similar to an infection, such as a fever, chills, weakness, and fatigue.
- Other symptoms: Some people lose weight without changing their lifestyle. They may also experience night fever and sweats.
Learn more about the symptoms of non-Hodgkin’s lymphoma.
No single cause accounts for all cases of B-cell lymphoma, and some people who get the condition have none of the known risk factors.
In general, doctors think that the interaction of several different factors may steadily change the immune system, which can lead to lymphoma.
- Immunosuppression: Conditions that weaken the immune system, such as HIV, may lead to lymphoma and increase the risk of more aggressive forms of the disease.
- Autoimmune conditions: Conditions that cause the immune system to attack healthy tissue, such as rheumatoid arthritis, may elevate the risk.
- Infections: Research has linked certain viruses, including the Epstein-Barr virus that causes mononucleosis, to higher rates of lymphoma.
- Medication: Some medications, including a group of immune-suppressing drugs called TNF antagonists, may elevate the risk.
- Chemicals: Exposure to certain toxins and pesticides could raise the risk of lymphoma.
- Age: Being over the age of 60 years puts a person at higher risk.
To assist with reaching an accurate diagnosis, a doctor may begin by performing a physical examination and asking questions about symptoms.
They may then order various tests, which
- excisional biopsy, which involves removing the whole lymph node
- incisional biopsy, which involves removing part of the tumor or node
- needle biopsy to remove a sample of the tumor
- bone marrow aspiration and biopsy
- blood tests
- imaging tests, such as MRI and CT scan
Staging
Doctors stage B-cell lymphoma according to how many areas of the body it affects.
For non-Hodgkin’s lymphoma, doctors tend to use the following Lugano classification
- Stage 1: Lymphoma is only present in one lymph node or lymphoid organ, or it is in one area of a single organ outside of the lymph system.
- Stage 2: The lymphoma exists on two or more lymph nodes or lymphoid organs on the same side (below or above) of the diaphragm, or it covers a group of lymphoid organs and a nearby organ.
- Stage 3: Cancer is present on multiple lymphoid organs on both sides of the diaphragm, or it is above the diaphragm but has also traveled to the spleen.
- Stage 4: The lymphoma has spread widely into at least one organ outside of the lymph system.
A person’s doctor can provide more information about how they stage the cancer and what the stage means.
Learn more about staging non-Hodgkin’s lymphoma.
Treatment for B-cell lymphoma varies depending on the type and stage of the lymphoma and the person’s overall health.
For some people, the risks of certain types of treatment may outweigh the potential benefits. For others, immediate aggressive treatment may cure the cancer and help a person live a long and healthy life.
Some treatment options include:
- Chemotherapy: Chemotherapy can shrink cancer cells, but it
may also damage healthy cells. Methotrexate is an effective chemotherapy drug for many types of B-cell lymphoma. - Immunotherapy: Immunotherapy uses medications to teach the immune system how to fight the cancer.
- Radiation therapy: As with chemotherapy, radiation therapy can kill cancer cells and healthy cells.
- Stem cell transplant: In certain types of cancer, including those that recur or resist treatment, a stem cell transplant may reduce symptoms or even cure the cancer. This
might include allogeneic hematopoietic stem-cell transplantation (allo-HSCT). - Targeted therapy: Targeted B-cell therapy may be beneficial in some cases. This
might involve the anti-CD20 monoclonal antibody rituximab. This targets the CD20 protein, which is on the surface of some of the lymphoma cancer cells. - Supportive therapy: Doctors may recommend additional therapy to reduce symptoms and the side effects of treatment. For example, a doctor may prescribe antiemetic medication to help with chemotherapy-related nausea.
Learn more about treating non-Hodgkin’s lymphoma.
The outlook for a person with B-cell lymphoma can depend on the type. For example, the 5-year relative survival rates for diffuse large B-cell lymphoma are:
73% for localized cancer- 74% for regional cancer
- 58% for distant cancer
- 65% for all SEER stages combined
The 5-year relative survival rates for follicular lymphoma are:
- 97% for localized cancer
- 91% for regional cancer
- 87% for distant cancer
- 90% for all SEER stages combined
In general, the overall 5-year relative survival rate for non-Hodgkin’s lymphoma is 74%.
However, the odds of survival depend on the type of cancer and the person’s overall health, as well as the treatment plan they follow and how well the cancer responds to it.
Learn more about non-Hodgkin’s lymphoma survival rates.
A relative survival rate helps give an idea of how long a person with a particular condition will live after receiving a diagnosis compared with those without the condition.
For example, if the 5-year relative survival rate is 70%, it means that a person with the condition is 70% as likely to live for 5 years as someone without the condition.
It is important to remember that these figures are estimates. A person can consult a healthcare professional about how their condition will affect them.
Here are some frequently asked questions about B-cell lymphoma.
Is B-cell lymphoma curable?
Some types of B-cell lymphoma, such as follicular lymphoma and CLL/SLL, can be hard to cure. Other types are more curable. According to the
Learn more about curing non-Hodgkin’s lymphoma.
Where does B-cell lymphoma usually start?
B-cell lymphoma starts in the B lymphocytes (B cells). B lymphocytes are responsible for creating antibodies. Where in the body the cancer begins can depend on the type. For example, diffuse large B-cell lymphoma typically begins in the chest, abdomen, neck, or armpit.
B-cell lymphoma is the most common type of non-Hodgkin’s lymphoma. There are different types of B-cell lymphoma, and symptoms can depend on the type. In general, it can cause symptoms such as pain, swollen lymph nodes, and fever-like symptoms.
Treatments for B-cell lymphoma can include chemotherapy, immunotherapy, and radiation therapy. Doctors may also recommend targeted therapy, stem cell transplant, and supportive therapy.
It is important to contact a doctor as soon as a person experiences symptoms of B-cell lymphoma. The doctor can order tests to confirm the diagnosis and advise on a suitable treatment plan.