There are more than 60 known subtypes of non-Hodgkin’s lymphoma (NHL). Doctors classify them in different ways, such as by how fast they grow and the type of cells they affect.

NHL is a group of cancers that begin in the lymphocytes, which are a type of white blood cell in the lymphatic system.

The lymphatic system is part of the immune system and includes the lymph nodes, bone marrow, and spleen. Around 85–95% of all NHL cases begin in lymphocytes called B cells.

Keep reading to learn more about the different NHL types.

Close-up of a microscope that a researcher is using to diagnose NHL.Share on Pinterest
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The World Health Organization (WHO) has identified more than 60 NHL subtypes, which fit into categories based on their characteristics, such as:

  • Origin: Lymphoma can start in several different types of lymphocytes. These include B cells, T cells, and “natural killer” (NK) cells.
  • Speed of growth: Some types of lymphoma are slow-growing, which doctors may refer to as “low grade,” while some are fast-growing, or “high grade.”
  • Stage: Cancer stages describe how far the disease has spread. With lymphoma, staging indicates how much of the lymphatic system the cancer is affecting or whether it has spread to other parts of the body.

List of types

The following is an inexhaustive list of NHL subtypes:

The WHO also classifies NHL types according to:

  • the appearance of lymphomas under a microscope
  • the presence of certain proteins on the surface of lymphoma cells
  • the features of chromosomes in lymphoma cells

Chromosomes are cell structures that carry genetic information.

B-cell lymphomas are more common than T-cell lymphomas.

They affect the B-cells, which are responsible for creating antibodies. These antibodies mark viruses and bacteria that the immune system needs to destroy.

Some examples of B-cell lymphomas include:

  • Diffuse large B-cell lymphoma: This is the most common type of NHL and can grow quickly in the lymph nodes and other parts of the lymphatic system.
  • Follicular lymphoma: This slow-growing type of NHL affects the lymph nodes and may spread to the spleen or bone marrow. Sometimes, it becomes more aggressive.
  • Lymphoplasmacytic lymphoma: In most cases of this type of NHL, certain B-cells make large amounts of an antibody called immunoglobulin M (IgM). High levels of IgM cause the plasma in the blood to thicken.

There are several types of T cells. Some eliminate germs or other atypical cells in the body, while others help increase or decrease the activity of other immune cells.

Some types of T-cell lymphomas include:

  • Angioimmunoblastic T-cell lymphoma: This begins in T cells and commonly causes swollen lymph glands.
  • T-cell leukemia/lymphoma: A virus known as human T-cell leukemia virus type 1 causes this type.
  • Peripheral T-cell lymphoma: This begins in mature T cells in the thymus gland, which is responsible for making T cells. It then spreads to other parts of the lymphatic system.

NK cells attack and kill other cells. They are not one of the main lymphocyte types, but lymphomas can still start in them.

For example, NK/T-cell lymphomas (NKTLs) are cancers that result from the Epstein-Barr virus (EBV). Most of them start in NK cells.

NKTLs are relatively common in Asia and, to a lesser extent, Latin America. However, they are rare in North America and Europe. Most form in the nasal cavity, but they can develop in any location.

Another way of categorizing NHL types is by the speed at which the cancer grows. Aggressive lymphomas grow and spread rapidly, while indolent lymphomas grow and spread slowly.

Aggressive NHL tends to cause more severe symptoms. For example, the most common type of aggressive NHL, diffuse large B-cell lymphoma, causes a cluster of symptoms known as “B symptoms,” which can also occur in other B-cell lymphomas.

B symptoms include:

Indolent NHL tends to cause few symptoms, if any. Sometimes, doctors do not find the disease in these cases until they run tests for other conditions.

Treatment for indolent and aggressive cancers can also be very different.

Aggressive NHL requires systemic treatments, such as chemotherapy and radiation, while some indolent lymphomas may only require monitoring. For example, follicular lymphoma does not always require treatment, as it can get better on its own.

Some examples of rare lymphomas include:

  • Burkitt lymphoma: This is an aggressive type of B-cell lymphoma that spreads quickly.
  • True histiocytic lymphoma: This is a rare and very aggressive type of NHL. Doctors do not know if it derives from B cells or T cells.
  • Nodal marginal zone lymphoma: This is a type of NHL that forms in lymph nodes. Doctors also call it monocytoid B-cell lymphoma.
  • Cutaneous anaplastic large cell lymphoma: This is a slow-growing type of NHL that mostly affects the skin.
  • Follicular large cell lymphoma: Although follicular lymphoma is usually indolent, this very rare type grows faster. Doctors treat it more like an aggressive type of NHL.

There are many types of non-Hodgkin lymphoma (NHL), ranging from common to rare and indolent to aggressive. Around 60% of all NHL cases are aggressive, while 40% are slower-growing.

Doctors can categorize NHL in several ways, such as by the cells they start in, how fast they grow, or their stage. Most NHLs start in B-cells, but they can also begin in T cells or NK cells.