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.
- 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:
- diffuse large B-cell lymphoma
- follicular lymphoma
- lymphoblastic lymphoma
- lymphoplasmacytic lymphoma
- primary cutaneous anaplastic large cell lymphoma
- extranodal NK/T-cell lymphoma
- intravascular large B-cell lymphoma
- lymphomatoid granulomatosis
- mantle cell lymphoma
- plasmablastic lymphoma
- peripheral T-cell lymphoma
- primary effusion lymphoma
- posttransplantation lymphoproliferative disorder
- T-cell leukemia/lymphoma
- angioimmunoblastic T-cell lymphoma
- marginal zone lymphoma
- gastric mucosa-associated lymphoid tissue (MALT) lymphoma
- Mediterranean abdominal lymphoma
- extragastric MALT lymphoma
- splenic marginal zone lymphoma
- primary mediastinal large B-cell lymphoma
- anaplastic large cell lymphoma
- systemic anaplastic large cell lymphoma
- subcutaneous panniculitis-like T-cell lymphoma
- enteropathy-type intestinal T-cell lymphoma
- hepatosplenic T-cell lymphoma
- true histiocytic lymphoma
- Burkitt lymphoma
- nodal marginal zone lymphoma
- follicular large cell lymphoma
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
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
- 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
Some types of T-cell lymphomas
- 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.
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
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
- 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.