Overview: Types of Lymphoma

Lymphoma is an overarching term, used by medical professionals to refer to over 50 different types of cancer that develops in a subset of lymphocytes, or the infection-fighting cells (white blood cells) located within the immune system (lymph nodes), thymus, bone marrow, or spleen.  

Lymphomas are generally referred to as either Hodgkin lymphoma (HL) or non-Hodgkin lymphoma (or NHL). Non-Hodgkin lymphoma is far more common than Hodgkin lymphoma. In fact, the National Cancer Society reports every lymphoma diagnosed is 85% or six (NHL cases) vs. one (HL case). The main difference between these two types of lymphoma depends, and the proper course of treatment depends on several factors, including:

1. Reed-Sternberg cells

Medical professionals distinguish between Hodgkin lymphoma and NHL in a lab. By thoroughly examining the specific cancer cells under microscope. If the Reed-Sternberg cell is present the lymphatic tumor, the lymphoma is deemed Hodgkin’s lymphoma, but if there is no Reed-Sternberg cell detected, the lymphoma is considered NHL.

2. Major lymphoma groups

Lymphomas, depending on type and group, require different treatment courses. In order to further diagnose a lymphoma properly, a doctor will attempt to classify the cancer among the 3 major groups, which are NK-cell lymphoma (less than 1% of cases), T-cell lymphoma (10% of cases), or B-cell lymphoma (roughly 90%) or North American cases.

3. Cancer growth

If a patient is found to have NHL (which makes up roughly 85% of lymphoma cases), the tumor will be assigned a description according to growth. For instance, cancers are considered either “aggressive” (or 60% fast growing NHL) or “indolent” (or 40% slow-growing NHL).

4. Watchful waiting

Most indolent (or slow-growing) NHL tumors are assigned something called “watchful waiting”, which means doctors prefer to put off treatment until symptoms develop or change. Obviously, patients are monitored very closely. Aggressive forms of NHL are treated immediately with intensive chemotherapy and radiation, on the other hand, due to their rapid growth.

5. Lymphoma by subtype

Lymphomas are divided as far as Hodgkin’s lymphoma vs. NHl, main type (aggressive or indolent), as well as according to cancer subtype, which will further determine prognosis and treatment approach. While there are over 60 subtypes of NHL alone, most are considered quite rare. Rather, the 3 most prevalent B-cell lymphoma NHL subtypes include the following:

  • Diffuse large B-cell lymphoma (DLBCL) is the most prevalent and aggressive form of NHL, accounting for approximately 30% of all cases in the U.S. DLBCL develops in organs (i.e., stomach, bowel, lungs) due to abnormal B cells.
  • Follicular lymphoma is the second most common NHL, making up roughly 20% of all NHL cases in the U.S., and developing slowly in the lymph nodes. Follicular lymphoma has no known cure.
  • Small lymphocytic lymphoma is linked to B-cell chronic lymphocytic leukemia (or CLL), a type of indolent lymphoma that accounts for roughly 5% of NHL
  • Splenic marginal zone B-cell lymphoma develops as a slow-growing tumor within a patient’s spleen.
  • Extranodal marginal zone B-cell lymphoma of MALT usually develops in the stomach, salivary glands, lungs, eye, or skin, in patients with a history of autoimmune disease (i.e., rheumatoid arthritis or lupus).
  • Primary mediastinal large B-cell lymphoma is considered an aggressive form of diffuse large B-cell lymphoma (or DLBCL). Mainly affecting women, this NHL subtype develops in the chest area, causing restricted breathing and/or superior vena cava (SVC) syndrome, which is partial compression of the superior vena cava (the main blood-transporting vein to the heart).
  • Mantle cell lymphoma accounts for between 5% and 7% of all NHL cases in the U.S., and often develops in the lymph nodes, gastrointestinal system, spleen, and bone marrow of mostly male patients over the age of 60-years old.
  • Lymphoplasmacytic lymphoma affects only 1% of NHL patients, who develop tumors in the spleen, bone marrow, or lymph nodes.

Nodal marginal zone B-cell lymphoma is another  rare form of indolent lymphoma that develops in the lymph nodes.