Non-Hodgkin lymphoma (NHL) has about 60 subtypes classified by the World Health Organization (WHO). It's important to know your subtype since it plays a large part in determining the type of treatment you'll receive. You should consider getting a second opinion of your diagnosis from a hematopathologist.
NHL subtypes are classified by certain factors such as the type of lymphocyte they developed in. The two major subtypes are:
- B-cell lymphoma
- T-cell and natural killer (NK) cell lymphoma
Most people (85 percent) have the B-cell lymphoma type. A small percentage of people have a type of NHL that falls into a third group: immunodeficiency-associated lymphoproliferative disorders.
Some of the subtype names relate to the lymph node areas ("follicle," "mantle" and "marginal" zones) they appear to originate in.
Listed below are some subtypes of B-cell and T-cell and NK lymphomas.
B-Cell Lymphoma Subtypes
- diffuse large B-cell lymphoma
- follicular lymphoma
- mucosa-associated lymphatic tissue (MALT) lymphoma
- small cell lymphocytic lymphoma/chronic lymphocytic leukemia
- mantle cell lymphoma
- mediastinal (thymic) large B-cell lymphoma
- lymphoplasmacytic lymphoma and Waldenstrom macroglobulinemia
- nodal marginal zone B-cell lymphoma
- splenic marginal zone lymphoma
- extranodal marginal zone B-cell lymphoma
- intravascular large B-cell lymphoma
- primary effusion lymphoma
- Burkitt lymphoma-Burkitt leukemia
- lymphomatoid granulomatosis
T-Cell and Natural Killer Cell Lymphoma Subtypes
- peripheral T-cell lymphoma, not otherwise specified
- cutaneous T-cell lymphoma (Sezary syndrome and mycosis fungoides)
- anaplastic large cell lymphoma
- angioimmunoblastic T-cell lymphoma
- lymphoblastic lymphoma (can sometimes be a B-cell subtype)
- NK-cell lymphoma
The most common subtype is diffuse large B-cell lymphoma (DLBCL), which makes up about 30 percent of all NHL cases in the United States.
Doctors classify the NHL subtypes into categories that describe how rapidly or slowly the disease is progressing:
- Aggressive NHL, also called fast-growing or high-grade, makes up about 60 percent of NHL cases in the United States. The most common aggressive subtype is diffuse large B-cell lymphoma.
- Indolent NHL, also called slow-growing or low-grade, makes up about 40 percent of NHL cases in the United States. The most common indolent subtype is follicular lymphoma.
Some patients have "intermediate grade" disease, which develops at a speed somewhere between indolent and aggressive. And, sometimes, indolent NHL can "transform" to aggressive NHL.