What is Non-Hodgkin Lymphoma

Non-Hodgkin lymphoma (NHL) is one of the most common cancers in the United States, accounting for about 4 percent of all cancers. Although some types of NHL are among the more common childhood cancers, more than 95percent of cases occur in adults. NHL is a group of blood cancers that develop in the white blood cells (lymphocytes). There are many different subtypes of NHL, and a subtype is then classified as either indolent (slow growing) or aggressive (fast growing). 

While there are about 60 different subtypes of NHL, the two main subtypes are B cell lymphomas and T cell lymphomas, which are named to indicate the origin cell of the lymphoma.

B cell lymphomas make up most (about 85 percent) NHL cases in the United States. The majority of B cell lymphomas are either Diffuse Large B-Cell Lymphoma (DLBCL) or Follicular lymphoma (FL). 

Diffuse Large B-Cell Lymphoma, accounts for about one out of every three cases of NHL. This type of aggressive NHL occurs mostly in people who are older, with the average age of mid-60s to 70 years old, although it can occur in children and younger adults in rare cases. 

It usually starts as a quickly growing mass in an internal lymph node, such as the chest or abdomen, or in a lymph node that you can feel, such as the neck or armpit. It can grow in other areas such as the intestines, bone, or even the brain or spinal cord. Although this is a fast-growing lymphoma, DLBCL usually responds well to treatment.

Follicular lymphoma (FL) accounts for nearly 20 percent of lymphomas in the United States. The average age for people with this lymphoma is about 60 and it is not often found in very young people. Most often, this lymphoma occurs in many lymph node sites in the body, as well as in the bone marrow. 

FL is curable; however, since it is often slow-growing it can be difficult to cure. It is important to note that this type of lymphoma may not require treatment initially. Dependent on stage and presentation, treatment for this type of lymphoma may be delayed until the person begins to develop symptoms or the disease begins to grow. Transformation to a more aggressive large cell lymphoma occurs in 25-60percent of people with FL.

Other subtypes of B cell lymphomas include:
  • Mucosa-associated lymphatic tissue (MALT) lymphoma
  • Small cell lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL)
  • Mantle cell lymphoma (MCL)
  • 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
  • Hairy cell leukemia
  • Primary Central Nervous System lymphoma

T cell lymphomas make up less than 15 percent of NHL cases in the United States. T-cell lymphomas can be aggressive (fast growing) or indolent (slow growing). A number of T-cell lymphoma subtypes exist. 

Common subtypes of T-cell lymphomas include: 
  • Peripheral T cell lymphoma, not otherwise specified (PTCL-NOS)
  • Cutaneous T cell lymphoma (Sézary syndrome and mycosis fungoides)
  • Anaplastic large cell lymphoma
  • Angioimmunoblastic T cell lymphoma

Updated 2/24/15