Types of NHL
While there are about 60 different subtypes of NHL, most subtypes fall within two main groups, named for the cell where the lymphoma originates: B-cell lymphomas or T-cell lymphomas.
B-cell lymphomas make up most (about 85 percent) of the 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 (DLBCL) accounts for about one out of every three cases of NHL. This type of aggressive NHL occurs mostly in people who are older, with rare occurrences in children and younger adults. The average age at diagnosis is mid-60s to 70 years old.
DLBCL usually starts as a quickly growing mass in an internal lymph node, such as the chest or abdomen, or in a lymph node 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; FL seldom occurs in very young people. This lymphoma appears in many lymph nodes throughout the body, as well as in the bone marrow.
FL is often slow-growing and responsive to treatment but difficult to cure. This type of lymphoma may not require any treatment initially. Depending on the stage and presentation, treatment may be delayed until the disease grows or the person begins to develop symptoms. When needed, treatment is often effective but may lead to a period of remission after which the cancer returns. Transformation to a more aggressive large cell lymphoma occurs in 25-60 percent 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). 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