Most Hodgkin’s lymphomas—about 95 percent—are the type called classic Hodgkin’s lymphoma. The rest are a type called nodular lymphocyte predominant. Correct identification is important in deciding which treatments are most likely to be effective. Doctors identify the type based on the appearance under a microscope of cells taken from biopsied tissue and based on other molecular features of the cells.
Classic Hodgkin’s Lymphoma
There are four subtypes of classic Hodgkin’s lymphoma.
- Nodular sclerosis
- Mixed cellularity
- Lymphocyte rich
- Lymphocyte depleted
The names of the four subtypes have to do with two factors.
- What’s happening to the lymph nodes. In the nodular sclerosis type, nodules (bumps) and fibrous bands form in the lymph nodes.
- The kinds of cells involved along with Reed-Sternberg cells. Other kinds of immune-system cells can be present to greater or lesser degrees.
Nodular Lymphocyte Predominant
About five percent of Hodgkin’s lymphomas are the type called nodular lymphocyte predominant because it involves nodules made up of lymphocytes. This type involves a variation of Reed-Sternberg cells that are sometimes called popcorn cells because of the way they look.
Patients with lymphocyte-predominant disease have earlier-stage disease, longer survival, and more successful treatment than those with classic Hodgkin’s lymphoma, according to the National Cancer Institute. Over time, however, about 10 percent of these lymphomas transform into aggressive diffuse B-cell lymphoma, a type of non-Hodgkin’s lymphoma.