Non-Hodgkin’s lymphoma (NHL) is divided into types based on whether it originates from B-cells or T-cells (types of infection-fighting white blood cells) and whether it is fast or slow growing.
According to the World Health Organization, there are about 60 subtypes, based on the genetic characteristics and other molecular features of the cells affected, how and where they grow in the body, their appearance under a microscope, and how quickly or slowly the disease progresses. It’s critical to correctly identify the type and subtype to determine which treatments are most likely to be effective.
B-Cell Lymphoma or T-Cell Lymphoma
Most NHLs—about 90 percent—begin in the B-cells. The most common subtype of B-cell lymphoma is diffuse large B-cell lymphoma, but there are several other subtypes. Read more about NHL B-cell subtypes.
About 10 percent of NHLs begin in the T-cells. In some of these, natural killer (NK) cells are also involved. These are called NK/T-cell lymphomas. There are many subtypes of T-cell lymphoma, but they are all fairly rare. Read more about NHL T-cell subtypes.
Cutaneous lymphoma, a rare type of NHL, may be either B-cell or T-cell type. Cutaneous lymphomas are found primarily in the skin but may involve lymph nodes, blood, and other organs.
Indolent or Aggressive
Non-Hodgkin’s lymphomas are also often described by how quickly they grow.
- Indolent (low-grade) NHL, which makes up about 40 percent of NHL cases in the United States, tends to grow slowly and cause fewer symptoms. The most common indolent subtype is follicular lymphoma. Over time, indolent NHL may transform into aggressive NHL.
- Aggressive (high-grade) NHL, which makes up about 60 percent of NHL cases in the United States, tends to grow and spread quickly and cause severe symptoms. The most common aggressive subtype is diffuse large B-cell lymphoma.
Some subtypes may have features of both indolent and aggressive disease, making them difficult to classify into either group.
Area of Disease Origin
Some of the NHL subtype names relate to the area where the disease originates.
- Mantle cell lymphoma originates in the mantle zone, or outer layer, of the lymph node.
- Marginal lymphomas start in the interface (margin) between lymphoid and non-lymphoid pulp in the spleen and lymph nodes.
- Follicular lymphoma usually starts in the follicle cells in the lymph and grows in a follicular pattern, meaning the cells clump together.
- Nodal lymphomas originate in the lymph nodes.
- Extranodal lymphomas start in places other than the lymph nodes.
- Contiguous lymphomas are those in which the lymph nodes with cancer are next to each other.
- Noncontiguous refers to lymphomas where the lymph nodes with cancer are not next to each other but are on the same side of the diaphragm.