Each cancer has a subtype that differs based on where it starts, how slowly or quickly it spreads, and how it affects the patient. Non-Hodgkin lymphoma (NHL) is the most common type of lymphoma and has more than 70 subtypes.
Here’s a look at the primary types and subtypes of NHL.
What Is Non-Hodgkin Lymphoma?
NHL is not a single cancer but a group of blood cancers developing in the lymphatic system. “Non-Hodgkin lymphomas are malignant transformations of your B cells, T cells, and NK (natural killer) cells,” said Danielle Leonardo, MD, an oncologist and writer at My BC Team.
There are more than 70 types of NHL, which are categorized by their aggressiveness or lack thereof.
Non-Hodgkin vs. Hodgkin Lymphoma
Although both are types of lymphoma, non-Hodgkin and Hodgkin lymphoma affect a patient’s body differently.
“Two major classifications of lymphomas are your Hodgkin and non-Hodgkin lymphoma, which are differentiated under a microscope,” Dr. Leonardo said. “The presence of Reed-Sternberg cells classifies the lymphoma as Hodgkin, and its absence makes it non-Hodgkin lymphoma.”
Indolent Lymphomas
Indolent lymphoma is an NHL that grows slowly in the body and tends to have fewer signs and symptoms. About 40% of patients are diagnosed with this type of NHL. Follicular lymphoma is the most common indolent non-Hodgkin lymphoma and starts in the B lymphocytes.
Other types of indolent NHL include the following:
- Lymphoplasmacytic lymphoma
- Marginal zone lymphoma
- Primary cutaneous anaplastic large cell lymphoma
Aggressive Lymphomas
Aggressive lymphomas are NHL that grow and spread quickly in the body and account for about 60% of NHL cases.
There are more than 10 types of aggressive lymphoma, some of which include the following:
- Diffuse large B-cell lymphoma
- Mantle cell lymphoma
- Lymphoblastic lymphoma
- Burkitt lymphoma
- Primary mediastinal large B-cell lymphoma
Types of NHL by Cell of Origin
NHL can be further divided into subtypes based on their cell of origin, which includes precursor B and T cells and mature B and T cells, Dr. Leonardo said.
Below are examples of each subtype of precursor and mature B and T cell NHL:
- Precursor B and T cells
- Lymphoblastic lymphoma
- Mature B cells
- Diffuse large B-cell lymphoma
- Burkitt lymphoma
- Mantle cell lymphoma
- Mature T cells
- Anaplastic large-cell lymphoma
- Peripheral T-cell lymphoma
- Cutaneous T-cell lymphoma
Most Common NHL Subtypes
Within the many subtypes of NHL, some are more commonly diagnosed than others.
“The most common subtypes of NHL are diffuse large B-cell lymphoma, which account for 30% of all NHL cases, followed by follicular lymphoma, accounting for 20%,” Dr. Leonardo said. “MALT lymphoma, peripheral T-cell lymphoma, small-cell lymphocytic lymphoma and mantle cell lymphoma each account for 6% to 7% of NHL cases.”
Indolent and Aggressive Lymphoma Symptoms
Patients with NHL can experience various symptoms that often resemble other health conditions. With this in mind, patients must seek medical care for an official diagnosis.
Common symptoms of NHL include:
- Swollen lymph nodes
- Abdominal pain or swelling
- Chest pain
- Coughing
- Persistent tiredness
- Unexplained fever
- Intense night sweats
- Unexplained weight loss
- A feeling of fullness in the stomach
NHL Risk Factors
Although there’s no exact cause for each of the various subtypes of NHL, certain risk factors make individuals susceptible to developing this cancer.
Risk factors for NHL may include:
- Age
- Sex
- Race and ethnicity
- Geography
- Family history
- Exposure to radiation, certain chemicals, and drugs
- Certain autoimmune conditions
- Having a weakened immune system
- Certain infections
- Being overweight or obese
- Breast implants
Treating and Managing Indolent and Aggressive NHL
Due to how rapidly aggressive NHL subtypes are, treatment starts immediately after diagnosis. Typically, patients with aggressive NHL are initially treated with chemotherapy.
However, treatment ultimately depends on the type of cancer, how advanced it is, and the patient’s current state of health.