There are several subtypes of non-Hodgkin lymphoma. They are categorized by the characteristics of the lymphoma cells, including which type of cell the lymphoma started in, their appearance, the presence of proteins on the surface of the cells, their genetic makeup, and the speed of their progression. Knowing which subtype has been diagnosed is very important as it affects the type of treatment used.
Non-Hodgkin lymphoma usually starts in the lymphocytes. A lymphocyte is a type of white blood cell in the immune system. Lymphocytes consist of B cells, T cells, and Natural Killer (NK) cells. The type of lymphocyte plays a significant role in the subtype of NHL:
Non-Hodgkin lymphomas are also described by their growth rate — rapidly growing lymphomas are “aggressive,” and slow-growing lymphomas are “indolent.”
Follicular lymphoma is a very slow-growing type of non-Hodgkin lymphoma that begins in B lymphocytes. It affects the lymph nodes and may spread to the bone marrow or spleen. Most patients diagnosed with follicular lymphoma are aged 50 or older. Follicular lymphoma may go away without treatment. The patient watched closely for signs or symptoms that the disease has come back. Treatment is needed if signs or symptoms occur after the cancer disappears or after initial cancer treatment. Sometimes follicular lymphoma can become a more aggressive type of lymphoma, such as diffuse large B-cell lymphoma.
Diffuse large B-cell lymphoma (DLBCL) grows quickly in the lymph nodes, and the spleen, liver, bone marrow, or other organs are often affected. Signs and symptoms of diffuse large B-cell lymphoma may include fever, drenching night sweats, and weight loss. These are also called B symptoms.
Sometimes, a non-Hodgkin lymphoma starts only in the skin (not in other organs or tissues). Although not a type of skin cancer, it is called skin lymphoma (or cutaneous lymphoma).
Cutaneous T-cell lymphomas (CTCLs) are the most common type of skin lymphoma. These skin lymphomas often appear as a red and dry rash and can affect widespread parts of the body. While the disease can affect women, it is most commonly found among men in their 40s, 50s, and 60s.
There are several subtypes of CTCL, which include:
Cutaneous B-cell lymphomas (CBCLs) are less common. They can cause lumps in the skin, usually in one or two areas of the body. There are four subtypes of CBCLs, which include:
It is important to know your subtype since it influences the type of non-Hodgkin lymphoma treatment you will receive.