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Subtypes of Non-Hodgkin Lymphoma

There are many different subtypes of non-Hodgkin lymphoma. These subtypes are categorized by the characteristics of the lymphoma cells, including their appearance, their genetic features, the presence of proteins on the surface of the cells, and how fast (or slow) they progress. Knowing which subtype has been diagnosed is very important as it affects the type of treatment used. 

Indolent (Slow-Growing) Non-Hodgkin Lymphomas

Follicular lymphoma is the most common type of indolent non-Hodgkin lymphoma.  It 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 is closely watched 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.

Other NHL subtypes that are slow-growing include: 

  • Lymphomatoid granulomatosis
  • Marginal zone B-cell lymphoma
  • Cutaneous B-cell lymphoma
  • Cutaneous T-cell lymphoma (mycosis fungoides and Sézary syndrome)
  • Waldenström macroglobulinemia (lymphoplasmacytic lymphoma) 
  • Hairy cell leukemia
  • Lymphoplasmacytic lymphoma/Waldenström macroglobulinemia
  • Gastric mucosa-associated lymphoid tissue (MALT) lymphoma
  • Chronic lymphocytic leukemia/small-cell lymphocytic lymphoma (CLL/SLL)
  • Primary central nervous system lymphoma

Aggressive (Fast-Growing) Non-Hodgkin Lymphomas

Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma. It grows quickly in the lymph nodes and often the spleen, liver, bone marrow, or other organs are also 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.

Other aggressive NHL subtypes include: 

  • Anaplastic large-cell lymphoma
  • Mantle cell lymphoma (MCL)
  • Acquired immune deficiency syndrome (AIDS)-associated lymphoma
  • Burkitt lymphoma
  • Peripheral T-cell lymphoma (PTCL)
  • Central nervous system (CNS) lymphoma
  • Lymphoblastic lymphoma
  • Transformed follicular and transformed mucosa-associated lymphoid tissue (MALT) lymphomas

Lymphomas of the Skin

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: 

  • Mycosis fungoides
  • Sezary syndrome (SS)
  • Adult T cell leukemia-lymphoma (ATLL)
  • Primary cutaneous anaplastic large cell lymphoma (C-ALCL)
  • Lymphomatoid papulosis
  • Subcutaneous panniculitis-like T-cell lymphoma
  • Extranodal NK/T-cell lymphoma, nasal type
  • Primary cutaneous peripheral T-cell lymphoma, rare subtypes

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 4 subtypes of CBCLs, which include: 

  • Primary cutaneous marginal zone B-cell lymphoma
  • Primary cutaneous follicle center lymphoma
  • Primary cutaneous diffuse large B-cell lymphoma, leg type
  • Primary cutaneous diffuse large B-cell lymphoma, other 
Compass Oncology - The US Oncology Network