Types of non-Hodgkin lymphoma (NHL)
There are many types of non-Hodgkin lymphoma (sometimes called non-Hodgkin's lymphoma). Your doctor needs to know which type you have so that they can give you the best treatment.
About non-Hodgkin lymphoma types
There are many different types of Non-Hodgkin lymphoma (NHL). Doctors can find out the type of NHL you have by examining some lymphoma cells under a microscope.
Some grow very slowly and may not need treatment for months or years. These are called low grade lymphomas. Other types grow quickly and always need treatment soon after diagnosis. These are called high grade lymphomas.
What are B-cell and T-cell lymphomas?
Lymphomas develop from white blood cells called lymphocytes.
Lymphocytes help fight infection. They are made in the bone marrow. They travel around the body and are found in lymph nodes and throughout the lymphatic system.
There are two main types of lymphocyte:
- B-cell lymphocytes - lymphoma that develops from an abnormal B-cell lymphocyte is called a B-cell lymphoma.
- T-cell lymphocytes - lymphoma that develops from an abnormal T-cell lymphocyte is called a T-cell lymphoma.
Types of B-cell lymphoma
B-cell lymphomas are more common than T-cell lymphomas. About 9 out of 10 people diagnosed with NHL (90%) have a B-cell lymphoma.
The most common types of B-cell lymphoma are:
- diffuse large B-cell lymphoma (DLBCL)
- follicular lymphoma (FL).
Other less common types include:
- mantle cell lymphoma
- Burkitt lymphoma
- primary mediastinal large B-cell lymphoma
- nodal marginal zone B-cell lymphoma
- extranodal marginal zone B-cell lymphoma (also called MALT lymphoma)
- splenic marginal zone lymphoma
- small lymphocytic lymphoma (also called chronic lymphocytic leukaemia)
- lymphoplasmacytic lymphoma (also called Waldenström’s macroglobulinaemia).
Types of T-cell lymphoma
T-cell lymphomas are much less common than B-cell lymphomas. There are a number of different types of T-cell lymphoma. They include:
- peripheral T-cell lymphoma
- anaplastic large cell lymphoma
- T-follicular helper lymphoma which includes angioimmunoblastic lymphoma
- lymphoblastic lymphoma (this is mainly T-cell but can be B-cell).
Other rare types of lymphoma
There are other types of lymphoma. Some can be difficult to diagnose. The cells may not clearly look like any single type of lymphoma. Or they may have features of 2 different types. For example, grey zone lymphoma is a B-cell lymphoma with features of both Hodgkin lymphoma and primary mediastinal B-cell lymphoma.
Lymphoma that starts outside the lymph nodes
Lymphomas that begin outside of the lymph nodes are called primary extranodal lymphomas (pENL). The most common places for pENL to start are the stomach and small bowel (intestine). But lymphoma can begin in almost any part of the body.
Like other lymphomas, pENLs are usually treated according to the type of lymphoma cells causing them.
The most common types of pENL are:
Lymphoma of the skin
Primary cutaneous lymphoma is non-Hodgkin lymphoma that mainly affects the skin. Cutaneous lymphoma is rare. The most common types are called mycosis fungoides and Sézary syndrome.
Visit our non-Hodgkin lymphoma cancer forum to talk with people who have been affected by non-Hodgkin lymphoma cancer, share your experience, or ask your questions.
Lymphoma Action has more information on cutaneous lymphoma.
Lymphoma of the brain or spinal cord
Rarely, lymphoma may start in the brain or spinal cord. This is called primary central nervous system lymphomas (PCNSL). The most common type of PCNSL is diffuse large B-cell lymphoma (DLBCL).
About our information
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.
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References
Below is a sample of the sources used in our lymphoma information. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk
Follows GA, Barrington SF, et al. Guideline for the first-line management of Classical Hodgkin Lymphoma — A British Society for Haematology guideline. Br J Haematol, 2022; 197, 558– 572. [accessed April 2024].
Fox CP, Chaganti S, McIlroy G, et al. The management of newly diagnosed large B-cell lymphoma: A British Society for Haematology Guideline. Br J Haematol. 2024; 204(4):1178–92. [accessed April 2024].
McKay P, Fielding P, et al. Guidelines for the investigation and management of nodular lymphocyte predominant Hodgkin lymphoma. Br J Haematol, 2015; 172, 32-43. [accessed April 2024].
McNamara C, Montoto S, et al. The investigation and management of follicular lymphoma. Br J Haematol, 2020; 191, 363-381. [accessed April 2024].
National Institute for Health and Care Excellence. Non-Hodgkin’s lymphoma: diagnosis and management. NICE guideline [NG52]. Published: 20 July 2016. Last update Oct 2021. [accessed April 2024].
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