Types of Non-Hodgkin’s Lymphoma

Diffuse large B-cell lymphoma is the most common type of lymphoma and makes up about a third of all cases of NHL. Approximately 7 out of 100,000 people in the United States receive diagnoses each year.

This aggressive type of lymphoma leads to the development of B cells that are larger than normal. It typically starts in a lymph node either deep in your body or in an area you can feel, such as your neck or armpit. It can also develop in your bones, brain, spinal cord, or intestines.

This type is more common in those assigned male at birth, and it becomes more common with age. The median age of those with this type is 64. The median age means that of all people with this condition, half are older than this age and half are younger.

Diffuse large B-cell lymphoma tends to develop quickly but often responds to treatment. About 75 percent of people have no signs of disease after initial treatment. Treatments commonly include chemotherapy, radiation therapy, or immunotherapy.

Follicular lymphoma is the second most common form of NHL and makes up 1 in 5 lymphomas in the United States. About 6 in 100,000 people in the United States receive a follicular lymphoma diagnosis each year.

The median age of those with follicular lymphoma is 55, and follicular lymphoma tends to be rare in children. Those assigned female at birth are affected slightly more than those assigned male.

Symptoms vary based on the extent of the cancer and the area affected. It often causes painless enlargement of a lymph node, most commonly in the neck, armpit, or groin.

This form of lymphoma arises in B cells. It gets its names from the clumps of B cells that tend to form inside lymph nodes.

Follicular lymphoma tends to progress slowly. It often responds to treatment but can be difficult to cure. Treatment can range from “watch and wait” to radiation therapy, chemotherapy, and immunotherapy.

The average survival rate is more than 20 years. Some people don’t develop any symptoms while others have reoccurring life threatening complications.

Marginal zone lymphoma is a group of slow-growing lymphomas that arise in B cells that look small under a microscope. They make up roughly 8 percent of NHL cases. The average age of diagnosis is 60, and it’s slightly more common in those assigned female at birth than those assigned male.

The most common type of marginal zone lymphoma, mucosa-associated lymphoid tissue (MALT) lymphoma, develops in tissues outside your lymph nodes, including your:

• stomach
• lung
• skin
• thyroid
• salivary glands
• eye tissue

Many types of MALT are linked to bacteria or viral infections. Symptoms can vary depending on which part of your body is affected. It often causes nonspecific symptoms such as:

• low-grade fever
• night sweats
• fatigue

People with this form of lymphoma tend to have a good prognosis, with more than half of people living more than 10 years. Three factors linked to favorable outcomes include:

• having stage 1 or 2 disease
• being under the age of 70
• a normal level of serum lactate dehydrogenase (LDH)

In people that fall into all three categories, the survival rate is more than 99 percent. Treatment often includes chemotherapy, immunotherapy, or radiation therapy. Surgery is used rarely if the cancer is only found in one part of your body.

Mantle cell lymphoma makes up about 6 percent of NHLs and is most commonly diagnosed in those assigned male at birth in their 60s. It affects about 1 person in 200,000 per year. Mantle cell lymphoma can grow slowly or quickly, but it has usually already spread throughout the body by the time it’s diagnosed.

Mantle cell lymphoma develops in B cells and is distinguished by the overexpression of a protein called cyclin D1 that stimulates cell growth.

Some people have no symptoms at the time of their diagnosis. More than 80 percent of people have swollen lymph nodes.

It remains largely incurable, with half of those with the condition surviving fewer than 5 years. Treatment options include:

• chemotherapy
• watching and waiting
• stem cell transplants
• targeted therapy
• immunotherapy

Peripheral T-cell lymphoma is a group of lymphomas that develop in T cells and natural killer (NK) cells. “Peripheral” means that it arises in lymph tissue outside your bone marrow. These lymphomas may develop in your:

• spleen
• lymph nodes
• gastrointestinal tract
• skin
• liver

They make up about 5 to 15 percent of NHLs in western countries.

The most common age range for diagnosis is 65 to 70.

Most subtypes are aggressive. Initial treatment usually consists of multiple chemotherapy drugs. Most patients relapse after initial treatment, so some doctors recommend high-dose chemotherapy in combination with a stem cell transplant.

Symptoms vary depending on the subtype. Many subtypes cause similar symptoms to other forms of lymphoma, such as fever, swollen lymph nodes, and fatigue. Some subtypes can cause skin rashes.

Risk factors of developing peripheral T-cell lymphoma include:

• family history of blood cancers
• eczema
• psoriasis
• celiac disease
• heavy smoking
• certain occupations such as textile workers and electrical fitters

Prognosis for people with peripheral T-cell lymphoma varies widely depending on the subtype.

Chronic lymphocytic leukemia (CLL) and small-cell lymphocytic lymphoma (SLL) are essentially the same disease. If most of the cancer cells are in your bloodstream and bone marrow, it’s called CLL. When most cancer cells are found in your lymph nodes, it’s called SLL.

CLL and SLL develop in B cells and tend to progress slowly. About 4.6 out of 100,000 people in the United States develop these diseases each year.

Most people have no obvious symptoms, and it’s often detected during routine bloodwork. Some people may experience general symptoms such as a tender abdomen or feeling full after eating a small amount.

Treatment may include watching and waiting, chemotherapy, or radiation therapy.

According to the National Cancer Institute, the 5-year relative survival rate of CLL is 87.2 percent.

There are more than 60 types of NHL that can be broadly categorized as B-cell lymphomas or T-cell and natural killer cell lymphomas. Most types of NHL affect your B cells.

The symptoms of many types of lymphoma are similar, and they’re usually impossible to differentiate without lab tests analyzing your blood and bone marrow cells. Talk with your doctor if you notice any symptoms or you have questions about non-Hodgkin’s lymphoma.