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

Non-Hodgkin lymphoma (NHL) usually starts in the lymph nodes. Often several areas of lymph nodes around the body are affected.

NHL can also start outside the lymph nodes in almost any part of the body. This is called primary extranodal lymphoma.

There are many different types of NHL. Doctors can find out which type you have by examining some lymphoma cells under a microscope. Knowing which type you have means they can give you the best treatment.

Some lymphomas grow very slowly and may not need treatment for months or years. These are low-grade lymphomas. Other types grow quickly and need treatment soon after diagnosis. These are high-grade lymphomas.

What are B-cell and T-cell lymphomas?

Lymphomas develop from white blood cells called lymphocytes.

There are two 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 non-Hodgkin lymphoma (90%) have a B-cell lymphoma.

The most common types of B-cell lymphoma are:

diffuse large B-cell lymphoma (DLBCL)
follicular lymphoma (FL).

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
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, including:

peripheral T-cell lymphoma
skin (cutaneous) lymphomas – including mycosis fungoides and Sézary syndrome
anaplastic large cell lymphoma
angioimmunoblastic lymphoma
lymphoblastic lymphoma – this is mainly T-cell but can be B-cell).

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 them to start are in the stomach and small bowel (intestine). But lymphoma can begin in almost any part of the body including the:

nose
throat
thyroid
breast
skin
testicles.

They are treated according to the type of lymphoma cells. The most common types of pENL are:

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 is diffuse large B-cell lymphoma (DLBCL).

About our information

References

Below is a sample of the sources used in our non-Hodgkin lymphoma (NHL) information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

National Institute of Health and Care Excellence (NICE). Blood and bone marrow cancers. NICE Pathways. Last accessed 3 December 2020.

Non-Hodgkin’s lymphoma: diagnosis and management; NICE Guideline (July 2016).

Newly Diagnosed and Relapsed Follicular Lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up; European Society for Medical Oncology (2020).

Reviewers

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. It has been approved by Senior Medical Editor, Professor Rajnish Gupta, Macmillan Consultant Medical Oncologist.

Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.