Types of NHL

Throughout the past 40 years, the classification of lymphoma has changed considerably. These changes have been based upon new insights provided by technological advances, as well as advances in our understanding of the clinical behavior of lymphoma.

Like Hodgkin's disease, non-Hodgkin's lymphoma is composed of a very mixed group of cancers. There are many subtypes, each with a different prognosis. The loosely divided classifications, as recognized by the International Lymphoma Study Group (ILSG), are:

NHLs may be separated further according to cell type: B-cell tumors are composed of B-cell variants, while T-cell tumors are composed of T cell. Among NHLs, roughly 85 percent of cases are B-cell cancers, whereas only 15 percent are T-cell cancers.

In the normal immune system, B-cells (B-lymphocytes) fight bacteria by developing into plasma cells. The plasma cells make antibodies that "tag" germs for removal by specialized immunologic cells which surround and digest them. By contrast, T-cells (T lymphocytes) are immunologic "conductors." They direct B-cells and other lymphatic cells in the production of an overall immune response. T-cells help to rid the body of viruses, fungi, and certain bacteria, and they also make cytokines—substances that draw other infection-fighting white blood cells to tissues that are under attack by microorganisms.

Table 2: NHL Groups

Suggested NHL groups recognized by the ILSG:
I. Slow-Growing Lymphomas and Lymphoid Leukemias

B-Cell Chronic Lymphocytic Leukemia (B-CLL)/Small Lymphocytic Lymphoma (SLL)
Lymphoplasmacytoid Lymphoma
Follicle Center Lymphoma, Follicular Small Cleaved Cell (FSC),
Follicular Mixed Cell (FM)
Marginal Zone B-cell Lymphoma
Hairy Cell Leukemia

T-cell Large Granular Lymphocyte Leukemia
Adult T-Cell Leukemia/Lymphoma (ATL/L ) [smoldering]
Mycosis Fungoides/Sézary Syndrome

II. Moderately Aggressive Lymphomas and Lymphoid Leukemias
B-cell B-Cell Prolymphocytic Leukemia (B-PLL)
Mantle Cell Lymphoma
Follicle Center Lymphoma, Follicular Small Cleaved Cell (FSC),
Follicle Center Lymphoma (follicular large cell)

T-cell T-cell Chronic Lymphocytic Leukemia/Prolymphocytic Leukemia (T-CLL/PLL)
Adult T-Cell Leukemia/Lymphoma (ATL/L) [chronic]
Angiocentric Lymphoma
Angioimmunoblastic Lymphoma

III. Aggressive Lymphomas
B-cell B-Cell Large B-Cell Lymphoma

T-cell Peripheral T-Cell Lymphomas
Intestinal T-Cell Lymphoma
Anaplastic Large Cell Lymphoma
Sézary Syndrome

IV. Highly Aggressive Lymphomas and Lymphoid Leukemias
B-cell Precursor B-Lymphoblastic Leukemia/Lymphoma (PB-LBL/L)
Burkitt's Lymphoma
High-Grade B-Cell Lymphoma, Burkitt's-like

T-cell Precursor T-lymphoblastic leukemia/lymphoma (T-LBL/L)
Adult T-cell leukemia/Lymphoma (ATLL) [acute and lymphomatous]

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 14 Aug 1999

Last Modified: 28 Sep 2015