More than 60 specific NHL subtypes have been identified and assigned names by the World Health Organization (WHO). NHL subtypes are categorized by the characteristics of the lymphoma cells, including their appearance, the presence of proteins on the surface of the cells and their genetic features. It's important to know your subtype since it plays a large part in determining the type of treatment you'll receive. A hematopathologist, a doctor who specializes in the diagnosis of blood disorders and blood cancers, should review your biopsy specimens.
Specialists further characterize the NHL subtypes according to how the disease progresses:
- Aggressive lymphomas are fast-moving and account for about 60 percent of all NHL cases. Diffuse large B-cell lymphoma (DLBCL) is the most common aggressive NHL subtype.
- Indolent lymphomas are slow-moving and tend to grow more slowly and have fewer signs and symptoms when first diagnosed. Slow-growing or indolent subtypes represent about 40 percent of all NHL cases. Follicular lymphoma (FL) is the most common subtype of indolent NHL.
The treatments for aggressive and indolent lymphomas are different. When a patient’s rate of disease progression is between indolent and aggressive, he or she is considered to have “intermediate grade” disease. Some cases of indolent NHL can transform into aggressive NHL.
Diagnostic Designations for Non-Hodgkin Lymphoma (NHL): Subtypes
This list provides some of the diagnostic designations for NHL subtypes based on the WHO classification, categorized by cell type (B cell, T cell or NK cell) and rate of progression (aggressive or indolent). The percentages listed reflect the frequency of diagnosed cases of the most common NHL subtypes.
Mature B-cell lymphomas (about 85%-90% of NHL cases)
Aggressive
- Diffuse large B-cell lymphoma (DLBCL) (31%)
- Mantle cell lymphoma (MCL) (can present as aggressive or indolent) (6%)
- Lymphoblastic lymphoma (2%)
- Burkitt lymphoma (BL) (2%)
- Primary mediastinal (thymic) large B-cell lymphoma (PMBCL) (2%)
- Transformed follicular and transformed mucosa-associated lymphoid tissue (MALT) lymphomas
- High-grade B-cell lymphoma with double or triple hits (HBL)
- Primary cutaneous DLBCL, leg type
- Primary DLBCL of the central nervous system
- Primary central nervous system (CNS) lymphoma
- Acquired immunodeficiency syndrome (AIDS)-associated lymphoma
Indolent
- Follicular lymphoma (FL) (22%)
- Marginal zone lymphoma (MZL) (8%)
- Chronic lymphocytic leukemia/small-cell lymphocytic lymphoma (CLL/SLL) (6%)
- Gastric mucosa-associated lymphoid tissue (MALT) lymphoma (5%)
- Lymphoplasmacytic lymphoma (1%)
- Waldenström macroglobulinemia (WM)
- Nodal marginal zone lymphoma (NMZL) (1%)
- Splenic marginal zone lymphoma (SMZL)
Mature T-cell and natural killer (NK)-cell lymphomas (about 10%-15% of NHL cases)
Aggressive
- Peripheral T-cell lymphoma (PTCL), not otherwise specified (6%)
- Systemic anaplastic large-cell lymphoma (ALCL) (2%)
- Lymphoblastic lymphoma (2%)
- Hepatosplenic gamma/delta T-cell lymphoma
- Subcutaneous panniculitis-like T-cell lymphoma (SPTCL)
- Enteropathy-type intestinal T-cell lymphoma
- Primary cutaneous anaplastic large-cell lymphoma
- Angioimmunoblastic T-cell lymphoma (AITL)
Indolent
- Cutaneous T-cell lymphoma (CTCL) (4%)
- Mycosis fungoides (MF)
- Sézary syndrome (SS)
- Adult T-cell leukemia/lymphoma
- Extranodal NK/T-cell lymphoma (ENK/TCL), nasal type
Source: The 2016 revision of the World Health Organization classification of lymphoid neoplasms
Download or order the following free LLS fact sheets:
- Cutaneous T-Cell Lymphoma Facts
- Mantle Cell Lymphoma Facts
- Peripheral T-Cell Lymphoma Facts
- Waldenström Macroglobulinemia Facts
Related Links
- Treatment for Aggressive NHL Subtypes
- Treatment for Indolent NHL Subtypes
- Download or order the following free LLS booklet and fact sheets: