The most common types of non Hodgkin's lymphoma

There are many different types of non Hodgkin's lymphoma. Understanding how different types of NHL are grouped, or classified, is not easy. A variety of systems for classifying lymphomas have been used over the years. The latest is the World Health Organisation classification of 2001. We give a simple description of the groups on this page.

Your doctor will find out which type of non Hodgkin's lymphoma you have by taking a lymph node out and looking at the cells under a microscope. This is called a biopsy. Look in the section about diagnosing non Hodgkin's lymphoma for more about this. Your doctor will examine the cells to see

• The grade of your NHL
• The type of cell affected (B cell or T cell)
• What the cells look like under a microscope

NHL is classified into two main types

• Low grade non Hodgkin's lymphomas
• High grade non Hodgkin's lymphomas

There are also rarer types of NHL and there is information on some of those at the end of this section.

Doctors put non Hodgkin's lymphomas into two groups depending on how quickly they are likely to grow and spread

• Low grade (slow growing)
• High grade (faster growing)

The different grades of non Hodgkin's lymphoma are treated in slightly different ways. Look in the treating non Hodgkin's lymphoma section for more information about how the different types of non Hodgkin's lymphoma are treated.

Your doctor will be able to give your type of non Hodgkin's lymphoma a name depending on the appearance of the lymphoma cells. These names are quite complicated. But they are useful to doctors because the different types are known to behave slightly differently. Different treatments are used for the different types. So knowing the type helps the doctor know how to treat them. In the laboratory a pathologist looks at the cells to see if they are

• Large or small
• Grouped together (follicular type) or spread out (diffuse type)

Low grade non Hodgkin's lymphomas tend to have small cells that are grouped together.

Remember that the word diffuse can also be used to describe NHL that is widespread in the body. This is not the same as diffuse type NHL. As you can see, the classification of lymphoma can be a confusing subject.

• Follicular
• Mantle cell
• Splenic marginal zone lymphoma
• MALT lymphoma
• Lymphoplasmacytic NHL (also called Waldenstrom's macroglobulinaemia)
• Small cell lymphocytic lymphoma (or chronic lymphocytic leukaemia)

Follicular lymphoma is a common type of lymphoma. Follicular lymphomas can be divided into 3 separate grades – 1, 2 and 3. Grade 3 is divided into 3A and 3B. The grades are based on how the lymphoma cells look under the microscope. There is a lot of discussion amongst doctors about whether grading for follicular lymphoma is accurate. It can be difficult to tell the difference between different types of lymphoma cells. Grade 3 follicular lymphoma is faster growing and is likely to be treated as a high grade lymphoma.

Even though mantle cell lymphomas are classed as low grade, they behave aggressively and are often treated more like high grade lymphomas.

Small cell lymphocytic lymphoma and chronic lymphocytic leukaemia are terms used for the same condition. In theory, lymphoma is an illness that starts in the lymph nodes and leukaemia is an illness of the blood. But leukaemia and lymphoma have many similarities and often affect the body in similar ways. Chronic lymphocytic leukaemia is the term used most often. The name small cell lymphoma is sometimes used when the disease involves the lymph nodes in particular. We have a whole section of information about chronic lymphocytic leukaemia which covers diagnosis, treatment and ways of coping.

• Diffuse large B cell
• Diffuse mixed cell lymphoma
• Burkitt's lymphoma
• Anaplastic large cell lymphoma
• Diffuse mixed cell lymphoma

Over time, low grade lymphomas may change into a more aggressive high grade type lymphoma. This can happen to between 10 and 70 out of every 100 people diagnosed with NHL (10 to 70%), depending on the type they have. So it doesn't always happen. If it does, it may be several years after you were first diagnosed with the low grade lymphoma.

Sometimes, a low grade and higher grade lymphoma can be there at the same time, in the same person. Even in the same lymph node. If this happens, your doctor may assume that it is in the process of transforming to the higher grade type.

After a low grade NHL has transformed, it has to be treated as high grade. Unfortunately, a transformed NHL is harder to control than it was when low grade. And the treatment is more intense.

If you would like more information about anything to do with the types of NHL, contact one of the cancer information NHL organisations. They often have free factsheets and booklets which they can send to you.

One rare type of non Hodgkin's lymphoma is mycosis fungoides. This is sometimes called cutaneous T cell lymphoma. This means T cell lymphoma that affects the skin. It is treated with ultraviolet light treatment, chemotherapy and radiotherapy. There is a page about cutaneous T cell lymphoma in this section.

MALT lymphoma is a type of NHL that starts outside the lymphatic system. MALT stands for mucosa associated lymphoid tissue. It means that the lymphoma begins to grow in lymphatic tissue that is found in the lining of other organs. MALT lymphoma is most  common in the stomach. It is linked to a bacterial infection called helicobacter pylori. Research over the past few years has discovered that treating the infection with antibiotics can put MALT lymphoma of the stomach into remission. It is too early to say how long the remission lasts. Treating the infection may actually cure this rare type of NHL. There is information about MALT lymphoma on another page in this section.

Mantle cell lymphoma is a rare type of NHL that makes up between 5 and 10 out of every 100 (5 to 10%) of all non Hodgkin's lymphomas diagnosed. It most often affects men over the age of 50. There is a page about mantle cell lymphoma in this section.