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Non-Hodgkin Lymphoma Overview

What is Non-Hodgkin Lymphoma (NHL)?

Non-Hodgkin lymphoma (NHL) is a group of blood cancers that includes all types of lymphoma except Hodgkin Lymphomas. All NHL’s are classified into two groups called B Cell Lymphomas or T Cell Lymphomas. Lymphomas arise when developing B and T lymphocytes undergo a cancerous change, and multiply in an uncontrolled way. These abnormal lymphocytes, called lymphoma cells, form collections of cancer cells called tumours, in lymph nodes and other parts of the body. The majority of lymphomas (around 85%) arise in developing B-lymphocytes (B-cell lymphomas). The remainder arise in developing T-lymphocytes (T-cell lymphomas). Within NHL there are over 60 specific types of lymphoma.

How common is NHL?

In the past 20 years, the number of people diagnosed with NHL has doubled. In Australia, there are now over 6000 people diagnosed with NHL each year. Lymphoma therefore represents the fifth most common cancer diagnosed in the Australian population.

How does NHL develop?

NHL can begin in any lymph node or lymph tissue found in the body. Tumours may involve just one lymph node or several lymph nodes at the same time. Since lymphocytes move throughout the body through either the bloodstream or more commonly the lymphatic system, any abnormal lymphocyte has a clear path to travel all through the body. This is why NHL can start in or spread to any part of the body. It is for this reason that many people have widespread disease at the time of diagnosis.

What are the subtypes of NHL?

There are over 80 subtypes of lymphoma and they are categorised under B Cell Lymphomas and T Cell Lymphoma below is a list of the main subtypes.  

B Cells
• Diffuse Large B Cell lymphoma (DLBCL)
• Follicular Lymphoma (FL)
• Mantle Cell Lymphoma (MCL)
• Burkitt’s Lymphoma (BL)
• Chronic Lymphocytic Leukeamia (CLL)/Small Lymphocytic Lymphoma (SLL)
• Marginal Zone Lymphoma (MZL)
• Waldenstroms Macrogloulineamia (WM)
• B Cell Acute Leukaemia/Lymphoma (B-ALL)

T Cells
• Cutaneous T Cell Lymphoma (CTCL)
• Adult T Cell Lymphoma/Leukaemia
• Anaplastic T Cell Lymphoma (ATCL)
• Peripheral T Cell Lymphoma (PTCL)
• T Cell Acute Leukaemia/Lymphoma (T-ALL)

“When you are diagnosed with lymphoma, do not forget to ask – what is my subtype?”

World Health Organization Classification of B-Cell and T-Cell Lymphomas

 B-Cell & T-Cell Lymphomas

B-Cell Lymphomas T-Cell Lymphomas
Precursos B-Cell Lymphomas
  • Precursor B-Cell lymphoblastic leukaemia/lymphoma 
Precursor T-Cell Lymphomas
  • Precursor T-Cell lymphoblastic leukaemia/lumphoma 
Mature B-Cell Lymphomas
  •  Follicular lymphoma
  • Mantle cell lymphoma
  • Diffuse large B-Cell lymphoma
  • Burkitt's lymphoma
  • B-Cell chronic lymphocytic lymphoma
  • Marginal zone lymphomas
    • Extranodal marginal zone B-Cell lymphoma of mucosa-associated lymphoid tissue (MALT) type
    • Splenic marginal zone B-cell lymphoma
    • Nodal marginal zone lymphoma
  • Lymphoplasmacytic lymphoma (Waldenstrom's macroglobulinaemia) 
Mature T-Cell Lymphomas
  • Mature B-Cell lymphoma Adult T-Cell leukaemia/lymphoma
  • Anaplastic large cell lymphoma
  • Cutaneous T-Cell lymphoma (including mycosis fungoides and Sezary syndrome)
  • Peripheral T-Cell lymphomas:
    • Subcutaneous panniculitis-like T-Cell lymphoma
    • Hepatosplenic gamma-delta T-Cell lymphoma
    • Enteropathy-type intestinal T-Cell lymphoma
    • Extranodal T-Cell lymphoma, nasal type
    • Angioimmunoblastic T-Cell lymphoma
    • Peripheral T-Cell lymphoma, unspecified