What Kind of Lymphoma Do You Have? Why Your Type Matters

Dr. Elise Chong Penn Medicine

The Different Types of Lymphoma

  • Lymphoma is a cancer of the immune system that affects infection-fighting cells called lymphocytes
  • Non-Hodgkin lymphoma is much more common than Hodgkin lymphoma, and it starts later in life
  • People with non-Hodgkin lymphoma can have either B-cell or T-cell lymphoma

Lymphoma is different from cancers of specific organs like the lung or breast. It’s not one cancer, but an umbrella term that encompasses several different types. Knowing which kind of lymphoma you have is important as you and your doctor plan your treatment.

“I always advise that people understand their specific type of lymphoma, because there are over 40 different types,” Dr. Elise Chong, medical oncologist at Penn Medicine, tells SurvivorNet. “One of the best ways to wrap your head around lymphoma is to start thinking about the different ways we categorize lymphoma.”

What is Lymphoma?

In general, lymphoma is a cancer of your immune system. It starts in the lymphatic system, a network of vessels, ducts, and nodes that runs throughout your body. This system drains excess fluid and waste from your tissues and drains them into your bloodstream. It also produces disease-fighting white blood cells called lymphocytes that defend your body against infections.

Lymphoma starts when lymphocytes develop a genetic mutation that makes them multiply much faster than usual. The mutation also makes older cells that would normally die stay alive. The quickly multiplying lymphocytes start to collect and build up in your lymph nodes, the small glands in your neck, armpits, and other parts of your body.

From there, the disease is divided into a number of different categories, Dr. Chong says.

Hodgkin and Non-Hodgkin Lymphoma: What’s the Difference?

The first differentiator is whether you have Hodgkin or non-Hodgkin lymphoma. Hodgkin lymphoma has distinctive, giant cells called Reed-Sternberg cells. The presence of these cells, which can be seen under a microscope, will help your doctor determine which of the two lymphoma types you have.

There are a few other important differences to note. For one thing, non-Hodgkin lymphoma is much more common. And you’re more likely to be diagnosed with it after age 55. People usually develop Hodgkin lymphoma at a younger age.

Another difference is that non-Hodgkin lymphoma is more likely to spread in a random fashion and be found in different groups of lymph nodes in the body, while Hodgkin lymphoma is more likely to grow in a uniform way from one group of lymph nodes directly to another.

Do You Have B-Cell or T-Cell Lymphoma?

Once you’ve been diagnosed with non-Hodgkin lymphoma, the next question your doctor will want to answer is whether you have B-cell or T-cell lymphoma. That answer is important, because it will help to determine which treatment you get.

B-cells and T-cells are two kinds of lymphocytes. They’re both infection-fighting cells, but they work in different ways.

Most non-Hodgkin lymphomas – about 85% — affect B-cells. These cells produce antibodies – proteins that react to foreign substances like viruses or bacteria in your body. The antibodies attach to another protein on the surface of the invading cells, called an antigen, to target and destroy them.

Types of B-cell lymphoma include:

  • Diffuse large B-cell lymphoma
  • Follicular lymphoma
  • Small lymphocytic lymphoma (SLL)/chronic lymphocytic leukemia (CLL)
  • Mantle cell lymphoma
  • Marginal zone lymphomas
  • Burkitt lymphoma

T-cell lymphomas make up only 15% of non-Hodgkin lymphomas. Unlike B-cells, T-cells directly destroy bacteria and other invaders.

Types of T-cell lymphoma include:

  • T-lymphoblastic lymphoma/leukemia
  • Peripheral T-cell lymphomas
  • Cutaneous T-cell lymphoma

Next Steps

Being diagnosed with any cancer can feel overwhelming, especially when you have a cancer as complex as lymphoma. Dr. Chong recommends that, once you know which type of cancer you have, start reading up on your cancer. Learn how your cancer might affect you, and which treatment options your doctor has available to use against it.

However, there are a lot of resources on the Internet that may be hard to navigate, and it may be hard to judge which ones are good, credible resources. Your doctor can provide you with more information and guide you toward reliable resources.

Don’t be afraid to ask questions. Your doctor and other members of your health care team (nurses, social workers) are good resources. You can also find information and advice at a lymphoma support group, which hospitals and organizations like the Leukemia & Lymphoma Society sponsor.

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Dr. Elise Chong is a medical oncologist at Penn Medicine, and an assistant professor of medicine at the Hospital of the University of Pennsylvania. She is board certified in medical oncology and internal medicine. Read More