Lymphoma is a type of cancer that affects the lymphatic system, particularly the white blood cells called lymphocytes that work as protection against infections and diseases.
Lymphocytes affected by the disease reproduce faster instead of dying normally to provide space for new cells. Lymphoma develops in different parts of the body, particularly the lymph nodes, and the first manifestation of the disease is swollen, though painless, lymph nodes.
There are different types of lymphomas; the most common type is Hodgkin’s lymphoma and non-Hodgkin’s lymphoma.
The Hodgkin’s lymphomas are the rarest types of the disease and are characterized by Reed-Sternberg cells. There are six different subtypes of Hodgkin’s lymphoma. This type of cancer has several unique characteristics, which can be observed under a microscope.
According to the WHO classification system, there are four types of classical Hodgkin’s lymphoma: nodular sclerosing, mixed cellularity, lymphocyte rich, and lymphocyte depleted, as well as two types of nodular lymphocyte predominant Hodgkin’s lymphoma, which are rare and occur only in 1 out of 20 cases of the disease.
Non-Hodgkin’s lymphomas are the most common. There are about 61 known types of the disease. Unlike Hodgkin’s lymphoma, non-Hodgkin’s lymphoma does not involve Reed-Sternberg cells. It is difficult to list every type of non-Hodgkin’s lymphoma due to the number and different methods used.
Therefore, the current standard classification of non-Hodgkin’s is that defined by the WHO. It is based on its appearance when analyzed under a microscope, the chromosomal features of the lymphoma cells, the existence of certain proteins, and whether it originated in B-cells or T-cells.
About 85 percent of non-Hodgkin’s lymphomas diagnosed in the U.S. are B-cell lymphomas, which means they originated from this type of cell. Diffuse large B-cell lymphoma (DLBCL) is the most common one, followed by its subtypes primary mediastinal B-cell lymphoma — a fast growing but usually easy to treat lymphoma, and intravascular large B-cell lymphoma — a more rare lymphoma.
are also B-cell lymphomas.
Other B-cell lymphomas include follicular lymphoma; chronic lymphocytic leukemia/small lymphocytic lymphoma; mantle cell lymphoma; marginal zone B-cell lymphomas; nodal marginal zone B-cell lymphoma; nodal marginal zone B-cell lymphoma; splenic marginal zone B-cell lymphoma; Burkitt lymphoma; lymphoplasmacytic lymphoma (Waldenstrom macroglobulinemia); hairy cell leukemia; and primary central nervous system (CNS) lymphoma.
In addition, extranodal marginal zone B-cell lymphomas or mucosa-associated lymphoid tissue (MALT) lymphomas are characterized by appearing outside the lymph nodes.
Less than 15 percent of non-Hodgkin’s lymphomas are T-cell lymphomas, and there are numerous subtypes, most of them rare. Precursor T-lymphoblastic lymphoma/leukemia is one the largest subgroups of T-cell non-Hodgkin’s lymphomas. It can also be considered a leukemia, according to the extent of bone marrow affected. The other large group is the peripheral T-cell lymphomas, which includes most of the subtypes.
These subtypes of peripheral T-cell lymphomas include cutaneous T-cell lymphomas (mycosis fungoides, Sezary syndrome, among others); adult T-cell leukemia/lymphoma; angioimmunoblastic T-cell lymphoma; extranodal natural killer/T-cell lymphoma; nasal type; enteropathy-associated intestinal T-cell lymphoma (EATL), which is subdivided into type 1 and type 2; anaplastic large cell lymphoma (ALCL); and peripheral T-cell lymphoma.
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