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Deciphering the Different Types of Non-Hodgkin Lymphoma – A Basic Guide

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Updated October 20, 2006

25 diseases and more descriptions:

The Non-Hodgkin Lymphomas are a very large group of diseases, often with very different symptoms, treatment and outcomes. The precise name of your type of NHL may have a number of descriptive terms that you find difficult to understand. Here is an explanation of some of these terms.

T-cell or B-cell:

Lymphomas arise from lymphocytes, a type of white blood cell. Lymphocytes are of 2 types – T cells and B cells. Both help in killing infectious agents but in slightly different ways. Depending on which type of lymphocyte turned into the cancer cell in your body, you may have a T-cell or a B-cell lymphoma. B-cell NHL is the more common variety. There are many different types of B cell and T cell lymphomas, each behaving in a different manner.

High, Intermediate or Low grade:

Pathologists, who look at the biopsy from your tumor, often describe cancers in terms of ‘grade’. A high grade lymphoma has cells which look quite different from normal cells, and seem to be multiplying very fast. They tend to grow fast. Low grade lymphomas have cells which look much like normal cells and multiply slowly. Intermediate grade lymphoma falls somewhere in the middle. The behavior of these types is also described as indolent and aggressive (see below).

Aggressive or Indolent:

What the pathologist describes as a high-grade or intermediate-grade lymphoma, usually grows fast in your body. These two types are called ‘aggressive’ NHL. Surprisingly, aggressive NHL also responds better to treatment, and the majority can be cured if they are diagnosed early. Low-grade NHL on the other hand grows slowly, and they are therefore called ‘indolent’ NHL. This group of NHL doesn’t give rise to too many symptoms, but they are also long-standing and are less likely to be cured.

Nodal or Extranodal:

When the lymphoma is mainly present in your nodes, it is called ‘nodal’ disease. Occasionally most of the lymphoma may be in an organ that is not a part of the lymph system – like the stomach, the skin or the brain. In such a situation, the lymphoma is referred to as ‘extranodal’.

Diffuse or Follicular:

These are two more terms used by the pathologist. In ‘follicular’ lymphoma, the cancer cells arrange themselves in spherical clusters called follicles. In ‘diffuse’ NHL, the cells are spread around without any clustering. Most of the time low-grade NHL looks follicular, and intermediate or high-grade NHL looks diffuse in your biopsy slides.

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