Types of Lymphoma
Lymphoma is a broad term for cancer that begins in the lymphatic system— particularly, the white blood cells called lymphocytes, which work as protection against infections and diseases. Because the disease is so complex, the specialists at Rocky Mountain Cancer Centers recommend learning as much as you can regarding your specific type of lymphoma, which can affect both your treatment and expected outcome (prognosis).
Many types of lymphoma exist. However, they are broadly categorized into two main types: Hodgkin lymphoma and non-Hodgkin lymphoma. Beyond that, there are many different subtypes, especially subtypes of non-Hodgkin lymphoma.
Some lymphomas arise from B-lymphocytes, while others arise from T-lymphocytes. Lymphomas are also described by their growth rate, with rapidly growing lymphomas referred to as “aggressive” and slow-growing lymphomas referred to as “indolent.”
Hodgkin lymphoma (HL), formerly called Hodgkin disease, almost always develops from B cells and typically affects the lymph tissue found in the lymph nodes, spleen, liver, and bone marrow. This disease is less common than its counterpart, Non-Hodgkin lymphoma, and tends to affect young adults in the prime of their lives. However, thanks to remarkable advances in treatment, Hodgkin lymphoma is now considered one of the most curable cancers.
Hodgkin lymphoma is divided into two main subtypes, which are:
- Classical Hodgkin lymphoma (cHL), which is characterized by the presence of very large cells called Reed-Sternberg (RS) cells
- Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL), which is characterized by the presence of lymphocyte-predominant cells, sometimes termed “popcorn cells” — a variant of Reed-Sternberg cells
About 95% of people with Hodgkin lymphoma have classical Hodgkin lymphoma, whereas Nodular lymphocyte-predominant Hodgkin lymphoma affects about 5% of Hodgkin lymphoma patients.
Non-Hodgkin lymphoma (NHL) is the most common type of lymphoma that generally develops in the lymph nodes and lymphatic tissue found in organs such as the stomach, intestines or skin. In some cases, however, NHL involves bone marrow and blood.
There are several different subtypes of NHL, which are categorized by the characteristics of the lymphoma cells, including their appearance, the presence of proteins on the surface of the cells, their genetic features, and how fast (or slow) they progress.
Some common subtypes of NHL that are aggressive (fast-growing) include:
- Anaplastic large-cell lymphoma
- Diffuse large B-cell lymphoma (DLBCL)
- Mantle cell lymphoma (MCL)
- Acquired immune deficiency syndrome (AIDS)-associated lymphoma
- Burkitt lymphoma
- Peripheral T-cell lymphoma (PTCL)
- Central nervous system (CNS) lymphoma
- Lymphoblastic lymphoma
- Transformed follicular and transformed mucosa-associated lymphoid tissue (MALT) lymphomas
Some common subtypes of NHL that are indolent (slow-growing) include:
- Cutaneous B-cell lymphoma
- Cutaneous T-cell lymphoma (mycosis fungoides and Sézary syndrome)
- Lymphomatoid granulomatosis
- Follicular lymphoma
- Waldenström macroglobulinemia (lymphoplasmacytic lymphoma)
- Hairy cell leukemia
- Lymphoplasmacytic lymphoma/Waldenström macroglobulinemia
- Marginal zone B-cell lymphoma
- Gastric mucosa-associated lymphoid tissue (MALT) lymphoma
- Chronic lymphocytic leukemia/small-cell lymphocytic lymphoma (CLL/SLL)
- Primary central nervous system lymphoma
Lymphoma of the Skin
Sometimes non-Hodgkin lymphomas develop in the skin without affecting other areas of the body at the time of diagnosis. Although not a type of skin cancer, these are called skin lymphomas (cutaneous lymphomas).
There are many types of skin lymphomas. These types are classified based on:
- Whether the lymphoma developed from T-cells or B-cells
- How the lymphoma looks under the microscope
- Whether certain proteins are on the lymphoma cells
The most common type of skin lymphoma is cutaneous T-cell lymphomas (CTCLs). T-cell skin lymphomas often appear as a red and dry rash and can affect widespread parts of the body. There are several subtypes of CTCL, which include:
- Mycosis fungoides
- Sezary syndrome (SS)
- Adult T cell leukemia-lymphoma (ATLL)
- Primary cutaneous anaplastic large cell lymphoma (C-ALCL)
- Lymphomatoid papulosis
- Subcutaneous panniculitis-like T-cell lymphoma
- Extranodal NK/T-cell lymphoma, nasal type
- Primary cutaneous peripheral T-cell lymphoma, rare subtypes
Cutaneous B-cell lymphomas (CBCLs) are a more unusual type. They can cause lumps in the skin, usually in one or two areas of the body. Some subtypes of CBCLs include:
- Primary cutaneous marginal zone B-cell lymphoma
- Primary cutaneous follicle center lymphoma
- Primary cutaneous diffuse large B-cell lymphoma, leg type
Your RMCC oncologist will be able to tell you more about your specific type of skin lymphoma including how advanced it is and how it responds to treatment.
How Common is Lymphoma of the Skin?
Lymphomas of the skin are uncommon, accounting for roughly 4% of all non-Hodgkin lymphomas. Although the rate has risen over the past few decades, there has been little increase in recent years. The American Cancer Society estimates 81,560 new cases of non-Hodgkin lymphoma (NHL) in the United States for 2021.
Risk Factors for Lymphoma of the Skin
At this time, there is no clear cause of skin lymphoma. However, there are some recognized risk factors which include:
- Age: Most skin lymphomas occur in people in their 50s and 60s.
- Gender and race: Skin lymphomas are more common in men, and African Americans tend to have a higher risk as well.
- Weakened immune system: This includes people with acquired immunodeficiency syndrome (AIDS), people who have had an organ transplant, and those who take immunosuppressive medication.
Can Lymphoma of the Skin Be Prevented?
Unfortunately, most lymphomas of the skin have no known cause, therefore, there is no sure way to prevent them from developing. With that said, having a weakened immune system may raise your risk of skin lymphoma. Healthy eating, exercise, not smoking, and following safe sex practices can help keep your immune system strong.
At Rocky Mountain Cancer Centers, our commitment to our patients is to provide the most advanced treatments for all types of cancers of the blood, including lymphomas. Please find the RMCC location that is most convenient for you and call to request an appointment.