Hodgkin’s Lymphoma or NHL

The first juncture in lymphoma classification involves typifying the lymphoma as either Hodgkin’s lymphoma or Non-Hodgkin’s lymphoma. This is crucial in order to utilize the types of treatment that work best against these lymphomas. Hodgkin’s lymphoma is of B-cell origin, and is identified by the presence of specific and unique “Reed-Sternberg cells,” which are absent in Non-Hodgkin’s lymphoma. Meanwhile, non-Hodgkin’s lymphoma can stem from B-, T-, or NK lymphocytes.

Because of the large number of NHL types, classification can be very confusing. However, because the various types may strike age groups differentially, and may have unique presentations, patterns and velocity of growth, and prognoses, it becomes important to identify each type and subtype. The World Health Organization has created a classification system that is used widely.

T-cell or B-cell?

The vast majority of NHL cases (nearly 85%) originate in B-lymphocytes, with almost 15% involving T-lymphocytes, and the small remainder arising in NK cells. There are perhaps 30-40 subtypes of NHL, identified by virtue of the microscopic appearance of the NHL cells, their growth characteristics, the types of chromosomal patterns they display, and the identification of specific proteins on the lymphoma cells’ surfaces. Subtypes of NHL differ in terms of their:

  • Tendency to strike a specific age group
  • Initial location in the body
  • Responsiveness to specific treatments
  • Indolence or aggressiveness: A measure of a malignancy’s speed of growth and spread, and the severity of the symptoms it causes.
    • Indolent cancers (also referred to as low- or intermediate-grade cancers) grow and spread in a more leisurely fashion, sometimes taking years before any symptoms are noted.
    • Aggressive cancers (also called high-grade cancers) grow and spread quickly, and tend to cause more severe symptoms.

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