Types of lymphoma

There are many different sub-types of lymphoma, which are divided into two main types: Hodgkin’s lymphoma (Hodgkin’s disease) and non-Hodgkin’s lymphoma.

Hodgkin’s lymphoma is rare form of lymphoma that is characterised by a particular abnormal tumour cell – Reed Sternberg cells – not present in other forms of lymphoma.

Non-Hodgkin’s lymphoma (NHL) is essentially any lymphoma that is not Hodgkin’s lymphoma NHL is the most common cancer of the lymphatic system and it occurs mainly in adults, with a peak incidence between 45 and 60 years old.

Approximately 286,000 people worldwide are diagnosed with non-Hodgkin’s lymphoma each year (58% are male and 42% are female). Approximately 161,000 people die of non-Hodgkin’s lymphoma each year.

There are more than 30 different subtypes of non-Hodgkin lymphoma, which are generally classified into two groups, depending on the rate at which the tumour is growing – Indolent (low-grade) and aggressive (intermediate/high grade).


Indolent (low grade)
Here, tumour cells divide and multiply slowly. They often cause no symptoms at first, and so often go undetected for some time. Even after diagnosis, many do not need immediate treatment, sometimes for months or years.

Treatment, when needed, is usually effective at making them shrink and even disappear, giving a disease-free period, or “remission”, to the patient. However, they often relapse, or “recur”, and more treatment will then be needed. Patients may live many years with the disease, yet standard treatment cannot cure the disease in its advanced stages.


Aggressive (intermediate/high grade)
Tumour cells divide and multiply rapidly in the body and, if left untreated, can be fatal within six months to two years. They are more likely to cause symptoms than the indolent type, and they usually need treatment straight away.

Although the name “aggressive” sounds very frightening, these lymphomas often respond very well to treatment. Unlike indolent NHL, treatment of aggressive NHL can lead to patients being cured. They are, in fact, more likely to be completely cured than indolent non-Hodgkin’s lymphomas.

Most lymphomas diagnosed in Malaysia are non-Hodgkin’s lymphoma (NHL, 80% to 90%) with a small number of Hodgkin’s disease (10-20%), notes Dr Goh.

“There are two main types of NHL – aggressive NHL and indolent NHL. Diffuse large B-cell lymphoma is the most common sub-type of aggressive NHL. There is a slight predominance in males, and these occur mainly in the 40-60 age group, even though children may develop lymphoma.

“Hodgkin’s disease is found mainly in female patients and mainly in the 20-30 age group.

“Lymphoma is a very peculiar disease as it can appear anywhere in the body – brain, eye, chest, spine, stomach, thigh,” observes Dr Goh.

The typical patient is a 40-year-old male with swelling in the neck or armpit, and usually not very sick.

Diagnosis of lymphoma

Source: The Star