There are over 80 recognized types of lymphoma, broadly divided into two main categories: Hodgkin lymphoma and non-Hodgkin lymphoma. Non-Hodgkin lymphoma alone accounts for the vast majority of subtypes, with B-cell lymphomas making up about 85% of non-Hodgkin cases in the United States and T-cell and NK-cell lymphomas covering the rest. The number keeps growing as scientists identify new genetic subtypes within already-known categories. Diffuse large B-cell lymphoma, for example, actually includes 15 to 20 different genetic varieties on its own.
The Two Main Categories
Every lymphoma falls into one of two broad groups: Hodgkin lymphoma or non-Hodgkin lymphoma. The distinction comes down to what the cancer cells look like under a microscope and which proteins they carry on their surface. Hodgkin lymphoma features distinctive giant cells called Reed-Sternberg cells, while non-Hodgkin lymphoma does not. This isn’t just an academic difference. It changes how the cancer behaves, how it’s treated, and what the outlook looks like.
Non-Hodgkin lymphoma is far more common, making up roughly 90% of all lymphoma diagnoses. Hodgkin lymphoma is rarer but tends to be highly treatable, even at advanced stages.
Hodgkin Lymphoma: 5 Subtypes
Hodgkin lymphoma breaks down into two groups containing five total subtypes. The first group, called classic Hodgkin lymphoma, includes four subtypes:
- Nodular sclerosis: the most common form, characterized by dense fibrous tissue surrounding nodules of lymphoma tissue
- Mixed cellularity: features a moderate number of Reed-Sternberg cells with a varied mix of other immune cells
- Lymphocyte-rich: has fewer Reed-Sternberg cells and many normal B cells, generally carrying a favorable prognosis
- Lymphocyte-depleted: the rarest classic subtype, with numerous Reed-Sternberg cells and extensive scarring of tissue
The fifth subtype, nodular lymphocyte-predominant Hodgkin lymphoma, behaves quite differently from the classic forms. Its cancer cells lack the surface proteins found in classic Hodgkin lymphoma and instead resemble B-cell non-Hodgkin lymphomas. This has led to an ongoing reclassification debate: one major international classification system now groups it with non-Hodgkin B-cell lymphomas, while the World Health Organization’s latest edition still keeps it under the Hodgkin umbrella.
B-Cell Non-Hodgkin Lymphomas
B-cell lymphomas are the most common lymphomas overall, and several subtypes dominate the landscape. Diffuse large B-cell lymphoma (DLBCL) is the single most common type of non-Hodgkin lymphoma, accounting for about 1 in every 3 cases. It’s an aggressive lymphoma, meaning it grows quickly and typically requires prompt treatment.
Follicular lymphoma is the second most common, making up about 1 in 5 lymphomas. Unlike DLBCL, follicular lymphoma is indolent, meaning it grows slowly. Some people with indolent lymphomas don’t need treatment right away and are instead monitored closely over time, a strategy sometimes called “watch and wait.”
Beyond these two, several other B-cell subtypes each account for a smaller share of cases:
- Mantle cell lymphoma: about 5% of lymphomas. It doesn’t fit neatly into the slow-growing or fast-growing category, sometimes behaving aggressively and other times following a more indolent course.
- Marginal zone lymphoma: about 5% to 10% of lymphomas. This group itself contains multiple subtypes depending on where in the body it arises.
- Burkitt lymphoma: 1% to 2% of adult lymphomas. One of the fastest-growing human cancers, but often highly responsive to treatment.
- Lymphoplasmacytic lymphoma: 1% to 2% of lymphomas. Also known as Waldenström macroglobulinemia, it produces abnormal amounts of a specific antibody protein.
- Hairy cell leukemia: very rare, with only about 700 new cases per year in the United States.
T-Cell and NK-Cell Lymphomas
T-cell and NK-cell lymphomas are considerably rarer than their B-cell counterparts, but they encompass a long list of subtypes. The WHO’s latest classification organizes them into several groups based on where they develop in the body.
Skin-based (cutaneous) T-cell lymphomas include mycosis fungoides, the most well-known form, along with several others that range from slow-growing skin conditions to aggressive diseases. Nodal T-cell lymphomas arise in the lymph nodes, with the angioimmunoblastic type being the most common T-cell lymphoma in some populations. Intestinal T-cell lymphomas develop in the digestive tract and include forms linked to celiac disease. NK-cell lymphomas, which involve a different type of immune cell called natural killer cells, are more common in parts of Asia and Latin America than in Western countries.
In total, the current WHO classification lists more than 30 distinct T-cell and NK-cell lymphoma entities. Many are individually quite rare, which can make diagnosis and treatment more complex.
Slow-Growing vs. Fast-Growing Lymphomas
Regardless of the specific subtype, lymphomas generally fall along a spectrum from indolent (slow-growing) to aggressive (fast-growing). This distinction matters as much as the specific name because it shapes the treatment approach.
Indolent lymphomas like follicular lymphoma may not cause symptoms for years. When they do need treatment, they often respond well but can recur over time. Aggressive lymphomas like DLBCL and Burkitt lymphoma progress quickly and cause noticeable symptoms sooner, but they also tend to be more curable with intensive treatment because fast-dividing cells are more vulnerable to therapy. Some subtypes, like mantle cell lymphoma, blur the line between these categories and require a treatment plan tailored to how the cancer is actually behaving in a given patient.
Why the Count Keeps Changing
The number of recognized lymphoma types has grown steadily over the past two decades as genetic testing has become more sophisticated. What once looked like a single disease under a microscope often turns out to be several genetically distinct cancers that happen to look similar. DLBCL is a good example: it’s classified as one lymphoma type, but molecular profiling reveals 15 to 20 different genetic varieties within it, each potentially responding differently to treatment.
Two major classification systems now exist side by side. The WHO published its 5th edition in 2022, and the International Consensus Classification (ICC) was released the same year. In practice, the two systems agree on about 93% of cases. Minor differences, mostly just naming conventions, affect about 6% of cases. True disagreements where a patient would be classified differently occur in less than 1% of cases, primarily involving certain rare B-cell lymphomas with specific genetic rearrangements and some splenic lymphomas.
For patients, this means the exact label your lymphoma receives can occasionally depend on which classification system your pathologist uses. The practical impact on treatment decisions is small for most people, but it’s one reason getting a diagnosis reviewed at a center experienced with lymphoma can be valuable, especially for rarer subtypes.