CancerQuest | Lymphoma: Types

There are three types of Lymphoma:

1. Hodgkin's Lymphoma (Hodgkin's Disease)

2. Non-Hodgkin Lymphoma

3. Burkitt's Lymphoma

Hodgkin's Lymphoma

Cancer cells of these patients are usually abnormal B-cells referred to as a Reed-Sternberg (R-S) cells.⁽¹⁾ Although less commonly observed, R-S cells may also develop from T-cells.⁽²⁾ R-S cells most often develop in lymph nodes located in the upper body regions and spread to neighboring lymph nodes via lymphatic vessels. There are two distinct types of Hodgkin's lymphoma: classical and non-classical Hodgkin's lymphoma.⁽¹⁾

Classical Hodgkin's Lymphoma: This lymphoma features R-S cells with a classical appearance. It may be diagnosed as Nodular Sclerosis Hodgkin Disease, Mixed Cellularity Hodgkin's Disease, Lymphocyte-Rich Hodgkin Disease or Lymphocyte-Depleted Hodgkin Disease.⁽¹⁾
Non-classical Hodgkin's Lymphoma: This lymphoma features larger cancer cells that are variants of R-S cells and is most often found in the nodes of the upper body, arms and neck.⁽¹⁾

For more detailed information regarding the five variants of Hodgkin lymphoma, please visit the American Cancer Society web page on Hodgkin's Lymphoma.

Non-Hodgkin Lymphoma

The cancerous cells of non-Hodgkin lymphoma patients may be either T or B cells. In the United States, approximately 15% of cases of non-Hodgkin lymphoma cases develop from T lymphocytes and 85% develop from B lymphocytes.⁽¹⁾ Normal white blood cells may develop into over thirty different variations of abnormal cells, each classified as a distinct type of non-Hodgkin lymphoma.

The American Cancer Society estimates approximately 65,540 (89%) of the 74,030 lymphoma cases diagnosed in the United States in 2010 will be classified as non-Hodgkin lymphoma.⁽³⁾

Burkitt's Lymphoma

Burkitt's lymphoma is an aggressive form of non-Hodgkin lymphoma involving B cells. It occurs as the result of chromosome translocation involving the Myc gene. Translocation disrupts Myc expression leading to abnormal cell growth and proliferation. The rate of cell division in Burkitt's lymphoma is one of the highest among human tumors. It was first described by Dr. Denis Burkitt in 1958 while he was working in Uganda. Burkitt's lymphoma was later discovered to be highly associated with the Epstein-Barr virus; this was the first time a virus was linked to a form of cancer.

The WHO describes three clinical variants of Burkitt's lymphoma: endemic, sporadic, and immunodeficiency-associated.

Endemic Burkitt's lymphoma primarily refers to cases occurring in African children. This type usually involves the facial bones, especially the jaw, maxilla, and orbit. The Epstein-Barr virus (EBV) is associated with over 90% of endemic Burkitt's lymphoma.

Sporadic Burkitt's lymphoma refers to cases occurring in no specific geographic or climatic region. This type usually involves the abdomen. Unlike endemic lymphoma, infection with EBV is found in only about 20% of sporadic lymphoma. It accounts for 40-50% of childhood non-Hodgkin lymphoma, but only 1-2% of adult lymphomas in Western Europe and the United States.

Immunodeficiency-associated Burkitt's lymphoma refers to cases occurring in patients infected with HIV, transplant patients (most often solid organ), or individuals with other immune system disorders. BL accounts for 30-40% of non-Hodgkin lymphomas diagnosed in HIV infected individuals. However, HIV is not directly related to cancer formation. EBV is found in 30-40% of these cases of Burkitt's lymphoma.⁽⁴⁾