There are different types of Hodgkin lymphoma. Knowing the type helps your doctor to decide what treatment you need.
The World Health Organisation's (WHO) classification system puts Hodgkin lymphoma into 2 main groups. They are:
- classical type
- nodular lymphocyte predominant type
Classical Hodgkin lymphoma
There are 4 types of classical Hodgkin lymphoma. They all contain abnormal cells called Reed-Sternberg cells. These cells are a type of white blood cell (B lymphocyte) that has become cancerous.
The 4 subtypes are:
Nodular sclerosing is the most common type of Hodgkin lymphoma in the UK. Nearly 60 out of 100 of all cases (60%) are this type.
Nodular sclerosing is the most common type in young adults. It is usually found at an early stage when lymph nodes in the neck become swollen (enlarged).
About 15 out of every 100 cases (15%) of Hodgkin lymphoma are the mixed cellularity type. It often affects a few groups of lymph nodes when it is diagnosed. These lymph nodes contain a mixture of different types of lymphocytes and other blood cells.
20 out of 100 cases (20%) of Hodgkin lymphoma are the lymphocyte rich type. The lymphocytes look very small. When doctors look at a sample of the affected lymph node under the microscope, they see lots of lymphocytes with very few Reed-Sternberg cells.
The lymphocyte depleted type of classical Hodgkin lymphoma is very rare. The lymph nodes may contain a lot of fibrous tissue with very few Reed-Sternberg cells. Or they may contain a lot of a type of lymphocyte called the reticular lymphocyte, and many Reed-Sternberg cells.
Nodular lymphocyte predominant type
Only about 5 in 100 cases (5%) of Hodgkin lymphoma are the nodular lymphocyte predominant type. It's more common in older people but can occur in young people.
The main difference between this type and classical Hodgkin lymphoma is that in the nodular lymphocyte predominant type there are very few Reed-Sternberg cells. But there are other abnormal cells that doctors call popcorn cells.
This type of Hodgkin lymphoma is often only in one group of lymph nodes when it is diagnosed (localised disease). It tends to be slower growing than classical Hodgkin lymphoma and the treatment is different.