B-cell lymphomas make up the majority (about 85%) of non-Hodgkin lymphomas (NHL) in the United States. These are types of lymphoma that affect B cells. The most common types of B cell lymphoma are listed below.
Diffuse large B-cell lymphoma (DLBCL)
This is the most common type of NHL in the United States, accounting for about 1 in 3 lymphomas. Lymphoma cells look quite large under a microscope.
DLBCL can affect people of all ages, but it mostly occurs in older people. The median age at diagnosis is 60 years. It usually begins as a rapidly growing mass in a lymph node deep in the body, such as the chest or abdomen, or in a lymph node that can be felt, such as in the neck or armpit. It can also start in other areas like the gut, the bones, or even the brain or spinal cord.
DLBCL is usually a fast-growing (aggressive) lymphoma, but it usually responds well to treatment. Generally, about 3 out of 4 people have no signs of the disease after initial treatment, and many are cured.
A subtype of DLBCL isPrimary B-cell lymphoma of the mediastinum. This type of lymphoma occurs mainly in young women. It starts in the mediastinum (the area in the middle of the chest behind the breastbone). It can get quite large and cause breathing difficulties because it often puts pressure on the windpipe (trachea) that leads to the lungs. It can also block the superior vena cava (the large vein that carries blood back to the heart from the arms and head), which can cause swelling of the arms and face. This is a fast-growing lymphoma, but it usually responds well to treatment.
There are several other subtypes of DLBCL, but these are rare.
follicular lymphoma
About 1 in 5 lymphomas in the United States is follicular lymphoma. It is usually a slow-growing (indolent) lymphoma, although some follicular lymphomas can grow rapidly.
The average age of people with this lymphoma is about 60 years. It is rare in very young people. Typically, this lymphoma occurs in many lymph node locations in the body as well as in the bone marrow.
Follicular lymphomas usually respond well to treatment but are difficult to cure. These lymphomas may not need treatment when they are first diagnosed. Instead, treatment can be delayed until the lymphoma starts causing problems. Over time, some follicular lymphomas can transform into a rapidly growing diffuse large B-cell lymphoma.
Chronic Lymphocytic Leukemia (CLL)/Small Lymphocytic Lymphoma (SLL)
CLL and SLL are closely related disorders. In fact, many doctors consider them to be different versions of the same disease. The same type of cancer cell (known assmall lymphocytes) is seen in CLL and SLL. The only difference is where the cancer cells are found. In CLL, most cancer cells reside in the blood and bone marrow. In SLL, cancer cells are mainly found in the lymph nodes and spleen.
Both CLL and SLL are generally slow-growing (indolent) diseases, although CLL, which is much more common, tends to be slower-growing. Treatment is the same for CLL and SLL. They are usually not curable with standard treatments, but many people can live with them for long periods (even decades). Sometimes they can develop into a more aggressive (rapidly growing) type of lymphoma over time.
For more information, seeChronic Lymphocytic Leukemia.
Mantle cell lymphoma (MCL)
About 5% of lymphomas are mantle cell lymphomas. MCL is much more common in men than women and is more common in people over the age of 60. By the time MCL is diagnosed, it has usually spread to the lymph nodes, bone marrow, and often the spleen.
MCL can be difficult to treat. It tends to grow faster than indolent (slow-growing) lymphomas, but usually doesn't respond to treatment as well as aggressive (fast-growing) lymphomas. But newer treatments may offer patients who are diagnosed a better chance of long-term survival.
marginal zone lymphoma
Marginal zone lymphomas account for about 5% to 10% of lymphomas. They tend to grow slowly (indolent). The cells of these lymphomas look small under the microscope. There are 3 main types of marginal zone lymphoma:
Extranodal marginal zone B-cell lymphoma, also known as mucosa-associated lymphoid tissue (MALT) lymphoma:This is the most common form of marginal zone lymphoma. It starts in places other than the lymph nodes (extranodal).
There are gastric and non-gastric MALT lymphomas. Gastric MALT lymphomas begin in the stomach and are associated with infectionHelicobacter pylori(the bacteria that cause many stomach ulcers). MALT lymphoma can also start outside the stomach (not in the stomach) in the lungs, skin, thyroid, salivary glands, or tissues around the eye. The lymphoma usually stays in the area where it started and is not widespread. Many of these other MALT lymphomas have also been linked to bacterial (such as Chamydophila and Campylobacter) or viral infections.
The average age of people with MALT lymphoma at diagnosis is around 60 years. This lymphoma tends to grow slowly and is usually curable if the amount of cancer is limited. Doctors often use antibiotics as the first treatment for MALT lymphoma of the stomach because treating theHelicobacter pylorithe infection often cures the lymphoma.
Nodal marginal zone B-cell lymphoma:This is a rare disease. It usually starts and stays in the lymph nodes, although sometimes lymphoma cells can also be found in the bone marrow.
This lymphoma tends to grow slowly (although usually not as slowly as MALT lymphoma) and is treated similarly to follicular lymphoma.
B-cell lymphoma of the splenic zone:This is a rare lymphoma. Lymphomas are often found primarily in the spleen, blood, and bone marrow.
It can cause fatigue and discomfort due to an enlarged spleen. Because the disease is slow growing, you may not need treatment unless the symptoms become bothersome. This type of lymphoma has been linked to hepatitis C infection. Treatment for the hepatitis C virus can sometimes treat this lymphoma as well.
Burkitt-lymphoma
This fast-growing lymphoma is named after the doctor who first described the disease in African children and young adults. It accounts for about 1% to 2% of all lymphomas in adults. It is rare in adults but more common in children. It is also much more common in men than women.
Burkitt lymphoma cells are medium-sized. A similar type of lymphoma,Burkitt-lymphoma, has slightly larger cells but different chromosomal abnormalities.
Different variants of this lymphoma are seen in different parts of the world:
- In Africa (theendemic), Burkitt lymphoma usually begins as a tumor in the jaw or other facial bones. Most of these cases are related to infection with Epstein-Barr virus (EBV, which can also cause infectious mononucleosis, or "mono"). This type of Burkitt lymphoma is rare in the United States.
- In the type most common in the United States (not endemic or sporadic), lymphoma usually begins in the abdomen (belly), where it forms a large tumor. It can also start in the ovaries, testicles, or other organs and spread to the brain and spinal fluid. Some of these are related to EBV infection.
- Another form of Burkitt's lymphoma (immunodeficiency-associated) is linked to problems with the immune system, for example in people with HIV or AIDS or after an organ transplant.
Burkitt's lymphoma grows very quickly, so it needs immediate treatment. But more than half of patients can be cured with intensive chemotherapy.
Lymphoplasmic lymphoma (Waldenstrom macroglobulinemia)
This slow-growing lymphoma is rare, accounting for only 1% to 2% of lymphomas. Lymphoma cells are small and are found mainly in the bone marrow, lymph nodes, and spleen. This lymphoma is discussed in detail inMacroglobulinemia de Waldenström.
Haarzell-Leukämie
Despite its name, hairy cell leukemia (HCL) is sometimes thought of as a type of lymphoma. It's rare: About 700 people are diagnosed in the United States each year. Men are much more likely to develop HCL than women, and the average age at diagnosis is around 50 years.
The cells are small B lymphocytes that have protrusions that give them a "hairy" appearance. They are usually found in the bone marrow, spleen, and blood.
Hairy cell leukemia grows slowly, and some people may never need treatment. An enlarged spleen or low blood cell count (due to cancer cells invading the bone marrow) are common reasons for starting treatment. When treatment is needed, it is usually very effective.
There is also talk of hairy cell leukemiaChronic Lymphocytic Leukemia.
Primary central nervous system (CNS) lymphoma.
This lymphoma affects the brain or spinal cord (central nervous system or CNS). Sometimes the lymphoma is also found in the tissues around the spinal cord. Over time, it tends to spread to the central nervous system.
Primary CNS lymphoma is rare overall, but is more common in older people and in people with immune system problems, such as: B. in people who have had an organ transplant or have AIDS. Most people develop headaches and confusion. You may also have vision problems; weakness or altered feeling in your face, arms or legs; and in some cases seizures.
The prognosis for patients with primary CNS lymphoma has improved over the years, mainly due to advances in treatment.
Primary intraocular lymphoma (lymphoma of the eye)
This is a rare type of lymphoma that begins in the eyeball and is often associated with primary CNS lymphoma. It is the second most common eye cancer in adultsMelanoma-Ocular (Melanoma-Ocular)Most people with primary intraocular lymphoma are older or have immune system problems that can be caused byHOWor anti-rejection drugs after an organ or tissue transplant.
People may notice eyeball bulging without pain, vision loss, or blurred vision. many ofTests to diagnose ocular melanomathey are the same ones used to diagnose lymphomas of the eye.
the most importantocular lymphoma treatmentit is external radiation when the cancer is confined to the eye. Depending on the type of lymphoma and how far it has spread outside the eye, chemotherapy (chemotherapy) or chemotherapy combined with radiation may be used.