Types of Hodgkin lymphoma

There are different types and subtypes of Hodgkin lymphoma. The World Health Organisation's (WHO) classification system puts Hodgkin lymphoma into 2 main groups. They are:

  • classical Hodgkin lymphoma

  • nodular lymphocyte predominant Hodgkin lymphoma

Classical Hodgkin lymphoma

Classical Hodgkin lymphoma is the most common type of Hodgkin lymphoma. 

There are 4 subtypes and they all contain abnormal cells called Reed-Sternberg cells. These cells are a type of white blood cell Open a glossary item (B lymphocyte) that have become cancerous. The 4 different subtypes of classical Hodgkin lymphoma are very similar. The specific subtype does not usually change what treatment you have.

The 4 subtypes are:

Nodular sclerosis classical Hodgkin lymphoma is the most common type of Hodgkin lymphoma in the UK. It is the most common type in young adults. It is often found at an early stage and usually starts in lymph nodes Open a glossary item in the neck or chest. The lymph nodes have Reed-Sternberg cells mixed with normal white blood cells. These lymph nodes contain thick bands of scar tissue (sclerosis).

Mixed cellularity classical Hodgkin lymphoma is more common in older people. It often affects a few groups of lymph nodes when it is diagnosed. These lymph nodes contain a mixture of Reed-Sternberg cells and other blood cells.

Lymphocyte rich classical Hodgkin lymphoma is rare. There are lots of lymphocytes with very few Reed-Sternberg cells in the affected lymph nodes. And the lymphocytes look very small.

Lymphocyte depleted classical Hodgkin lymphoma is very rare. Around 1 out of 100 people (around 1%) with Hodgkin lymphoma have this type. The lymph nodes often have dense tissue called fibrous tissue and Reed-Sternberg cells in them.

Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL)

Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is not very common. Around 5 out of 100 people (around 5%) with Hodgkin lymphoma have NLPHL. It's more common in older people but can happen in young people.

The main difference between NLPHL and classical Hodgkin lymphoma is that there are very few Reed-Sternberg cells in NLPHL. 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. This is called stage 1 Hodgkin lymphoma. It tends to be slower growing than classical Hodgkin lymphoma and the treatment is different. Sometimes NLPHL turns into B-cell non-Hodgkin lymphoma, after about 10 years.

Treatment for Hodgkin lymphoma

Knowing the type of Hodgkin lymphoma helps your doctor decide the best treatment for you. There are different treatment options for classical Hodgkin lymphoma and NLPHL. The treatment you have also depends on the stage of your Hodgkin lymphoma. The stage tells you about the number and places in the body that are affected by Hodgkin lymphoma.

  • Cancer Research UK incidence statistics for Hodgkin lymphoma 

    Last accessed December 2023

  • Cancer and its management (7th edition)
    J Tobias and D Hochhauser
    Wiley-Blackwell, 2015

  • Principles and practice of oncology (11th edition)
    VT De Vita, TS Lawrence and SA Rosenberg
    Wolters Kluwer, 2019

  • The 2016 revision of the World Health Organization classification of lymphoid neoplasms
    SH Swerdlow and others
    Blood, 2016. Volume 127, Issue 20, Pages 2375 - 2390

  • Nodular lymphocyte-predominant Hodgkin lymphoma: a unique disease deserving unique management
    Dennis A. Eichenauer and Andreas Engert
    American Society of Haematology, 2017 

  • The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. Please contact patientinformation@cancer.org.uk with details of the particular issue you are interested in if you need additional references for this information.

Last reviewed: 
27 Nov 2023
Next review due: 
27 Nov 2026

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