Types of Hodgkin lymphoma

Main types 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​ (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

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​ 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

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

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

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.

Read about the stages of Hodgkin lymphoma

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.

Read more about the treatments for Hodgkin lymphoma