The information on this page was reviewed and approved by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on September 21, 2021.

About non-Hodgkin lymphoma

The most common type of blood cancer is non-Hodgkin lymphoma, with more than 81,000 newly diagnosed cases expected in the United States in 2021, according to the National Cancer Institute. The disease is sometimes called non-Hodgkin’s lymphoma, NHL or just “lymphoma.” It develops in white blood cells, called lymphocytes, which are part of the body’s immune system. It forms in the lymph system, which filters wastes and toxins and carries immune cells to different parts of the body via a network of vessels, tissues and organs—including the spleen, tonsils and thymus.

Non-Hodgkin lymphoma that infiltrates sites other than lymph nodes is called extranodal. Some of the most common extranodal sites for the disease are the stomach, Waldeyer ring, central nervous system, lung, bone and skin. In non-Hodgkin lymphoma, the spleen is also considered an extranodal site.

Lymphoma may affect either the B lymphocytes (B cells) or T lymphocytes (T cells). B cells help produce antibodies to protect the body against germs such as bacteria and viruses. The antibodies fight infection by attaching to the germs, marking them for destruction by other parts of the immune system. T cells may either destroy germs or abnormal cells, or they may help boost or slow the activity of other immune system cells, according to the American Cancer Society.

A second type of lymphoma, Hodgkin lymphoma, is a far less common cancer than non-Hodgkin lymphoma, accounting for fewer than 10,000 new lymphoma cases each year. The main difference between non-Hodgkin lymphoma and Hodgkin lymphoma is the type of lymphocytes affected. Hodgkin lymphoma is marked by oversized B-cells called Reed-Sternberg cells, which are not present in non-Hodgkin lymphoma. Hodgkin lymphoma is usually diagnosed at a younger age, while a majority of non-Hodgkin lymphoma cases are diagnosed in people over 55, with the cancer often at a more advanced stage.

Non-Hodgkin lymphoma is different than leukemia, another blood cancer. While lymphoma tends to affect the lymph nodes and related tissues, leukemia affects the blood and bone marrow. Lymphoma, like leukemia, may appear in the bloodstream as a form of liquid tumor or liquid cancer, but lymphoma is frequently detected after it forms a solid mass of cancerous cells that have built up in a lymph node, gland or organ.

At Cancer Treatment Centers of America® (CTCA), our medical oncologists, hematologist-oncologists and other experts have years of experience delivering the standard-of-care and precision cancer treatments available to treat non-Hodgkin lymphoma. Our whole-person care model is also designed to support patients throughout the treatment journey, offering supportive care services to help them manage side effects and maintain their quality of life.

What causes non-Hodgkin lymphoma

Non-Hodgkin lymphoma is caused by changes in cell DNA. Some of these changes may be genetic, some may develop during a person's lifetime due to an external influence, and still others may occur for no known reason. Gene changes that lead to non-Hodgkin lymphoma are usually acquired during a person's lifetime, commonly as a result of exposure to:

  • Radiation
  • Carcinogenic chemicals
  • Infections

Age is also a major risk factor for non-Hodgkin lymphoma. Researchers believe this is because gene mutations occur more often as we get older. Other risk factors for non-Hodgkin lymphoma include a family history of lymphoma and changes in the immune system due to:

  • An immune deficiency or inherited immune disorder
  • An autoimmune disease, such as lupus
  • A chronic infection like HIV/AIDS
  • Treatment with certain drugs, such as methotrexate for rheumatoid arthritis
  • Treatment with immunosuppressant drugs to treat patients who have had an organ transplant

Learn more about risk factors for non-Hodgkin lymphoma

Who gets non-Hodgkin lymphoma

People with weakened immune systems are at greater risk of getting the disease. It’s more typical in men than women and more common in whites than African Americans. More than three-quarters of new cases are diagnosed in individuals over the age of 55, although it may also affect people in their 20s or 30s.

Types of non-Hodgkin lymphoma

Non-Hodgkin lymphoma is classified into more than 30 types depending on the kind of lymphocyte—either B cells or T cells—involved. The disease is then further categorized by other factors, including whether the cancer is fast- or slow-growing.

The main types of non-Hodgkin lymphoma include:

  • B cell lymphomas, which make up the majority of non-Hodgkin lymphomas in the United States, and include these common forms: 
    • Diffuse large B-cell lymphoma (DLBCL)
    • Follicular lymphoma
    • Mantle cell lymphoma (MCL)
    • Marginal zone lymphoma
  • T cell lymphomas, which account for about 10 percent of non-Hodgkin lymphomas in the United States

Learn more about non-Hodgkin lymphoma types

Symptoms of non-Hodgkin lymphoma

Symptoms for non-Hodgkin lymphoma may include:

Learn more about symptoms of non-Hodgkin lymphoma

Diagnosing non-Hodgkin lymphoma

Tools and procedures for diagnosing non-Hodgkin lymphoma may include:

  • Lab tests, including blood tests, urine tests and liver function tests
  • Biopsy, either of bone marrow or from a lymph node
  • Flow cytometry test, which determines the relative growth rate of a tumor and the amount of DNA in it
  • Imaging tests, such as an X-ray, computed tomography (CT) scan, positron emission tomography (PET) scan, PET/CT scan, magnetic resonance imaging (MRI), ultrasound or multiple-gated acquisition scan
  • Lumbar puncture, also called a spinal tap

Learn about diagnostic procedures for non-Hodgkin lymphoma