Hodgkin Lymphoma Subtypes

The World Health Organization (WHO) divides Hodgkin lymphoma into two main subtypes. They are:

  • Classical Hodgkin lymphoma
  • Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL)
    • This subtype has been reclassified as nodular lymphocyte-predominant B-cell lymphoma (NLPBL).

Classical Hodgkin lymphoma is characterized by the presence of both Hodgkin and Reed-Sternberg cells. Nodular lymphocyte-predominant Hodgkin lymphoma is characterized by the presence of lymphocyte-predominant cells, sometimes termed “popcorn cells,” which are a variant of Reed-Sternberg cells.

It is important to know your subtype since it plays a large part in determining the type of treatment you will receive.

Classical Hodgkin Lymphoma

About 95 percent of people with Hodgkin lymphoma have classical Hodgkin lymphoma. This subtype is further divided into four distinct subtypes shown in the table below.

Classical Hodgkin Lymphoma Subtypes

 
Subtype Characteristics
Nodular Sclerosis 
  • Accounts for 70 percent of classical Hodgkin lymphoma (cHL) cases
  • Most common type in young adults  
  • Involved lymph nodes contain elements of fibrous tissues (sclerosis)
  • Incidence similar in males and females
  • Highly curable
  • B symptoms in approximately 40 percent of cases
Mixed Cellularity 
  • Accounts for 20-25 percent of cHL cases
  • More prevalent in children, older adults and patients with HIV infection
  • Most common in males
  • Involved lymph nodes contain Reed-Sternberg cells and several other cell types
  • B symptoms common
  • Associated with EBV infection 
Lymphocyte-rich
  • Accounts for about 5 percent of cHL cases
  • Involved lymph nodes contain numerous normal-appearing lymphocytes and Reed-Sternberg cells
  • Usually diagnosed at an early stage
  • More common in males
  • B symptoms are rare
Lymphocyte-depleted 
  • Rarest cHL subtype 
  • Involved lymph nodes contain few normal lymphocytes but numerous RS cells 
  • More prevalent in older adults and patients with HIV infection 
  • Usually diagnosed at an advanced stage 
  • B symptoms common
  • Associated with EBV infection 

Nodular Lymphocyte-Predominant B-cell Lymphoma

Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) has been reclassified as nodular lymphocyte-predominant B-cell lymphoma (NLPBL). In the near future, it will be considered a separate disease and not a Hodgkin lymphoma subtype. 

Nodular lymphocyte-predominant B-cell lymphoma (NLPHL) affects about 5 percent of Hodgkin lymphoma patients. The following are some characteristics of NLPHL:

  • Most common in 30 to 50 year-old age group
  • More common in males
  • Slow growing and can relapse many years later
  • Highly curable
  • Small risk of transformation to aggressive non-Hodgkin lymphoma (7 percent of cases)

Related Links​

  • Download or order The Leukemia & Lymphoma Society's free booklet, Hodgkin Lymphoma.