Types of B-Cell Lymphoma

Medically Reviewed by Carmelita Swiner, MD on September 01, 2022
4 min read

When your doctor talks to you about your B-cell lymphoma, they'll tell you what type you have. It's an important piece of info to get, because each type of this cancer acts differently and has its own treatment.

To help figure out what type of B-cell lymphoma you have, your doctor will do a biopsy, which means they remove some of your cells and run some tests on them. You may also need to get tests like a CT scan, PET scan, and blood tests to learn more about the cancer and whether it has spread.

Doctors group B-cell lymphomas based on:

  • How the cancer cells look under a microscope
  • Whether the cancer cells have certain proteins on their surface
  • What kinds of gene changes are inside the lymphoma cells

This is the most common kind of B-cell lymphoma. Up to one-third of all people with non-Hodgkin's lymphoma have diffuse large B-cell lymphoma (DLBCL).

DLBCL grows quickly, but it's possible to cure it. Most people learn they have this type after age 60, but you can get it at any age.

This cancer often starts in the lymph nodes or any other area that has lymph tissue.

It can also start in other parts of the body, including:

  • Bone
  • Skin
  • Intestines
  • Brain

Doctors also divide DLBCL into a few subtypes, based on how it looks under a microscope and which part of your body it's in. Learning which type you have will help you and your doctor choose the right treatment.

One subtype of DLBCL is called primary mediastinal large B-cell lymphoma (PMBCL), which most often happens to young women. It grows in the mediastinum -- the part of the chest that's between the lungs and behind the breastbone.

About 2% to 4% of all non-Hodgkin's lymphomas are PMBCL. It grows quickly, but treatment can usually cure it.

The main symptoms that you have are a cough, shortness of breath, and swelling of the face and neck.

This is a slow-growing form of B-cell lymphoma. About 20% to 30% of all non-Hodgkin's lymphomas are follicular lymphoma (FL).

This cancer usually starts in people who are over 65. It usually grows in your lymph nodes and bone marrow. The first symptom you may notice is often swollen lymph nodes in your neck, armpit, or groin.

Usually there's no cure for FL, but you can manage the disease with the right treatment.

This group of slow-growing cancers starts in the "marginal zone" -- an area of the lymph nodes where there are a lot of B cells. About 8% of all non-Hodgkin's lymphomas are this type.

Doctors usually spot marginal zone B-cell lymphoma (MZL) when you're in your 60s. You may be more likely to get it if you have an infection with the H. pylori bacteria or hepatitis C virus, or if you have autoimmune diseases such as:

  • Rheumatoid arthritis
  • Sjögren's syndrome
  • Lupus
  • Wegener's granulomatosis

Chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) are very similar because they have the same type of cancer cell. They're both slow-growing, and you treat them the same way.

The only difference is where these cancers start:

  • CLL is mainly in the blood and bone marrow
  • SLL is mainly in the lymph nodes

Mantle cell lymphoma (MCL) is a rare and fast-growing cancer. About 6% of all non-Hodgkin's lymphomas are this type.

MCL starts in B cells of the "mantle zone" -- an area on the outer edge of the lymph nodes. This cancer often grows in the lymph nodes, bone marrow, and spleen.

If you have the disease, you make too much of a protein called cyclin D1. Measuring cyclin D1 and other proteins can help doctors predict how likely the cancer might spread, and which treatments are likely to work best.

Burkitt lymphoma is one of the fastest-growing cancers, but it can be cured. About 1% of all non-Hodgkin's lymphomas in the U.S. are this type. It's more common in children and males.

In the U.S., this cancer most often happens in the belly and affects the intestines, ovaries, testicles, and other organs. A different type of Burkitt lymphoma that is more common in Africa usually occurs in the jaw or bones of the face.

There are three types of Burkitt lymphoma:

  • Endemic Burkitt lymphoma
  • Sporadic Burkitt lymphoma
  • Immunodeficiency-related Burkitt lymphoma (affects people with HIV/AIDS and those who had an organ transplant)

Burkitt lymphoma cells look similar to DLBCL under a microscope. One difference is that they have a change to a gene called MYC. Telling these two cancers apart is important, because the treatments are different.

Lymphoplasmacytic lymphoma is a rare and slow-growing lymphoma, but it can change into a fast-growing form. The average age when people get a diagnosis is 60.

If you have this cancer, you make too much of a protein called immunoglobulin M (IgM). You may get symptoms such as bleeding easily and feeling weak or tired.