Doctors categorize non-Hodgkin lymphoma as aggressive if it grows and spreads quickly. There are many types, and they typically require immediate treatment.

Non-Hodgkin lymphoma (NHL) is a type of cancer that originates in white blood cells called lymphocytes, which are part of the immune system.

Indolent lymphomas are ones that grow and spread slowly. Aggressive lymphomas grow and spread quickly.

This article examines the symptoms, causes, and types of aggressive NHL. It also discusses treatments and outlook for this cancer.

A person with aggressive lymphoma having an IV line inserted into their arm.Share on Pinterest
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Lymphoma is a cancer that affects the lymphatic system, which is part of the immune system that helps the body fight disease and infection.

Lymphomas can begin anywhere in the body where there is lymph tissue. These areas can include the lymph nodes, digestive tract, and spleen.

The lymphatic system consists of lymphocytes known as B lymphocytes (B cells) and T lymphocytes (T cells). NHL can begin in either type of cell, though it more commonly begins in B cells.

Lymphomas can be:

  • Indolent: These grow and spread slowly. The most common type of indolent lymphoma is follicular lymphoma, which typically involves bone marrow and lymphoid organs (organs in which the body stores white blood cells). Indolent lymphomas may not require immediate treatment, and doctors may opt to monitor the condition closely instead.
  • Aggressive lymphomas: These grow and spread quickly. The most common type of aggressive lymphoma is diffuse large B-cell lymphoma (DLBCL). Doctors typically recommend treating aggressive lymphomas immediately.

The most common symptom of NHL is painless swelling in a lymph node in the groin, neck, or armpit.

Other symptoms may include:

Experts do not know the exact cause of NHL, though some believe it may involve genetic changes. Mutations in genes that manage cell growth, division, and death could play a role in lymphoma development.

There are several risk factors for aggressive lymphomas, including:

There are many types of aggressive NHL. Some of the most common types are:

Diffuse large B-cell lymphoma (DLBCL)

This is the most common type of aggressive lymphoma. It typically affects the lymph nodes, liver, spleen, bone marrow, and other organs. DLBCL grows and spreads quickly and typically requires immediate treatment.

Anaplastic large cell lymphoma (ALCL)

ALCL typically begins in T cells. There may be a marker called CD30 on the cells’ surface. A marker gives doctors clues that disease may develop in the cell.

Burkitt lymphoma

Burkitt lymphoma is a type of B-cell lymphoma. There are three main types:

  • Sporadic: This type occurs across the world.
  • Endemic: This type commonly occurs in Africa, and is related to the Epstein-Barr virus.
  • Immunodeficiency-related: This type occurs most often in people who have AIDS.

Burkitt lymphoma typically affects the facial bones, ovaries, kidneys, and bowel. It may also spread to the spinal cord.

Primary central nervous system (CNS) lymphoma

CNS lymphoma occurs when cancer cells grow in the spinal cord or brain lymph tissue. Symptoms of CNS lymphoma may include seizures, nausea, and vomiting.

Mantle cell lymphoma (MCL)

MCL is a type of B-cell lymphoma. It typically affects people ages 60–70 years old.

This cancer starts in lymph nodes and may spread to the blood, bone marrow, the spleen, and sometimes to the stomach, intestines, and esophagus.

Peripheral T-cell lymphoma (PTCL)

PTCL is an aggressive lymphoma that starts in mature T cells found in the thymus gland in the neck. It can spread to other areas of the lymphatic system.

T-cell lymphoblastic lymphoma (T-LBL)

With T-LBL, a person has too many immature white blood cells, called lymphoblasts, in the thymus gland and lymph nodes. These cells spread to other areas of the body, such as the brain, spinal cord, and bone marrow.

The treatment and outlook for aggressive lymphoma vary depending on the type and stage of cancer and a person’s age and overall health.

Aggressive lymphomas typically require immediate treatment. However, doctors consider them highly treatable. According to the National Cancer Institute, doctors are able to cure around half of all aggressive NHL cases.

Between 2012–2018, the 5-year relative survival rate for NHL was 73.8%. This means 73.8% of people were still alive 5 years after diagnosis.

Aggressive NHL originates in white blood cells called lymphocytes. It grows and spreads quickly. Lymphocytes are part of the lymphatic system, present in areas such as the lymph nodes and vessels, tonsils, and spleen.

People with weakened immune systems may be at higher risk of developing aggressive NHL.

Aggressive NHL often requires immediate treatment. Doctors can cure this type of cancer in around half of cases.