Lymphomas are put into groups according to how the cells look under a microscope. The groups are part of a classification system called the REAL classification, which stands for Revised European American Lymphoma classification. It is used to define all types of lymphoma, including the different types of Non-Hodgkin’s lymphoma.

The two major types of Hodgkin lymphoma are classical Hodgkin lymphoma and nodular lymphocyte-predominant Hodgkin lymphoma.

Classical types

There are 4 different types of classical Hodgkin’s lymphoma:

• Nodular sclerosing

• Mixed cellularity

• Lymphocyte rich

• Lymphocyte depleted

Nodular sclerosing is the most common type of Hodgkin’s lymphoma. Nearly 60% of all diagnosed cases of Hodgkin’s lymphoma are nodular sclerosing. Nodular sclerosing is most common in young adults, and is usually diagnosed at an early stage from enlarged lymph nodes in the neck.

Other classical Hodgkin’s lymphoma cases are mixed cellularity or lymphocyte rich. About 15% of Hodgkin’s lymphomas are mixed cellularity type and about 10% are lymphocyte rich type.

The lymphocyte depleted type of classical Hodgkin’s lymphoma is very rare.

Nodular lymphocyte predominant type

Nodular lymphocyte predominant account for 5% of Hodgkin’s lymphomas—the main difference being that there are few or none of the typical Reed Sternberg cells. There are other abnormal cells that doctors call ‘popcorn’ cells (L & H cells). This type of Hodgkin’s lymphoma is typically localized when it is diagnosed.