# B-cell, T-cell and NK-cell lymphoma

Source: https://onco.cc/terms/lymphoma-b-versus-t-cell/  
OnCo record `lymphoma-b-versus-t-cell` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The first thing a lymphoma report says is which kind of lymphocyte the cancer came from. B cells make antibodies and carry a surface protein called CD20; T and NK cells kill infected cells directly and carry no CD20. That single difference is why B-cell lymphomas have had thirty years of new antibody treatments and T-cell lymphomas have not.

## Summary

Lymphocytes come in three lineages and a lymphoma inherits the one it arose from. B cells mature in the bone marrow and in the germinal centres of lymph nodes, and make antibodies. T cells mature in the thymus and either help other immune cells or kill infected ones. Natural killer cells kill without needing to recognise a specific antigen, and share many surface proteins with cytotoxic T cells, which is why the classifications treat T-cell and NK-cell lymphomas as one group.

The proportions are lopsided. In the UK Haematological Malignancy Research Network series of 5,796 lymphomas, 94.7 per cent were B-cell and 5.3 per cent T-cell. The outcomes are lopsided in the same direction: five-year relative survival was 68.8 per cent for the B-cell group and 45.4 per cent for the T-cell group.

The reason is mostly pharmacological rather than biological. B cells carry CD20, a protein with no essential function that the body can do without, so an antibody against it can be given safely and kills the lymphoma along with the normal B cells. Rituximab was licensed in 1997 and every later B-cell treatment, from antibody-drug conjugates to CAR-T to bispecific antibodies, built on the same idea of a surface address. T cells have no equivalent: the obvious targets are proteins the healthy T cells need, so removing them removes the immune system, and a CAR-T cell aimed at a T-cell protein attacks the other CAR-T cells, a problem called fratricide that the engineering is only now starting to solve.

On a report, the lineage is read from immunohistochemistry: CD20, CD79a and PAX5 for B cells, CD3, CD2, CD5 and CD7 for T cells, CD56 and cytoplasmic CD3 for NK cells. A clonal rearrangement of the immunoglobulin or T-cell receptor genes confirms that the population is a single clone rather than a reaction.

## Fields

- Kind: Term
- Last checked: 2026-09-29
- Also known as: B-cell lymphoma; T-cell lymphoma; NK-cell lymphoma; cell of origin; lineage
- Tags: heme; lymphoma

## Sources

- WHO Classification of Haematolymphoid Tumours, 5th edition: lymphoid neoplasms (Alaggio, Leukemia 2022): https://doi.org/10.1038/s41375-022-01620-2
- Lymphoma incidence, survival and prevalence 2004 to 2014, subtype analyses from the UK Haematological Malignancy Research Network (Smith, Br J Cancer 2015): https://doi.org/10.1038/bjc.2015.94

## Connected records

- terms: [Lymphoma (tissue type)](https://onco.cc/terms/lymphoma-type/), [The two lymphoma classifications of 2022 (WHO-HAEM5 and ICC)](https://onco.cc/terms/lymphoma-classification-2022/)
- targets: [CD20](https://onco.cc/targets/cd20/)
- cancers: [Adult T-cell leukaemia/lymphoma](https://onco.cc/cancers/adult-t-cell-leukaemia-lymphoma/), [ALK-negative anaplastic large cell lymphoma](https://onco.cc/cancers/alk-negative-anaplastic-large-cell-lymphoma/), [ALK-positive anaplastic large cell lymphoma](https://onco.cc/cancers/alk-positive-anaplastic-large-cell-lymphoma/), [Breast implant-associated anaplastic large cell lymphoma](https://onco.cc/cancers/breast-implant-associated-alcl/), [Cutaneous T-cell lymphoma (mycosis fungoides and Sezary syndrome)](https://onco.cc/cancers/cutaneous-t-cell-lymphoma/), [Diffuse large B-cell lymphoma](https://onco.cc/cancers/dlbcl/), [EBV-positive diffuse large B-cell lymphoma](https://onco.cc/cancers/ebv-positive-dlbcl/), [Extranodal NK/T-cell lymphoma](https://onco.cc/cancers/extranodal-nk-t-cell-lymphoma/), [Hodgkin lymphoma](https://onco.cc/cancers/hodgkin-lymphoma/), [Non-Hodgkin lymphoma (all types)](https://onco.cc/cancers/non-hodgkin-lymphoma/), [Peripheral T-cell lymphomas (including cutaneous T-cell lymphoma)](https://onco.cc/cancers/peripheral-t-cell-lymphoma/), [Plasmablastic lymphoma](https://onco.cc/cancers/plasmablastic-lymphoma/), [T-cell/histiocyte-rich large B-cell lymphoma](https://onco.cc/cancers/t-cell-histiocyte-rich-large-b-cell-lymphoma/)
- drugs: [Brentuximab vedotin](https://onco.cc/drugs/brentuximab-vedotin/), [Rituximab](https://onco.cc/drugs/rituximab/)

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