Morphologically they have similarities with B-cell immunoblastic Iymphomas and anaplastic large cell Iymphomas, including large polyploid and lobated nuclei, prominent nucleoli, and abundant sometimes plasmacytoid cytoplasm. The majority of patients have disease localized to body cavities, but occasional cases have involved adjacent organs such as lung, soft tissues, regional nodes, and bone marrow either at presentation or with advanced disease. Cells in solid tumor masses appear morphologically similar to those in malignant effusions. As with other high grade Iymphomas in immunosuppressed individuals, prognosis is poor, and the majority have died within one year of diagnosis. They express activation antigens including HLA-DR and CD30.
Molecular analysis reveals immunoglobulin gene rearrangements confirming their B-cell derivation.
Although a rare Iymphoma type, the unique association with human herpesvirus and involvement of body cavities offer an opportunity to investigate viral Iymphomagenesis and homing mechanisms in neoplastic cells. Almost all the HIV-positive males with BCBL have homosexuality as a risk factor. And Usually are associated with a tumor mass. In order to make the diagnosis of BCBL a combination or clinical, morphologic, and phenotypic studies arc Required, and The association with KSHV should he confirmed by polymerase chain reaction. Conclusions BCBL are distinct clinicopathologic entities which require clinical, morphologic, phenotypic, and molecular studies for diagnosis.