CTICasesPrimary Effusion Lymphoma (PFL) in HIV-Positive Patient
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Imaging findings
Initial pleural effusion progressed rapidly within 10-11 days to complete opacification of the left hemithorax with mediastinal shift. Subsequent CT imaging revealed very large, circumferential, and extensive nodular pleural thickening, resulting in collapse of the entire left lung. PET imaging showed intense, blazing hot uptake confined solely to the pleura, with no other sites of uptake.
Key takeaways
This is a rare and dramatic case of Primary Effusion Lymphoma (PFL), a B-cell lymphoma exclusively seen in HIV-positive patients and associated with HHV8 infection. The rapid progression from a small effusion to extensive nodular pleural thickening and lung collapse, with avid pleural PET avidity, is characteristic. Despite high mortality, this patient survived without developing systemic disease, highlighting the variable course of this aggressive lymphoma.
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