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Hemorrhagic pleural effusion as the sole manifestation of pancreatitis is exceedingly rare and often presents diagnostic challenges due to its misleading symptoms. We report the case of an adult male with a large left-sided black pleural effusion secondary to chronic necrotizing pancreatitis. The patient presented with progressive shortness of breath and cough, with a history of alcohol use and a previous diagnosis of acute severe pancreatitis.

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Pleural effusion as an initial presentation of malignancy poses significant diagnostic challenges, particularly when linked to gynecologic cancers. We discuss the case of a 53-year-old female who presented with progressive dyspnea and a massive right-sided pleural effusion. Cytological analysis of the pleural fluid revealed malignant cells and immunohistochemical staining confirmed high-grade serous carcinoma (HGSC) of ovarian origin.

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Background: Rosai-Dorfman disease (RDD), also known as sinus histiocytosis with massive lymphadenopathy, is a rare non-malignant disorder characterized by excessive proliferation of histiocytes, the cause of which remains unknown. Although the lymph nodes are the most commonly affected site, some patients may present with extranodal involvement, particularly in the skin, nasal cavity, eyes, and bones. In this report, we aim to present a unique case of RDD with pleural involvement in a 61-year-old patient.

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Rosai-Dorfman disease (RDD) is a rare proliferative histiocytic disorder characterized by sinus histiocytosis with massive lymphadenopathy, rarely presenting with severe and life-threatening extra-nodal features. The rarity of RDD, clinically variant phenotype, limited data, and lack of a current standardized management approach make treatment decisions difficult. Herein, we present a case of life-threatening, disseminated RDD with rare clinical features of recurrent pericardial effusion, bilateral pleural effusions, and abdominal tissue fibrosis successfully treated with six cycles of cladribine, achieving clinical remission.

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