Background: Primary pleural lymphoma is a rare disease posing diagnostic and therapeutic challenges. Case presentation: We present a 65-year-old woman with dyspnoea, cough, and asthenia, with no significant past medical history. Chest X-ray and computed tomography showed extensive right pleural effusion. Video-assisted thoracoscopy demonstrated multiple pleural nodules, while pleural fluid analysis revealed a lymphocytic exudate, and finally, a primary pleural lymphoma diagnosis was confirmed by immunohistochemistry analysis in pleural nodules biopsy. Discussion: In this regard, eight cycles of chemotherapy with cyclophosphamide, doxorubicin, vincristine, dexamethasone, and rituximab were indicated, and after one year of follow-up, complete clinical and radiological remission was observed. Conlusions: We conclude that video-assisted thoracoscopy with an appropriate histopathological examination remains the gold standard for diagnosis, while R-CHOP chemotherapy plus rituximab may represent a highly effective therapeutic choice.

Electronic cigarettes are devices that heat liquid into aerosols for inhalation. According to the CDC and FDA, a 2022 survey found that 14.1% of high school students and 3.3% of college students in the U.S. used these devices, totaling 2.55 million young users. This growing trend gained serious attention in 2019 with the emergence of EVALI (E-cigarette or Vaping Product Use-Associated Lung Injury), predominantly affecting teenagers and young adults. EVALI presents with acute respiratory symptoms, often requiring hospitalization, and by February 2020, it had caused approximately 2800 hospitalizations and 68 deaths. Although vitamin E acetate (VEA) was strongly implicated, other factors (including solvents, psychoactive substances, heavy metals, and flavorings) are under investigation. Compounding the issue, the COVID-19 pandemic has posed diagnostic challenges due to symptom overlap. The long-term health effects of electronic cigarette use remain uncertain, but research has linked it to chronic respiratory diseases like COPD, cancer, and systemic and cardiovascular diseases.