Abstract
We describe a 50-year-old incarcerated transgender female with advanced human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) who was not compliant with antiretroviral therapy (ART). She presented with a three-cavity effusion (peritoneal, pleural, and pericardial) complicated by superimposed spontaneous bacterial peritonitis (SBP). Cytologic smears, flow cytometry, and immunostaining revealed primary effusion lymphoma (PEL). This case report aims to provide a clinical presentation of PEL and offers an overview of its diagnosis and current management strategies.