Imaging revealed generalized lymphadenopathy, multifocal osteolytic lesions, and bilateral pleural effusions; infectious studies were unrevealing apart from chronic hepatitis B. Cervical node biopsy (CD30<sup>+</sup>, ALK-L<sup>+</sup>, EMA<sup>+</sup>; Ki-67 ~80%; EBER-; pan-B/T and epithelial markers negative) established ALK-positive anaplastic large-cell lymphoma. The gene discussed is MKI67; the disease is Pleural effusion.