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Primary lung cancer typically presents in the older adult with a history of significant tobacco use. We present a young adult male with a rapid onset of dyspnea, and a large pleural and pericardial effusion with tamponade, necessitating urgent surgical intervention. Copyright © 2020, Richard et al.Histoplasmosis is an endemic fungal infection that can lead to disseminated disease, especially in immunosuppressed patients. Hairy cell leukemia is a rare, slow-growing hematological malignancy. Concurrence of histoplasmos