Same clinical entity can have different biology and can behave differently. This must be kept in mind while making therapeutic decisions. Primary effusion lymphoma is a rare and devastating disease with high fatality. Chemotherapy provides limited benefit. We describe a unique case of a good outcome with steroid alone treatment.

Background Primary effusion lymphoma (PEL) is a rare disease occurs mostly in immunosuppressed young males. Treatment consists of chemotherapy and prognosis is poor. Case presentation Our case described immunocompetent elderly woman with PEL who survive 30 months without chemotherapy. Conclusion Physicians should be aware of all clinical scenarios of PEL