1st August 2023

A 39-year-old man, who emigrated to the United Kingdom two years ago from Lithuania, presents to A&E in acute respiratory distress.

A 39-year-old man, who emigrated to the United Kingdom two years ago from Lithuania, presents to A&E in acute respiratory distress. A chest x-ray demonstrates massive bilateral pleural effusions. His past medical history is unknown, and he speaks little English. Lesions are noted in his oral cavity, an image of which can be seen below.

Observation of lesions

What is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.