He was aware of the difficulty in breathing general malaise, on exertion than 1 month ago.He was seen a decrease (5kg) in body weight due to the decrease in food intake due to abdominal distension. In addition, it was referred to our hospital because the night sweats were observed. No jaundice and anemia in the palpebral conjunctiva. Breathing sound attenuation in the lower right lung field. To the right hepatic hypochondrial under 4cm spleen left subcostal 15cm palpable. Admit cervical lymph node tumors.