Non-Hodgkin lymphoma

非霍奇金淋巴瘤
  • 文章类型: Case Reports
    背景:Warthin肿瘤(WT)是唾液腺中第二常见的良性肿瘤。它的生长速度缓慢,最常见于腮腺。大多数患者出现耳下/耳前无痛性肿块的偶然发现。除了肿瘤的上皮成分,WT在特征上与被认为是良性的淋巴间质相关。虽然有一些关于WT中淋巴成分恶性转化的报道,WT合并套细胞淋巴瘤(MCL)的病例极为罕见。据我们所知,英语文献中描述了两种情况。在这里,我们报告了一例WT合并MCL的70岁女性患者,并强调仔细检查WT中淋巴间质的重要性,以免错过并发淋巴瘤。
    方法:一名70岁的中国女性,有40年的吸烟史,有1年的右颌下肿块史,近期肿大。
    方法:颈部超声(US)和计算机断层扫描(CT)扫描显示右腮腺中有一个界限明确的肿块,最大直径为3.1cm。对肿块进行手术切除。组织病理学检查显示肿瘤上皮的特征性双层,具有突出的淋巴间质,建议WT。此外,形态学和免疫组织化学研究证实了MCL的共存。此后,该病例的最终诊断为WT合并MCL.
    方法:患者在临床评估后分期为I期。由于腮腺病变生长缓慢,密切观察是通过定期临床和放射学监测决定的。
    结果:目前,通过临床评估,患者显示病情稳定。
    结论:据我们所知,报告的WT合并MCL的病例非常罕见。该病例强调了对WT的淋巴间质进行全面评估的重要性,以避免在碰撞肿瘤中漏诊淋巴瘤成分。
    BACKGROUND: Warthin tumor (WT) is the second most common benign tumor in salivary gland. It has a slow growth rate and most frequently occurs in the parotid gland. Most patients present with an incidental finding of a painless mass inferior/anterior to the ear. Besides the epithelial component of the tumor, WT is characteristically associated with lymphoid stroma that is considered benign. While there have been a few reports of malignant transformation of the lymphoid components in WT, cases of WT concomitant with mantle cell lymphoma (MCL) are extremely rare. To the best of our knowledge, two cases have been described in the English literature. Herein, we report a case of WT concomitant with MCL in a 70-year-old female patient, and emphasize the importance of careful examination of lymphoid stroma in WT so that concurrent lymphoma is not missed.
    METHODS: A 70-year-old Chinese woman with a 40-year history of cigarette smoking presented with a one year history of a right submaxillary mass with recent enlargement.
    METHODS: Cervical ultrasound (US) and computed tomography (CT) scans of the neck revealed a well-circumscribed mass in the right parotid with a maximum diameter of 3.1 cm. Surgical resection of the mass was performed. Histopathological examination revealed a characteristic double-layer of neoplastic epithelium with prominent lymphoid stroma, suggesting WT. In addition, morphology and immunohistochemistry studies confirmed the coexistence of MCL. Thereafter, the final diagnosis of this case was WT concomitant with MCL.
    METHODS: The patient was staged as stage I after clinical assessment. Due to the slow growth of parotid lesions, close observation was decided with periodic clinical and radiological monitoring.
    RESULTS: Currently, the patient demonstrates a stable disease by clinical evaluation.
    CONCLUSIONS: To the best of our knowledge, reported cases of WT concomitant with MCL are very rare. This case highlights the importance of a comprehensive assessment of the lymphoid stroma of WT to avoid missed diagnosis of a lymphoma component in a collision tumor.
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  • 文章类型: Case Reports
    背景:“包虫囊肿”或囊性棘球蚴病是由细粒棘球蚴幼虫期引起的寄生虫感染。肝脏和肺是最常见的发生部位。肌肉的发病率非常罕见。手术一直是治疗囊性包虫病的传统方法。
    方法:我们报告了一例罕见的44岁男性多发性包虫囊肿;肺,椎旁肌肉.肌肉囊肿表现为背部肿胀,是主要的临床表现,因为它引起疼痛和不适。他接受了阿苯达唑治疗,并进行了治疗肺囊肿的胸外科手术。入院时和手术后,已经出现淋巴结病,经过适当的诊断方法,他被诊断为非霍奇金淋巴瘤.然后,三个月后,体格检查显示,他的背部囊肿的大小明显减少,不再可见。
    结论:这里我们提出了一种成功治疗肌肉包虫囊肿的方法。虽然以前的报道已经通过手术治疗;阿苯达唑在我们的病例中发挥了重要作用,除了在治疗多个包虫囊肿的过程中诊断NHL。
    结论:非霍奇金淋巴瘤合并肝囊性疾病的情况很少见,NHL和肌肉包虫病的共存在医学文献中是前所未有的。
    BACKGROUND: \"Hydatid cyst\" or cystic Echinococcosis is a parasitic infection caused by the larval stage of Echinococcus granulosus. The liver and lungs are the most common sites to occur. Incidence in muscles is exceptionally rare. Surgery has been the traditional approach for treatment of cystic echinococcusis.
    METHODS: We report a rare case of 44 years old man with multiple hydatid cysts; liver, lungs, paraspinal muscles. The muscular cyst had manifested as a swelling in his back and was the principal clinical presentation as it caused pain and discomfort. He was treated with Albendazole, and a thoracic surgery for the management of the lung cysts had been performed. On admission and after his surgery, lymphadenopathy had manifested and following adequate diagnostic modalities he was diagnosed with Non-Hodgkin lymphoma. Then, after three months, physical examination revealed significant reduction in the size of his back cyst that was no longer visible.
    CONCLUSIONS: Here we present a successful treatment for muscular hydatid cysts. While prior reports have managed it surgically; albendazole has played a significant role in our case, in addition to the diagnosis of the NHL in the course of managing multiple hydatid cysts.
    CONCLUSIONS: The presence of non-Hodgkin lymphoma alongside hepatic cystic disease is rare, and the coexistence of NHL and muscular hydatidosis is unprecedented in medical literature.
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  • 文章类型: Case Reports
    由舌头引起的粘膜相关淋巴组织(MALT)淋巴瘤是一种罕见的病理状况,尚未建立标准的治疗模式。这种疾病是一种低度淋巴瘤,常见于胃部,但很少见于舌头的淋巴组织。只有6个已报告的病例可以检索。我们介绍了一名79岁妇女的情况,她的舌头上有肿块。肿块的活检证实了MALT淋巴瘤的诊断。进行了17个部分的30.6Gy的放射治疗,并实现了完整的代谢反应。
    Mucosa-associated lymphoid tissue (MALT) lymphoma arising from the tongue is a rare pathologic condition for which a standard treatment mode has not been established. This disease represents a low-grade lymphoma frequently found in the stomach but rarely in the lymphoid tissue of the tongue. Only six cases that have been reported could be retrieved. We present the case of a 79-year-old woman who manifested with a mass on her tongue. A biopsy of the mass confirmed a diagnosis of MALT lymphoma. Radiation therapy of 30.6 Gy in 17 fractions was performed, and a complete metabolic response was achieved.
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  • 文章类型: Case Reports
    鳞状细胞癌(SCC)是通常通过手术切除治疗的皮肤恶性肿瘤。非霍奇金淋巴瘤(NHL)是一组用各种策略治疗的淋巴组织恶性肿瘤,包括化疗和放疗。
    一名64岁男性,先前患有SCC,出现新的头皮病变。检查发现一个高架,不规则,无触痛病变,轻度黄色变色。影像学显示头皮病变,颈淋巴结病,和一个定义明确的质量。超声检查发现淋巴结受累和脾肿大。细针抽吸,活检,淋巴结的免疫染色证实了NHL。头皮病变局部广泛切除,重建,进行了淋巴结活检,确认SCC和NHL。患者接受放疗和化疗。
    这种独特的罕见情况强调了SCC和NHL的复杂相互作用,需要警惕的SCC患者随访。
    UNASSIGNED: Squamous cell carcinoma (SCC) is a skin malignancy typically treated with surgical resection. Non-Hodgkin lymphoma (NHL) is a group of lymphoid tissue malignancies treated with various strategies, including chemotherapy and radiotherapy.
    UNASSIGNED: A 64-year-old male with prior SCC presented with a new scalp lesion. Examination revealed an elevated, irregular, non-tender lesion with mild yellow discoloration. Imaging showed a scalp lesion, cervical lymphadenopathies, and a well-defined mass. Ultrasonography uncovered lymph node involvement and splenomegaly. Fine needle aspiration, biopsy, and immune stains of the lymph node confirmed NHL. Wide local excision of the scalp lesion, reconstruction, and lymph node biopsies were performed, confirming SCC and NHL. The patient received radiotherapy and chemotherapy.
    UNASSIGNED: This unique rare case emphasizes the complex interplay of SCC and NHL, necessitating vigilant SCC patient follow-up.
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  • 文章类型: Case Reports
    背景:淋巴样肿瘤是一种常见疾病,产生于淋巴样细胞.分为霍奇金淋巴瘤和非霍奇金淋巴瘤。非霍奇金淋巴瘤可以是结内或结外,这发生在25%的主要病例中。结节性非霍奇金淋巴瘤最常见的位置是皮肤和胃肠道。生殖道是一个罕见的位置;大多数淋巴瘤来自子宫颈和阴道,而子宫体是一个极其罕见的位置。在我们的案例中,患者在生殖道不同部位被诊断为原发性结节性非霍奇金淋巴瘤.
    方法:一名48岁的叙利亚非产妇主诉弥漫性腹痛,疲劳,衰弱,高烧,呕吐,和尿潴留一周。患者的最后一次月经期是5年前。体格检查显示周期性腹痛,严重疲劳和腹部尺寸增加。除了低水平的血红蛋白和高水平的癌症抗原125外,实验室检查均在正常范围内。放射学检查显示子宫有相当大的分叶肿块,边界不规则,密度高且不均匀,延伸到左右卵巢,腹主动脉和右髂血管周围淋巴结肿大,严重右侧胸腔积液伴右下叶肺不张。进行了全子宫切除术和卵巢切除术。组织病理学检查显示患者患有非霍奇金淋巴瘤(原发性肿瘤)。
    结论:女性生殖道原发性非霍奇金淋巴瘤是一种极为罕见的疾病。快速诊断和治疗可以改善结果,因此,即使没有淋巴瘤的系统性表现,这种鉴别诊断也应该在我们的脑海中。需要更多的研究来解释这种疾病的病理学,并制定指导方针,以确定诊断和治疗的完美方法。
    BACKGROUND: Lymphoid neoplasm is a common disease, arising from lymphoid cells. It is divided into Hodgkin lymphoma and non-Hodgkin lymphoma. Non-Hodgkin lymphoma can be intranodular or extranodular, which happens in 25% of primary cases. The most common locations of extranodular non-Hodgkin lymphoma are the skin and gastrointestinal tract. The genital tract is a rare location; most lymphomas arise from the cervix and vagina, while the uterine corpus is an extremely rare location. In our case, the patient was diagnosed with primary extranodular non-Hodgkin lymphoma in different locations of her genital tract.
    METHODS: A 48-year-old nonparous Syrian woman complained of diffuse abdominal pain, fatigue, debility, high fever, vomiting, and urinary retention for a week. The last menstrual period of the patient was 5 years previously. The physical examination showed periodic abdominal pain with severe fatigue and increased abdominal size. The laboratory investigations were within normal limits except for a low level of hemoglobin and a high level of cancer antigen 125. The radiological investigations showed a uterine sizable lobulated mass with irregular borders and high and heterogeneous density, extending to the right and left ovaries, enlargement lymph nodes around the abdominal aortic and right iliac vessels, and severe right pleural effusion with right inferior lobe atelectasis. A total hysterectomy and oophorectomy were done. The histopathological examination showed that the patient had non-Hodgkin lymphoma (primary tumor).
    CONCLUSIONS: Primary non-Hodgkin lymphoma in the female genital tract is an extremely rare disease. Fast diagnosis and treatment can improve the outcomes, so this differential diagnosis should be in our minds even in the absence of systematic manifestations of lymphoma. More studies are needed to explain the pathology of this disease and to put guidelines that determine the perfect methods for diagnosis and treatment.
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  • 文章类型: Case Reports
    背景:膜性肾病(MN)是成人肾病综合征(NS)的常见类型,约占病例的20-30%。尽管仅次于特定因素,临床文献中很少报道MN和套细胞淋巴瘤(MCL)的共存。
    方法:一名59岁的中国男性因全身瘙痒性皮疹伴双侧下肢水肿入院,对症治疗后没有明显改善。他做了肾活检,诊断被认为是继发性MN(SMN),因此,我们对患者进行了淋巴结活检,发现MN并发MCL。不久之后,患者入院血液科接受BR化疗方案(由苯达莫司汀90mg/m2BSA(体表面积)组成,利妥昔单抗375mg/m2BSA和地塞米松5mg),在治疗后的随访中,症状和肾功能都有改善.
    结论:SMN和MCL结合的潜在机制仍然难以捉摸且极为罕见,因此在临床实践中经常被忽视。该病例为诊断和治疗提供了有价值的临床见解,同时强调肾脏病理学在临床评估中的关键作用。
    BACKGROUND: Membranous nephropathy (MN) is a common type of nephrotic syndrome (NS) in adults, accounting for about 20-30% of cases. Although secondary to specific factors, the coexistence of MN and mantle cell lymphoma (MCL) has been scarcely reported in clinical literature.
    METHODS: A 59-year-old Chinese male was admitted to the hospital with a generalized pruritic rash with bilateral lower extremity edema, which did not improve significantly after symptomatic treatment. He had undergone renal biopsy, and the diagnosis was thought to be secondary MN (SMN), therefore, we did a lymph node biopsy on the patient and found that MN was complicated with MCL. Soon after, the patient was admitted to the hematology department for a BR chemotherapy regimen (composed of bendamustine 90 mg/m2 BSA (body surface area), rituximab 375 mg/m2 BSA and dexamethasone 5 mg), and during the post-treatment follow-up, both his symptoms and renal function improved.
    CONCLUSIONS: The mechanism underlying the combination of SMN and MCL remains elusive and exceedingly rare, consequently often overlooked in clinical practice. This case serves to offer valuable clinical insights for diagnosis and treatment, while emphasizing the pivotal role of renal pathology in clinical assessment.
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  • 文章类型: Case Reports
    血管免疫母细胞性T细胞淋巴瘤(AITL)是一种罕见的非霍奇金淋巴瘤(NHL)。我们介绍了一例60岁的女性,她因疲劳而去急诊科(ED)就诊,反复发烧,减肥,和腺病六个月。实验室检查结果显示贫血,淋巴细胞增多,嗜酸性粒细胞增多,血小板增多症,胆汁淤积,低蛋白血症,和低蛋白血症.腹盆腔计算机断层扫描(CT)显示多发腺病。在门诊进行的淋巴结活检结果尚无定论。稍后,入院期间,患者接受了正电子发射断层扫描-计算机断层扫描(PET-CT),显示一个整体切除的宫颈腺病簇。组织学证实了AITL的诊断。医疗团队开始化疗,但由于疾病进展而选择了独家对症治疗。患者在诊断后六个月死亡。AITL的波动和非特异性表现可能会阻碍和延迟明确的诊断,因此影响治疗和预后。
    Angioimmunoblastic T-cell lymphoma (AITL) is a rare type of non-Hodgkin lymphoma (NHL). We present a case of a 60-year-old female who attended the emergency department (ED) with fatigue, recurrent fever, weight loss, and adenopathy for six months. Laboratory findings showed anemia, lymphocytosis, eosinophilia, thrombocytosis, cholestasis, hypoproteinemia, and hypoalbuminemia. Abdominopelvic computed tomography (CT) revealed multiple adenopathies. A lymph node biopsy yielded inconclusive results in the outpatient clinic. Later, during admission, the patient underwent a positron emission tomography-computed tomography (PET-CT), revealing a cervical adenopathy cluster that was excised en bloc. Histology confirmed the diagnosis of AITL. The medical team initiated chemotherapy but opted for exclusive symptomatic treatment due to disease progression. The patient died six months after diagnosis. The fluctuating and nonspecific presentation of AITL can hinder and delay definitive diagnosis, therefore impacting treatment and prognosis.
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  • 文章类型: Case Reports
    脾破裂和血肿是非霍奇金淋巴瘤(NHL)患者可能发生的重要并发症。了解这些相关并发症对于优化患者管理和提高患者预后至关重要。组织病理学和免疫组织化学分析对于诊断NHL和评估脾受累至关重要。在这项研究中,检察官办公室要求进行司法尸检,要求因医院摔倒而提出医疗事故索赔。在急诊室,一名72岁男子从轮床上摔下来,报告额头受伤。未报告其他症状。面部和脑部CT扫描未显示异常。出院后9天,患者出现腹痛。腹部CT显示脾破裂和腹膜积血。患者接受了开放性脾切除术,但出现了血液动力学休克的迹象,随后死亡。尸检的证据使我们能够诊断出脾受累的套细胞非霍奇金淋巴瘤,以前未知。进行组织病理学和免疫组织化学分析以评估脾破裂的诊断并估计其时机。结果强烈提示脾破裂与患者跌倒和先前存在的恶性肿瘤有关。此病例强调了在研究延迟性脾破裂时考虑潜在血液恶性肿瘤的重要性。脾脏样本的免疫组织化学研究允许评估脾血肿和破裂的时间。导致与创伤建立因果关系。
    Splenic rupture and hematoma are significant complications that can occur in patients with non-Hodgkin lymphoma (NHL). Understanding these associated complications is essential for optimal patient management and enhanced patient outcomes. Histopathological and immunohistochemical analyses are crucial in diagnosing NHL and assessing splenic involvement. In this study, a judicial autopsy had been requested by the Prosecutor\'s Office for a malpractice claim due to a fall in the hospital. In the Emergency Department, a 72-year-old man fell from a gurney and reported sustaining a wound to his forehead. No other symptoms were reported. A face and brain CT scan showed no abnormalities. Nine days after discharge, the patient presented with abdominal pain. An abdominal CT revealed splenic rupture and hemoperitoneum. The patient underwent open splenectomy but showed signs of hemodynamic shock and subsequently died. The evidence from the autopsy allowed us to diagnose mantle cell non-Hodgkin lymphoma with spleen involvement, previously unknown. Histopathological and immunohistochemical analyses were performed to assess the diagnosis of splenic rupture and estimate its timing. The findings strongly suggest that the splenic rupture was associated with the patient\'s fall and the pre-existing malignancy. This case highlights the importance of considering an underlying hematological malignancy when investigating delayed splenic rupture. An immunohistochemical study of spleen samples allowed the timing of splenic hematoma and rupture to be assessed, leading to the establishment of a causal relationship with trauma.
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  • 文章类型: Case Reports
    伯基特淋巴瘤(BL)是一种侵袭性非霍奇金淋巴瘤,其特征是8号染色体MYC基因易位。它表现在三种临床类型:免疫缺陷相关,零星(非地方性),和地方性(非洲),流行病学和临床行为各有不同。治疗通常涉及临床试验或强化化疗方案如R-CODOX-M/IVAC的登记。作者介绍了一例治疗后复发的BL病例。
    一名13岁女性患者出现左侧顶枕区逐渐进行性肿胀。检查显示生命体征正常,格拉斯哥昏迷评分,具有血清阴性调查结果。切除了神经节下软组织肿瘤,显示组织病理学特征,提示一个小的圆形蓝色细胞肿瘤。化疗后,患者头皮区域复发,诊断为BL。
    虽然头皮区域的BL报告很少,已在各个身体位置记录了病例。治疗策略,包括化疗和手术,在控制疾病和改善症状方面显示出有希望的结果。
    BL的复发是罕见的,强调在治疗后监测患者的警惕性的重要性。作者报告了一名13岁女性反复发作的BL病例,强调在管理这种侵袭性恶性肿瘤方面需要持续的研究和监测.
    UNASSIGNED: Burkitt lymphoma (BL) is an aggressive non-Hodgkin lymphoma characterized by chromosome 8 MYC gene translocation. It manifests in three clinical types: immunodeficiency-related, sporadic (nonendemic), and endemic (African), each differing in epidemiology and clinical behavior. Treatment typically involves enrollment in clinical trials or intensive chemotherapy regimens like R-CODOX-M/IVAC. The authors present a case of recurrent BL following treatment.
    UNASSIGNED: A 13-year-old female presented with a gradually progressive swelling in the left parieto-occipital region. Examination revealed normal vital signs and a Glasgow coma scale, with seronegative findings on investigations. An excision of a subganglion soft tissue tumor was performed, revealing histopathological features suggestive of a small round blue cell tumor. After chemotherapy, the patient experienced a recurrence in the scalp region, diagnosed as BL.
    UNASSIGNED: While scarce reports exist on BL in the scalp region, cases have been documented in various body locations. Treatment strategies, including chemotherapy and surgery, have shown promising results in managing the disease and improving symptoms.
    UNASSIGNED: The recurrence of BL is rare, highlighting the importance of vigilance in monitoring patients post-treatment. The authors report a case of recurrent BL in a 13-year-old female, emphasizing the need for continued research and surveillance in managing this aggressive malignancy.
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  • 文章类型: Journal Article
    目的:免疫功能紊乱是非霍奇金淋巴瘤(NHL)发生发展的危险因素之一,炎症可能与它的病因有关。在开始化疗之前,关于细胞因子水平对淋巴瘤神经行为功能的影响的数据很少。因此,我们旨在通过评估细胞因子和脂肪因子水平及其与神经行为改变的相关性来探讨NHL的风险.
    方法:本病例对照研究纳入62名受试者(年龄性别匹配:31例和31名对照)。使用蒙特利尔认知评估问卷(MoCA)和患者健康问卷(PHQ-9)进行神经行为评估。使用EORTC核心生活质量问卷(EORTCQLQ-C30)评估生活质量。在患者入组后和第一周期化疗前进行问卷评估和样本收集。
    结果:NHL患者和健康对照组的平均年龄分别为51.9±11.8和50±10.9岁,分别。NHL患者的IL-6(0.77±0.11)和TNF-α(1.47±1.31)水平明显高于对照组(分别为0.55±0.4和0.66±0.89),p值<0.005。此外,NHL患者的脂联素(0.31±0.24)和网膜素(0.46±0.1)水平明显低于对照组(分别为0.42±0.13和0.53±0.11),p值<0.005。与健康对照相比,在NHL患者中观察到较低的MoCA和EORTCQLQC-30评分和较高的PHQ-9评分。
    结论:我们的结果表明脂联素,网膜素IL-6和TNF-α可用作NHL风险的预诊断标志物。在NHL患者中观察到的神经行为变化可能会改变生活质量。
    Immune dysfunction is one of the risk factors which plays an important role in the development of non-Hodgkin lymphoma (NHL), and inflammation may be involved in its etiology. Minimal data is available on the effect of cytokine levels on neurobehavioral function in lymphoma before the initiation of chemotherapy. Therefore, we aimed to explore the risk of NHL by assessment of cytokine and adipokine levels and their correlation with neurobehavioral changes.
    This case-control study enrolled 62 subjects (age-sex matched: 31 cases and 31 controls). Neurobehavioral assessment was done using Montreal Cognitive Assessment questionnaire (MoCA) and Patient Health Questionnaire (PHQ-9). EORTC Core Quality of Life questionnaire (EORTC QLQ-C30) was used to assess quality of life. Questionnaire assessment and sample collection were done after the patient enrolment and before first cycle of chemotherapy.
    Mean age of NHL patients and healthy controls was 51.9 ± 11.8 and 50 ± 10.9 years, respectively. NHL patients showed significantly higher levels of IL-6 (0.77 ± 0.11) and TNF- α (1.47 ± 1.31) than controls (0.55 ± 0.4 and 0.66 ± 0.89, respectively) with p-value<0.005. Also, NHL patients showed significantly lower levels of adiponectin (0.31 ± 0.24) and omentin (0.46 ± 0.1) than controls (0.42 ± 0.13 and 0.53 ± 0.11, respectively) with p-value<0.005. Lower MoCA and EORTC QLQ C-30 scores and higher PHQ-9 scores were observed in NHL patients in comparison to healthy control.
    Our results showed that adiponectin, omentin IL-6 and TNF-α may be used as pre-diagnostic markers of NHL risk. Neurobehavioral changes observed in NHL patients may alter the quality of life.
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