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Jiang H, Liu H, Zhao L, Yang L, Zhao Y. A rare presentation of primary cardiac diffuse large B‑cell lymphoma: A case report. Oncol Lett 2024; 27:40. [PMID: 38108070 PMCID: PMC10722522 DOI: 10.3892/ol.2023.14174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/20/2023] [Indexed: 12/19/2023] Open
Abstract
Primary cardiac lymphomas display a low frequency, sudden onset, swift progression of illness and elevated mortality rates. The current study presents a unique instance of primary cardiac diffuse large B-cell lymphoma and examines its clinical manifestations, pathological characteristics and differential diagnosis. A 64-year-old male patient sought medical attention due to cardiac debility and exertional dyspnea persisting for >10 days. Chest enhanced computed tomography revealed a moderately enhancing irregular mass in the ventricular area, exhibiting limited demarcation from the pericardium and left atrium, accompanied by irregular thickening of the interventricular septum. The postoperative specimen showed the presence of yellow fish-like tumor tissue. Immunohistochemical analysis revealed the presence of lymphocytes positive for CD20, BCL-2, BCL-6, c-Myc-binding protein, mutated melanoma-associated antigen 1 and CD79a, along with a high Ki-67 proliferation index of 80%. Conversely, CD10, CD30, CD3, pan cytokeratin, cyclin D1, desmin and vimentin marker results were found to be negative. Additionally, in situ hybridization demonstrated a lack of Epstein-Barr virus-encoded small RNA expression. The present case report emphasizes the significance of conducting a thorough analysis of the clinical manifestations of diffuse large B-cell lymphoma to assist clinicians in establishing a diagnosis and determining an effective treatment approach, thereby enhancing the patient's prognosis.
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Affiliation(s)
- Hongyan Jiang
- Department of Pathology, Suining Central Hospital, Suining, Sichuan 629000, P.R. China
| | - Haijun Liu
- Department of Ultrasound, Suining Central Hospital, Suining, Sichuan 629000, P.R. China
| | - Linwei Zhao
- Department of Radiology and Imaging, Suining Central Hospital, Suining, Sichuan 629000, P.R. China
| | - Ling Yang
- Department of Pathology, Suining Central Hospital, Suining, Sichuan 629000, P.R. China
| | - Yunfei Zhao
- Department of Pathology, Suining Central Hospital, Suining, Sichuan 629000, P.R. China
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He LF, Zhang JD, Chen XX, Wei RL. Epidemiology and survival outcomes of patients with primary intraocular lymphoma: a population-based analysis. BMC Ophthalmol 2022; 22:486. [PMID: 36514001 PMCID: PMC9749366 DOI: 10.1186/s12886-022-02702-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 11/23/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Primary intraocular lymphoma (PIOL) is a rare malignancy with a poor prognosis, but its optimal therapy remains unclear. Herein, we aimed to analyze the epidemiology and survival outcomes of PIOL patients based on a population-based cancer registry in the United States. METHODS Patients diagnosed with PIOL between 1992 and 2018 were identified from the Surveillance Epidemiology and End Results program. The patients were divided into two groups: those aged < 60 years and ≥ 60 years. We used the chi-squared test to analyze the differences between the two groups. Descriptive analyses were performed to analyze epidemiological characteristics and treatment. The likely prognostic factors were analyzed by Kaplan-Meier curves and Cox proportional hazards models. RESULTS The overall incidence of PIOL was 0.23/1,000,000, which was steadily increasing from 1992 to 2018, with an annual percentage change of 2.35. In total, 326 patients (mean age, 66.1 years) with PIOL were included in this study, 72.1% were aged ≥ 60 years, 84.4% were White, and 60.4% were female. The most common pathological type was diffuse large B-cell lymphoma (DLBCL), but in patients aged < 60 years, extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue was the most common. The disease-specific survival rates were 74.2% and 61.5% 5 and 10 years after diagnosis, respectively. Survival analysis found that surgery, radiation, and chemotherapy did not lead to better prognosis. CONCLUSIONS PIOL is a rare disease with poor prognosis, and its incidence has been increasing for nearly 30 years. It usually affects people aged ≥ 60 years, and DLBCL is the most common pathological type of PIOL. Patients aged < 60 years and with non-DLBCL type have improved survival. Survival of PIOL has improved in recent years.
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Affiliation(s)
- Lin-feng He
- grid.413810.fDepartment of Ophthalmology, Changzheng Hospital of Naval Medicine University, 415 Fengyang Road, Shanghai, China
| | - Jin-di Zhang
- grid.413810.fDepartment of Ophthalmology, Changzheng Hospital of Naval Medicine University, 415 Fengyang Road, Shanghai, China
| | - Xin-xin Chen
- grid.413810.fDepartment of Ophthalmology, Changzheng Hospital of Naval Medicine University, 415 Fengyang Road, Shanghai, China
| | - Rui-li Wei
- grid.413810.fDepartment of Ophthalmology, Changzheng Hospital of Naval Medicine University, 415 Fengyang Road, Shanghai, China
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Liu E, Huang J, Dong H, Chen Z, Liu C, Xie Q, Xu W, Wang S, Liu Z. Diagnostic challenges in primary cardiac lymphoma, the opportunity of 18F-FDG PET/CT integrated with contrast-enhanced CT. J Nucl Cardiol 2022; 29:2378-2389. [PMID: 34318397 DOI: 10.1007/s12350-021-02723-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 06/22/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The purpose of this study was to retrospectively evaluate the value of 18F-FDG PET/CT integrated with contrast-enhanced CT (CECT) in the differential diagnosis of primary cardiac lymphomas (PCLs) and primary cardiac angiosarcomas (PCAs). METHODS Clinical and imaging data of patients with PCLs and PCAs were collected. All patients underwent preoperative 18F-FDG PET/CT and thoracic CECT. The enhancement pattern and tumor morphology were analyzed using CECT images. The intensity- and volume-based PET parameters of cardiac lesions were analyzed. The performance characteristics of all parameters were assessed. RESULTS Nine patients with PCL and eight patients with PCA were analyzed. There were significant differences in SUVmax (t = 3.790, P = .002), SUVmean (t = 4.273, P = .001), metabolic tumor volume (U = 13.00, P = .027), tumor-to-liver ratio (U = 10.00, P = .011), and total lesion glycolysis (U = 4.0, P = .001) between PCLs and PC18As. There were significant differences in the enhancement pattern of tumors (P = .002) and tumor morphology (P = .015). The combination of F-FDG PET/CT and CECT improved the diagnostic accuracy, and the combination cutoff (SUVmean > 5.17) could reach 100%, but the difference was not statistically significant (P > .05). CONCLUSION The intensity- and volume-based PET parameters of PCL were significantly higher than those of PCA. The enhancement pattern and tumor morphology were also different. According to these characteristics, the two most common types of primary cardiac malignancies can be differentiated.
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Affiliation(s)
- Entao Liu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- WeiLun PET Center, Department of Nuclear Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jia Huang
- Department of Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Room 201, 2/F, WeiLun Building of Guangdong Provincial People's Hospital, 106 Zhongshan ER Road, Guangzhou, 510080, China
| | - Haojian Dong
- Department of Cardiology, Vascular Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zerui Chen
- Department of Cardiovascular Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Chao Liu
- Department of Pathology and Laboratory Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Qiu Xie
- Division of Adult Echocardiography, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Weiping Xu
- WeiLun PET Center, Department of Nuclear Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Shuxia Wang
- WeiLun PET Center, Department of Nuclear Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zaiyi Liu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
- Department of Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Room 201, 2/F, WeiLun Building of Guangdong Provincial People's Hospital, 106 Zhongshan ER Road, Guangzhou, 510080, China.
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Zhang M, Xiao F, Lin M, Chen M, Hou J, Huang H. The epidemiology and prognosis of patients with primary gastric T-cell lymphoma in the SEER program. Cancer Med 2022; 12:84-98. [PMID: 35698430 PMCID: PMC9844593 DOI: 10.1002/cam4.4936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 05/15/2022] [Accepted: 05/28/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Primary gastric T-cell lymphoma (PG-TCL) is a rare hematological malignancy with few data reported. The objective of this study is to investigate the epidemiology, clinical characteristics, and survivals of PG-TCL. METHODS Totally, 164 patients with PG-TCL from 1975 to 2016 extracted from the Surveillance, Epidemiology, and End Results Program (SEER) database were analyzed. Kaplan-Meier method was applied to plot overall survival (OS) and cancer-specific survival (CSS). The prognostic factors of OS and CSS were explored by Cox proportional hazard regression. Nomograms were constructed to predict survival possibilities. RESULTS The age-adjusted incidence rate of PG-TCL was 0.0091 per 100,000 person-years and increased with age. The median age at onset was 65 years old with male predominance. The major histological type was peripheral T-cell lymphoma, NOS (63.4%). The 1-, 2-, and 5-year OS were 45.5%, 34.7%, and 23.5%, respectively while the 1-, 2-, and 5-year CSS were 47.4%, 37.3%, and 29.6%, respectively. Multivariate Cox analysis demonstrated that age at diagnosis, use of chemotherapy, and radiotherapy were the independent prognostic factors for OS. Chemotherapy combined with radiotherapy could significantly improve patients' OS compared with chemotherapy alone. Moreover, age at diagnosis and use of chemotherapy were also the independent prognostic factors for CSS. Nomograms for PG-TCL were developed to predict 1-, 2-, and 5-year OS possibilities. The predictability of nomograms was verified by high concordance index and good agreement with the predicted value in calibration plots. CONCLUSION PG-TCL is a rare neoplasm with low incidence. Patients with PG-TCL generally exhibited poor prognosis. Use of chemotherapy plus radiotherapy was associated with favorable OS.
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Affiliation(s)
- Minyue Zhang
- Division of Hematology, Renji Hospital, School of MedicineShanghai Jiaotong UniversityShanghaiChina
| | - Fei Xiao
- Division of Hematology, Renji Hospital, School of MedicineShanghai Jiaotong UniversityShanghaiChina
| | - Meisi Lin
- State Key Laboratory of Southwestern Chinese Medicine Resources, Pharmacy SchoolChengdu University of Traditional Chinese MedicineChengduChina,Sichuan Provincial Acupuncture SchoolChengduChina
| | - Mengping Chen
- Division of Hematology, Renji Hospital, School of MedicineShanghai Jiaotong UniversityShanghaiChina
| | - Jian Hou
- Division of Hematology, Renji Hospital, School of MedicineShanghai Jiaotong UniversityShanghaiChina
| | - Honghui Huang
- Division of Hematology, Renji Hospital, School of MedicineShanghai Jiaotong UniversityShanghaiChina
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Wang Y, Song J, Wen S, Zhang X. A visual model for prognostic estimation in patients with primary diffuse large B-cell lymphoma of small intestine and colon: analysis of 1,613 cases from the SEER database. Transl Cancer Res 2022; 10:1842-1855. [PMID: 35116506 PMCID: PMC8798054 DOI: 10.21037/tcr-20-3086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 02/18/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Treatment modalities for primary diffuse large B-cell lymphoma of Small intestine and colon (PIC-DLBCL) have changed significantly during the past decades. However, limited information on the trends of clinical outcome of PIC-DLBCL patients has been reported, and the influence of marital status and medical insurance on prognosis is ignored. METHODS This was a retrospective analysis the survival of PIC-DLBCL patients using the Surveillance, Epidemiology, and End Results (SEER) database between 2002 and 2016. The patients were divided into the training and validation cohort. In the training cohort, univariate and multivariable Cox regression analysis, Log-rank test and the Kaplan-Meier method were used to find out the independent prognostic factors, from which the visual prognostic model (nomogram and graphical web page) was established. C-index and calibration plots were used to evaluate the prediction accuracy of the model. In the validation cohort, both Decision curve analysis (DCA) and Receiver operating characteristic (ROC) curve was performed to compare the model with the International Prognostic Index (IPI) scoring model which is universally used to estimate prognosis of PIC-DLBCL. RESULTS A total of 1,613 patients were collected, and the 5-year overall survival of all cases was 64.5%. Age at diagnosis (HR =2.58, 95% CI: 2.29-2.91), Ann Arbo stage (HR =1.34, 95% CI: 1.24-1.44), Divorced or Separated (HR=1.21, 95% CI: 1.06-1.38), Uninsured (HR =1.32, 95% CI: 1.19-1.45) and Primary colon (HR =1.23, 95% CI: 1.08-1.40) were associated with prognosis and were used to build up the visual model (nomogram and graphical web page). Both DCA and ROC curve showed that the model had better authentication capability than the IPI scoring model (AUC 0.820 vs. 0.714). The calibration plots showed that the model could accurately predict patient prognosis. CONCLUSIONS The visual model could output individual estimate prognosis simply and correctly, including marital status and medical insurance for the first time. Consideration of both medical and social factors, this study provided a new way to explore the improving prognosis of PIC-DLBCL.
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Affiliation(s)
- Yang Wang
- Department of Gastroentology, the Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jia Song
- Department of Gastroentology, the Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Shupeng Wen
- Department of Haematology, the Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xiaolan Zhang
- Department of Gastroentology, the Second Hospital of Hebei Medical University, Shijiazhuang, China
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Lei Y, Huang Q, Li X, Zheng X, Liu M. Characteristics and survival outcomes of primary splenic cancers: A SEER population-based study. Medicine (Baltimore) 2022; 101:e28539. [PMID: 35060511 PMCID: PMC8772628 DOI: 10.1097/md.0000000000028539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 12/20/2021] [Indexed: 02/05/2023] Open
Abstract
Primary splenic cancers represent a small number of cancer cases and studies on its clinicopathological features and outcomes are limited. Splenic lymphomas and primary splenic angiosarcoma (PSA) are the 2 most common histological types of splenic cancers. This population-based study aimed to investigate the clinical characteristics and survival outcomes of patients with splenic lymphomas or PSA.Patients diagnosed with splenic lymphomas or PSA between 2000 and 2015 were identified from the Surveillance Epidemiology and End Results database of the National Cancer Institutes. Overall survival (OS) and cancer-specific survival (CSS) rates were calculated using the Kaplan-Meier method. A Cox proportional hazard models were used to identify independent predictors of cancer-specific mortality.A total of 700 patients with splenic lymphoma and 48 patients with PSA were included in this study. The median age of patients with splenic lymphoma was 65 years and 57 years for patients with PSA. For patients with splenic lymphoma, the most prevalent histological subtypes were splenic marginal zone lymphoma and diffuse large B-cell lymphoma. A total of 52.6% of the cases had stage IV disease based on the Ann Arbor staging system. Five-year OS and CSS were 76.9% and 83.4%, respectively. Multivariate analysis revealed that independent predictors of splenic lymphoma CSS included race, stage, chemotherapy, and histological subtype. However, a much shorter OS time was seen in the PSA cohort which had a 5-year OS of 11.8%, a median OS of 10.0 months and the 5-year CSS of 12.4%. Chemotherapy was correlated with better outcomes in patients with PSA. However, the survival benefits of surgery for splenic cancer were not statistically significant in our study.The current study is the largest cohort of primary splenic cancer presented in literature based on the Surveillance Epidemiology and End Results database and our large series describe the characteristics and survival outcomes of such rare diseases which may provide reliable information for further studies and clinicians.
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Papanastasiou L, Skarakis N, Vardaka M, Dimitriadi A, Lampropoulou P, Perpinia A, Vidalakis E, Choreftaki T, Marinakis T, Kounadi T, Vatalas IA, Michalis E. A very rare case of extranodal B-cell non-Hodgkin lymphoma presenting with adrenal and heart involvement. Leuk Res Rep 2022; 17:100318. [PMID: 35539018 PMCID: PMC9079230 DOI: 10.1016/j.lrr.2022.100318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 03/31/2022] [Accepted: 04/25/2022] [Indexed: 11/24/2022] Open
Abstract
We report an extremely rare case of extranodal B-cell NHL: DLBCL (diffuse large B-cell non-Hodgkin lymphoma), stage IVE, presenting with heart and bilateral adrenal involvement. On admission, adrenal and thorax imaging identified large bilateral adrenal masses and a 4.6 cm mass in the right atrium wall. An adrenal biopsy revealed the presence of a DLBCL, with triple expression of bcl2, bcl6, C-MYC(+70%). Following six cycles of systemic immunochemotherapy with R-DA-EPOCH, and high methotrexate dose for CNS prophylaxis a marked decrease of lymphoma infiltration was observed. The selection of the appropriate treatment modality can lead to profound response and improve patient's outcome.
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Clinical characteristics and prognostic factors of primary malignant cardiac tumors. Chin Med J (Engl) 2021; 135:341-343. [PMID: 34608070 PMCID: PMC8812652 DOI: 10.1097/cm9.0000000000001623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Tazi I, Benmoussa A, Boufarissi FZ, Sifsalam M, Lahlimi FZ. [Non-Hodgkin cardiac lymphomas]. Ann Cardiol Angeiol (Paris) 2021; 70:237-244. [PMID: 34274110 DOI: 10.1016/j.ancard.2021.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 06/08/2021] [Indexed: 10/20/2022]
Abstract
Cardiac non-Hodgkin lymphoma (CNHL) is a rare extranodal lymphoma with a poor prognosis. Secondary cardiac lymphoma is more frequent than primary cardiac lymphoma. CNHL often involves the right side of the heart. Diagnosis of CNHL can be suggested by echocardiography and magnetic resonance imaging. Cytological examination of pericardial fluid or histological of cardiac tissue is essential. The majority of cases are diffuse B-cell lymphoma. A prompt immediate diagnosis and early treatment are essential for better outcome. Management should be individualized and the most effective treatment is chemotherapy containing anthracycline variably combined with radiotherapy. A multidisciplinary approach is essential to the successful treatment of CNHL.
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Affiliation(s)
- I Tazi
- Service d'hématologie clinique, faculté de médecine, université Cadi Ayyad, CHU Mohamed VI, Marrakech, Maroc.
| | - A Benmoussa
- Service d'hématologie clinique, faculté de médecine, université Cadi Ayyad, CHU Mohamed VI, Marrakech, Maroc
| | - F Z Boufarissi
- Service d'hématologie clinique, faculté de médecine, université Cadi Ayyad, CHU Mohamed VI, Marrakech, Maroc
| | - M Sifsalam
- Service d'hématologie clinique, faculté de médecine, université Cadi Ayyad, CHU Mohamed VI, Marrakech, Maroc
| | - F Z Lahlimi
- Service d'hématologie clinique, faculté de médecine, université Cadi Ayyad, CHU Mohamed VI, Marrakech, Maroc
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Suen HC, Hsin MKY. Commentary: Surgical resection has limited role in primary cardiac lymphoma. J Thorac Cardiovasc Surg 2020; 164:581-582. [PMID: 33618874 DOI: 10.1016/j.jtcvs.2020.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 09/04/2020] [Accepted: 09/08/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Hon Chi Suen
- The Hong Kong Sanitorium and Hospital, Hong Kong
| | - Michael K Y Hsin
- Department of Cardiothoracic Surgery, Queen Mary Hospital, Hong Kong.
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