A 42-year-old man presented to the oncology clinic with changes in his fingernails (Cover image). He was undergoing treatment for non-Hodgkin’s lymphoma. Medical history: Five months earlier, he had presented with gastric-outlet obstruction and had received a diagnosis of high-grade B-cell non-Hodgkin’s lymphoma. What is the most likely underlying cause of this presentation?

*Th is case is from the Editorial Team of Docplexus and is meant for educational purposes only. The correct answer is posted in the comment section below! Source: NEJM