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A 38-year-old male patient presented to the ear, nose and throat department with shortness of breath over last 2 months. The CT scan of the neck and chest revealed a 3.3×3 cm tumour behind the right thyroid lobe extending into the tracheo-oesophageal (TO) groove with tracheal compression. The ultrasound scan of the neck and targeted fine needle aspiration followed by core biopsy raised a suspicion of Hodgkin's lymphoma. The patient underwent a right hemithyroidectomy and incisional biopsy of the right TO groove tumour. The histology confirmed a Hasenclever's three nodular sclerosing Hodgkin's lymphoma for which he received adjuvant chemotherapy. An incidental pT1a pN0 thyroid papillary microcarcinoma in the adjacent thyroid parenchyma was completely excised. This represents a case of TO Hodgkin's lymphoma, of which there are no current published case reports. We aim to raise awareness about this rare condition by sharing the diagnostic work up and successful management in a multidisciplinary team setting., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Patients with schizophrenia show attention deficit characterized by a larger validity effect (fast responses to cued than uncued stimuli) in the right visual field than in the left visual field. In addition, schizophrenia patients do not show inhibition of return (IOR--a mechanism that enables efficient visual search), unless attention is summoned back to the center after the peripheral cue. The present study examined the short-term effect of neuroleptic medications on these two components of visual spatial attention in schizophrenia patients. In order to do this we tested schizophrenia patients that were treated with long-acting neuroleptic medication. These patients were treated once a month, which allowed us to test them with either low or high levels of medication. Here we show that neuroleptic medications reverse the attentional hemispheric asymmetry. In the group with a high level of medication fast RTs to cued trials were found in the right visual field, while in the group with a low level of medication the opposite pattern was found - fast RTs to cued trials were found in the left visual field. In addition, level of medication did not influence IOR - regardless of the level of medication, IOR was observed only when attention was summoned back to the center, unlike control group. These finding suggest an imbalance in dopaminergic activity, possibly in subcortical structures such as the basal ganglia. This study also shows a dissociation between the two components of visual orienting of attention and suggests that facilitation and inhibition are independent processes.

The developing brain may be particularly vulnerable to exposure to acetylcholinesterase (AChE) inhibitors because of the role of AChE on neuronal development and the effects of cholinergic pathways in mediating behavioral and hormonal responses to stress. C57BL/65 mice of both sexes were injected with 1 mg/kg s.c. diisopropylfluorophosphate (DFP) or saline in three separate experiments, on postnatal days (PNDs) 4-10, 14-20, or 30-36. Anxiety and conditioned avoidance were assessed on the elevated-plus maze (EPM) and step-down passive avoidance (PA) paradigms, respectively, at age 4-5 months. In addition, locomotion and reactivity to pain on the hot plate were assessed. Mice treated on PNDs 4-10 or PNDs 14-20 spent relatively more time and made more entries to the open arms on the first, but not second, exposure to the EPM. Females, but not males, treated with DFP showed deficits in PA retention after 24 h when treated on PNDs 4-10 and on PNDs 14-20. Mice treated on PNDs 30-36 were not impaired in either behavior. Administration of DFP in the preweanling period did not affect locomotor activity or pain reactivity. The results suggest that preweanling exposure to DFP results in anxiolysis in novel conflict situations but exacerbated context-enhanced anxiety.