TNF and hepatosplenic T-cell lymphoma: Hepatosplenic T-cell lymphoma (HSTCL), a rare but aggressive complication, occurs almost exclusively in males under 35 treated with thiopurines—either alone (1 per 10,000 patient-years) or in combination with anti-TNF agents (3 per 10,000 patient-years)—for more than two years [58].