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| {{CMG}} {{AE}} {{Trusha}} | | {{CMG}} {{AE}} {{Trusha}} |
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| # [[Endometriosis|Bowel endometriosis]] vs [[Hemorrhoids]] vs [[Diverticular disease|Diverticular diseases]] vs [[Anal fissure]] vs [[Ulcerative colitis]] vs [[Crohn's disease]],
| | ==new== |
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| | {| align="right" |
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| | [[Image:Squamous cell mircopathology2.jpeg|x200px|thumb| Micropathology: Squamous cell carcinoma of the lung. H&E stain, By Nephron [https://commons.wikimedia.org/wiki/File%3ALung_squamous_carcinoma_--_high_mag.jpg Wikimedia Commons]]] |
| | |} |
| | {| align="right" |
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| | [[Image:Bronchial cancer.jpeg|x200px|thumb|Gross pathology: Bronchial squamous lung cell cancer By John Hayman [Public domain], (Image source: [https://commons.wikimedia.org/wiki/File%3ACa_bronchus.jpg Wikimedia Commons])]] |
| | |} |
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| | {| |
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| # [[Superior vena cava obstruction]] | | # [[Superior vena cava obstruction]] |
| # [[Partial anomalous pulmonary venous connection]] | | # [[Partial anomalous pulmonary venous connection]] |
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| # [[Dermoid cyst]] | | # [[Dermoid cyst]] |
| # [[Anthrax]]: | | # [[Anthrax]]: |
| # [[Tularemia]]. | | # [[Tularemia]] |
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| | [[File:Mediastinal lymohangioma GIF.gif|x200px|thumb| CT scan shows cystic mass which was located on the posterior to the lower esophagus later diagnosed as thoracic duct lymphangioma. [https://doi.org/10.5090/kjtcs.2014.47.4.423 Source:Case courtesy of Jin San Bok et al, Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital]]] |
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| | [[File:Posterior-mediastinal-schwannoma.gif|x200px|thumb| CT scan showing a soft tissue density lesion within the left posterior mediastinum, in a paravertebral location. The lesion is closely related to the left neural exit foramen, but there is no definite extension into the spinal canal. The lesion does extend into the intercostal space. |
| | Case courtesy of Dr Paul Leong |
| | (Picture courtesy:[https://radiopaedia.org/cases/26625 Radiopedia])]] |
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| | __NOTOC__ |
| | {{SI}} |
| | {{CMG}}; {{AE}} {{Trusha}}, {{AM}} |
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| {| | | {{SK}} Mediastinal enlargement; mass in the mediastinum |
| |- style="background: #4479BA; color: #FFFFFF; text-align: center;" | | |
| !'''Class'''
| | ==Overview== |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Disease | | |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Sign/Symptoms
| | The [[mediastinum]] is a non-delineated group of structures in the thorax (chest), surrounded by loose connective tissue. Since it is the central compartment of the thoracic cavity, and it contains a lot of important structures, it is the site of involvement of various tumors. |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Age group
| | |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard
| | ==Causes== |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Image
| | |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Additional findings
| | |
| |-
| | |
| | colspan="7" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Anterior mediastinal mass'''
| | ==Initial Evaluation== |
| |- | | {{familytree/start}} |
| | rowspan="5" style="background: #4479BA; color: #FFFFFF; padding: 5px;" |Tumors | | {{Family tree |border=2|boxstyle=background: WhiteSmoke;| | | | | A01 | | | | |A01=<div style="float: left; text-align: center; height: 1.25em; width: 25em; padding: 1em;">'''Mediastinal Mass'''</div>}} |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Thymoma]]
| | {{familytree | | | | | |!| | | | | | | | }} |
| | style="background: #F5F5F5; padding: 5px;" | | | {{familytree | | | | | B01 | | | |B01=<div style="float: left; text-align: left; line-height: 150%; padding: 1em; "> '''Workups''' |
| * Facial swelling
| | ---- |
| * [[Dysphagia]]
| | ❑ CT chest with contrast <br> ❑ Serum beta-HCG, AFP, if appropriate <br> ❑ CBC, platelets <br> ❑ PET-CT scan (optional) <br> ❑ Pulmonary function tests if clinically indicated <br> ❑ MRI chest if clinically indicated |
| * [[Cough]]
| | </div>}} |
| * [[wheezing]]
| | {{familytree | |,|-|-|-|^|-|-|-|.| | | | | | | }} |
| * [[Chest pain]]
| | {{familytree | C01 | | | | | | C02 | | | |C01=<div style="float: left; text-align: center; height: 1.25em; width: 15em; padding: 1em;"> '''Thymic Tumor Likely''' </div> |C02= <div style="float: left; text-align: center; height: 1.25em; width: 15em; padding: 1em;"> '''Thymic Tumor Unlikely''' </div>}} |
| * [[Muscle weakness]] ([[Myasthenia gravis|MG]])
| | {{familytree | |!| | | | | | | |!| | | | | }} |
| * [[Anemia]]
| | |
| | style="background: #F5F5F5; padding: 5px;" |Equal distribution
| | {{familytree | D01 | | | | | | D02 | | | |D01=<div style="float: left; text-align: center; height: 1.25em; width: 15em; padding: 1em; text-size: 85%;">Consider [[Thymoma surgery|surgery]]</div>|D02=<div style="float: left; text-align: center; height: 1.25em; width: 15em; padding: 1em; text-size: 85%;">Disease-specific management</div>}} |
| | style="background: #F5F5F5; padding: 5px;" |Biopsy
| | |
| | style="background: #F5F5F5; padding: 5px;" |[[File:Thymoma gif 2.gif|x350px|thumb| CT scan showing smooth anterior mediastinal mass, with mixed internal density of containing both enhancing soft tissue and cystic areas. The outline of the mass is relatively well defined. No lymphadenopathy, pleural effusion or infiltration. Case courtesy of Dr. Abdallah Al Khateeb
| | {{familytree/start}} |
| (Picture courtesy: [https://radiopaedia.org/cases/43403 Radiopedia])]]
| |
| | style="background: #F5F5F5; padding: 5px;" |'''Associated condition'''
| |
| * NM
| |
| ** [[Myasthenia gravis]]
| |
| ** [[Neuromyotonia]]
| |
| ** [[Rippling muscle disease]]
| |
| ** [[Polymyositis and dermatomyositis|Polymyositis/dermatomyositis]]
| |
| ** [[Encephalitis]] (limbic, cortical and brain stem)
| |
| ** [[Intestinal pseudoobstruction]]
| |
| * Hematological
| |
| ** [[Anemia]]: [[pure red cell aplasia]], [[pernicious anemia]], [[hemolytic anemia]], [[aplastic anemia]]
| |
| ** Other isolated [[Cytopenia|cytopenias]]: [[eosinophils]], [[basophils]] [[neutrophils]]
| |
| ** Immunodeficiencies: [[Hypogammaglobulinaemia|hypogammaglobulinemia]]/- T-cell deficiencies [[Good syndrome|(Good syndrome)]]
| |
| * Dermatological
| |
| ** [[Pemphigus]] ([[Pemphigus foliaceus|foliaceus]] or [[Paraneoplastic syndrome|paraneoplastic]])
| |
| ** [[Lichen planus]]
| |
| ** [[Alopecia areata]]
| |
| * Endocrine
| |
| ** [[Addison's disease|Addison disease]]
| |
| ** [[Graves' disease|Grave's disease]]
| |
| ** [[Cushing's disease]]
| |
| * Hepato-renal
| |
| ** [[Glomerulonephritis]]
| |
| ** [[Autoimmune hepatitis]]
| |
| * Systemic Autoimmune Diseases
| |
| ** [[SLE]]
| |
| ** [[Sjögren's syndrome]]
| |
| ** [[Systemic sclerosis]]
| |
| ** [[Graft-versus-host disease]]
| |
|
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|
| |-
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| | style="background: #DCDCDC; padding: 5px; text-align: center;" |Fatty mass
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |[[File:Lipomatosis gif.gif|x200px|thumb| CT scan showing excessive fatty tissue deposition within the posterior mediastinum with anterior displacement of the oesophagus. Case courtesy of Dr Ahmed Abdrabou (Picture courtesy: [https://radiopaedia.org/cases/50447Radiopedia])]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Neurilemmoma]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Non-Hodgkin lymphoma]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Teratoma]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
| |
| | rowspan="2" style="background: #4479BA; color: #FFFFFF; padding: 5px;" |Thyroid disease
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Thyroid cancer]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Goitre]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
| |
| | colspan="7" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Middle mediastinal mass'''
| |
| |-
| |
| | rowspan="4" style="background: #4479BA; color: #FFFFFF; padding: 5px;" |CVS disease
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pericardial effusion]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Aortic dissection]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Superior vena cava obstruction]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Partial anomalous pulmonary venous connection]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
| |
| | rowspan="4" style="background: #4479BA; color: #FFFFFF; padding: 5px;" |GI disease
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Esophageal achalasia]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Esophageal cancer]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Esophageal rupture]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
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| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hiatus hernia]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| |-
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| | rowspan="3" style="background: #4479BA; color: #FFFFFF; padding: 5px;" |Pulmonary disease
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| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hilar lymphadenopathy]]
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| |-
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| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pneumomediastinum]]
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| |-
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| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Sarcoidosis]]
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
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| | rowspan="2" style="background: #4479BA; color: #FFFFFF; padding: 5px;" |Mediastinal tumor
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| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Mediastinal tumor]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| |-
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| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Mediastinal germ cell tumor]]
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
| |
| | rowspan="3" style="background: #4479BA; color: #FFFFFF; padding: 5px;" |Infection
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Mediastinitis]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
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| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Anthrax]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Tularemia]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
| |
| | rowspan="2" style="background: #4479BA; color: #FFFFFF; padding: 5px;" |Cystic disease
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Dermoid cyst]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Bronchogenic cyst]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
| |
| | style="background: #4479BA; color: #FFFFFF; padding: 5px;" |Chronic
| |
| inflammatory
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Churg-Strauss syndrome]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| |-
| |
| | colspan="7" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Posterior mediastinal mass'''
| |
| |-
| |
| | style="background: #4479BA; color: #FFFFFF; padding: 5px;" |CNS disease
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Meningocele]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
| |
| |-
| |
| |}
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|
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| ==References== | | ==References== |
| {{Reflist|2}} | | {{Reflist|2}} |