Alopecia differential diagnosis: Difference between revisions

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__NOTOC__
{{Alopecia}}
{{Alopecia}}
{{CMG}} [[Ogechukwu Hannah Nnabude, MD]]
{{CMG}} [[Ogechukwu Hannah Nnabude, MD]]
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==Overview==
==Overview==


There is a very wide list of diseases and conditions that can lead to alopecia. Proper history taking and physical examination, along with laboratory, microbiology, and in some cases, imaging studies, are helpful in narrowing down the diagnosis.
There is a very wide list of diseases and conditions that can lead to [[alopecia]]. Proper history taking and physical examination, along with laboratory, microbiology, and in some cases, imaging studies, are helpful in narrowing down the diagnosis.
[[Alopecia]] can be caused by many different diseases. Some of the most well known and common causes are: [[androgenetic alopecia]], [[alopecia areata]], [[telogen effluvium]], anagen effluvium, and [[trichotillomania]]. Endocrine disorders such as [[hypothyroidism]], [[hypoparathyroidism]] and [[Cushing's syndrome]] as well as [[malnutrition]] and medications are also possible causes of alopecia.
[[Alopecia]] can be caused by many different diseases. Some of the most well known and common causes are: [[androgenetic alopecia]], [[alopecia areata]], [[telogen effluvium]], [[anagen effluvium]], [[traction alopecia]], and [[trichotillomania]]. Endocrine disorders such as [[hypothyroidism]], [[hypoparathyroidism]] and [[Cushing's syndrome]] as well as [[malnutrition]] and medications are also possible causes of [[alopecia]].


==Differentiating Alopecia from other Diseases==
==Differentiating Alopecia from Other Diseases==
The following lists the complete differential diagnosis of Alopecia.
 
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! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Disease/Condition}}
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Clinical presentation }}
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Demographics/History}}
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Diagnosis }}
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Other notes }}
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Androgenetic Alopecia <ref name="pmid24591533">{{cite journal| author=Qi J, Garza LA| title=An overview of alopecias. | journal=Cold Spring Harb Perspect Med | year= 2014 | volume= 4 | issue= 3 | pages=  | pmid=24591533 | doi=10.1101/cshperspect.a013615 | pmc=3935391 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24591533  }} </ref> <ref name="pmid30513014">{{cite journal| author=Rinaldi F, Marzani B, Pinto D, Sorbellini E| title=Randomized controlled trial on a PRP-like cosmetic, biomimetic peptides based, for the treatment of alopecia areata. | journal=J Dermatolog Treat | year= 2019 | volume= 30 | issue= 6 | pages= 588-593 | pmid=30513014 | doi=10.1080/09546634.2018.1544405 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30513014  }} </ref> <ref name="pmid26455063">{{cite journal| author=Vidal CI| title=Overview of Alopecia: A Dermatopathologist's Perspective. | journal=Mo Med | year= 2015 | volume= 112 | issue= 4 | pages= 308-12 | pmid=26455063 | doi= | pmc=6170065 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26455063  }} </ref>
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* Male pattern: The frontal hairline is thinner, hair loss occurs at the crown of the scalp, hair recession is seen at the temporal aspects of the scalp; Female pattern: Hair loss occurs at the crown of the scalp, however, the frontal hairline remains preserved.
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* [[Androgenetic alopecia]] is believed to have a worldwide [[prevalence]] of about 50,000 per 100,000 men and 15,000 per 100,000 women with post-menopausal women making up the majority.
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* Diagnosis is mostly clinical and is based on the pattern and absence of other explanations.
* Unlike in [[telogen effluvium]], [[hair pull test]] shows a less than 20% telogen count.
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* It is the most common cause of hair loss.
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Alopecia Areata <ref name="pmid24591533">{{cite journal| author=Qi J, Garza LA| title=An overview of alopecias. | journal=Cold Spring Harb Perspect Med | year= 2014 | volume= 4 | issue= 3 | pages=  | pmid=24591533 | doi=10.1101/cshperspect.a013615 | pmc=3935391 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24591533  }} </ref> <ref name="pmid29241771">{{cite journal| author=Strazzulla LC, Wang EHC, Avila L, Lo Sicco K, Brinster N, Christiano AM | display-authors=etal| title=Alopecia areata: Disease characteristics, clinical evaluation, and new perspectives on pathogenesis. | journal=J Am Acad Dermatol | year= 2018 | volume= 78 | issue= 1 | pages= 1-12 | pmid=29241771 | doi=10.1016/j.jaad.2017.04.1141 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29241771  }} </ref> <ref name="pmid7791384">{{cite journal| author=Safavi KH, Muller SA, Suman VJ, Moshell AN, Melton LJ| title=Incidence of alopecia areata in Olmsted County, Minnesota, 1975 through 1989. | journal=Mayo Clin Proc | year= 1995 | volume= 70 | issue= 7 | pages= 628-33 | pmid=7791384 | doi=10.4065/70.7.628 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7791384  }} </ref> <ref name="pmid24202232">{{cite journal| author=Mirzoyev SA, Schrum AG, Davis MDP, Torgerson RR| title=Lifetime incidence risk of alopecia areata estimated at 2.1% by Rochester Epidemiology Project, 1990-2009. | journal=J Invest Dermatol | year= 2014 | volume= 134 | issue= 4 | pages= 1141-1142 | pmid=24202232 | doi=10.1038/jid.2013.464 | pmc=3961558 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24202232  }} </ref> <ref name="pmid26455063">{{cite journal| author=Vidal CI| title=Overview of Alopecia: A Dermatopathologist's Perspective. | journal=Mo Med | year= 2015 | volume= 112 | issue= 4 | pages= 308-12 | pmid=26455063 | doi= | pmc=6170065 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks &id=26455063 }} </ref> <ref name="pmid26244028">{{cite journal| author=Villasante Fricke AC, Miteva M| title=Epidemiology and burden of alopecia areata: a systematic review. | journal=Clin Cosmet Investig Dermatol | year= 2015 | volume= 8 | issue=  | pages= 397-403 | pmid=26244028 | doi=10.2147/CCID.S53985 | pmc=4521674 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26244028  }} </ref> <ref name="pmid21616562">{{cite journal| author=Chu SY, Chen YJ, Tseng WC, Lin MW, Chen TJ, Hwang CY | display-authors=etal| title=Comorbidity profiles among patients with alopecia areata: the importance of onset age, a nationwide population-based study. | journal=J Am Acad Dermatol | year= 2011 | volume= 65 | issue= 5 | pages= 949-56 | pmid=21616562 | doi=10.1016/j.jaad.2010.08.032 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21616562  }} </ref> <ref name="pmid26499292">Chen CH, Wang KH, Lin HC, Chung SD (2016) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=26499292 Follow-up study on the relationship between alopecia areata and risk of autoimmune diseases.] ''J Dermatol'' 43 (2):228-9. [http://dx.doi.org/10.1111/1346-8138.13165 DOI:10.1111/1346-8138.13165] PMID: [https://pubmed.gov/26499292 26499292]</ref>
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* It presents with round patches of total hair loss with retained follicular ostia with the beard and scalp being the most frequently affected areas.
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* [[Alopecia areata]] has a [[prevalence]] of 100-200 per 100,000 individuals, and a risk of about 2% over an individual's life. The mean age for diagnosis of [[alopecia areata]] is about 32 years in males and 36 years in females.
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* Close observation reveals the characteristic exclamation mark hairs. A [[hair pull test]] followed by [[trichogram]] shows telogen and pencil point shafts.
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* It is associated with several autoimmune diseases including [[thyroid disease]], [[rheumatoid arthritis]], [[inflammatory bowel disease]], and [[vitiligo]].
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Telogen Effluvium <ref>Sperling LC, Cowper SE, Knopp EA. An atlas of hair pathology with clinical correlations. 2. Informa Healthcare; 2014. [Google Scholar]</ref> <ref name="pmid30237729">{{cite journal| author=Sant'Anna Addor FA, Donato LC, Melo CSA| title=Comparative evaluation between two nutritional supplements in the improvement of telogen effluvium. | journal=Clin Cosmet Investig Dermatol | year= 2018 | volume= 11 | issue=  | pages= 431-436 | pmid=30237729 | doi=10.2147/CCID.S173082 | pmc=6136400 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30237729  }} </ref> <ref name="pmid26455063">{{cite journal| author=Vidal CI| title=Overview of Alopecia: A Dermatopathologist's Perspective. | journal=Mo Med | year= 2015 | volume= 112 | issue= 4 | pages= 308-12 | pmid=26455063 | doi= | pmc=6170065 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26455063  }} </ref>
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* There is a massive amount of hair shedding that is triggered by physiologic or psychologic stress.
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* Although considered to be a relatively common condition, the precise [[prevalence]] of [[telogen effluvium]] remains unknown.  However, it is believed that it is more commonly seen in females than in males
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* [[Hair pull test]] followed by [[trichogram]] reveals numerous clubbed-shaped hairs; telogen count must exceed 20% for diagnosis.
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* It could be an acute self-limiting form triggered by stressors such as crash diets, childbirth, febrile illness, or psychological stress.
* It may be chronic and present in association with female pattern hair loss.
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Anagen Effluvium <ref name="pmid24591533">{{cite journal| author=Qi J, Garza LA| title=An overview of alopecias. | journal=Cold Spring Harb Perspect Med | year= 2014 | volume= 4 | issue= 3 | pages=  | pmid=24591533 | doi=10.1101/cshperspect.a013615 | pmc=3935391 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24591533  }} </ref>
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* There is diffuse hair loss and it is characterized by hair breakage that takes place in the anagen phase.
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* Associated with exposure to [[radiation]], as in [[radiotherapy]] and [[cancer chemotherapy]].
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* [[Trichoscopy]] would reveal the characteristic narrowing, fractured hair shafts with an absence of bulbs.
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Trichotillomania <ref>Sperling LC, Cowper SE, Knopp EA. An atlas of hair pathology with clinical correlations. 2. Informa Healthcare; 2014. [Google Scholar]</ref> <ref name="pmid1938977">{{cite journal| author=Christenson GA, Pyle RL, Mitchell JE| title=Estimated lifetime prevalence of trichotillomania in college students. | journal=J Clin Psychiatry | year= 1991 | volume= 52 | issue= 10 | pages= 415-7 | pmid=1938977 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1938977  }} </ref> <ref name="pmid7559316">{{cite journal| author=King RA, Zohar AH, Ratzoni G, Binder M, Kron S, Dycian A | display-authors=etal| title=An epidemiological study of [[trichotillomania]] in Israeli adolescents. | journal=J Am Acad Child Adolesc Psychiatry | year= 1995 | volume= 34 | issue= 9 | pages= 1212-5 | pmid=7559316 | doi=10.1097/00004583-199509000-00019 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7559316  }} </ref> <ref name="pmid19926375">{{cite journal| author=Duke DC, Keeley ML, Geffken GR, Storch EA| title=Trichotillomania: A current review. | journal=Clin Psychol Rev | year= 2010 | volume= 30 | issue= 2 | pages= 181-93 | pmid=19926375 | doi=10.1016/j.cpr.2009.10.008 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19926375  }} </ref> <ref name="pmid20946585">{{cite journal| author=Quercetani R, Rebora AE, Fedi MC, Carelli G, Mei S, Chelli A | display-authors=etal| title=Patients with profuse hair shedding may reveal anagen hair dystrophy: a diagnostic clue of alopecia areata incognita. | journal=J Eur Acad Dermatol Venereol | year= 2011 | volume= 25 | issue= 7 | pages= 808-10 | pmid=20946585 | doi=10.1111/j.1468-3083.2010.03869.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20946585  }} </ref> <ref name="pmid24591533">{{cite journal| author=Qi J, Garza LA| title=An overview of alopecias. | journal=Cold Spring Harb Perspect Med | year= 2014 | volume= 4 | issue= 3 | pages=  | pmid=24591533 | doi=10.1101/cshperspect.a013615 | pmc=3935391 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24591533  }} </ref> <ref>Habif TP 2010. Hair diseases. In Clinical dermatology, 5th ed Mosby, Maryland Heights, MO [Google Scholar]</ref> <ref>Otberg N, Shapiro J 2012. Hair growth disorders. In Fitzpatrick’s dermatology in general medicine, 8th ed (ed. Goldsmith LA, et al.). McGraw-Hill, New York [Google Scholar]</ref>
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* Presents with uneven broken hairs in the most frequently selected areas which are the scalp, eyebrows, eyelashes, body hair, facial hair, and pubic hair.
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* Based on the limited studies that have been done to determine the [[prevalence]] of [[trichotillomania]] among U.S. university students, Israeli adolescents, and older adults within the same community, the [[prevalence]] was shown to be between 500 per 100,000 to 2000 per 100,000.
* It usually starts around the age of 12–13 years
* It is more common in males during the childhood years while it is more common in females in the adult years.
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* Scalp inspection reveals uneven patches of hair loss with broken hairs that remain well attached to the skin.
* A characteristic finding that distinguishes [[trichotillomania]] from [[alopecia areata]] is that the affected areas are not totally devoid of hair shafts.
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* It occurs as a result of a lack of impulse control in which an individual pulls on hair.
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Traction Alopecia <ref>Otberg N, Shapiro J 2012. Hair growth disorders. In Fitzpatrick’s dermatology in general medicine, 8th ed (ed. Goldsmith LA, et al.). McGraw-Hill, New York [Google Scholar]</ref> <ref name="pmid24591533">{{cite journal| author=Qi J, Garza LA| title=An overview of alopecias. | journal=Cold Spring Harb Perspect Med | year= 2014 | volume= 4 | issue= 3 | pages=  | pmid=24591533 | doi=10.1101/cshperspect.a013615 | pmc=3935391 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24591533  }} </ref> <ref name="pmid15113284">{{cite journal| author=Callender VD, McMichael AJ, Cohen GF| title=Medical and surgical therapies for alopecias in black women. | journal=Dermatol Ther | year= 2004 | volume= 17 | issue= 2 | pages= 164-76 | pmid=15113284 | doi=10.1111/j.1396-0296.2004.04017.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15113284  }} </ref> <ref name="pmid29265342">{{cite journal| author=Aguado Lobo M, Jiménez-Reyes J| title=Traction alopecia. | journal=Int J Dermatol | year= 2018 | volume= 57 | issue= 2 | pages= 231-232 | pmid=29265342 | doi=10.1111/ijd.13846 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi? dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29265342  }} </ref> <ref name="pmid15113284">{{cite journal| author=Callender VD, McMichael AJ, Cohen GF| title=Medical and surgical therapies for alopecias in black women. | journal=Dermatol Ther | year= 2004 | volume= 17 | issue= 2 | pages= 164-76 | pmid=15113284 | doi=10.1111/j.1396-0296.2004.04017.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15113284  }} </ref>
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* Hair loss at regions of the scalp exposed to tension on hair follicles for a prolonged period of time in people who make tight hairstyles.
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* [[Traction alopecia]] is more commonly seen among black populations with females being affected more often than males at a rate of about 31,000-32,000 per 100,000 women compared to about 2,300 per 100,000 men.
* [[Traction alopecia]] is seen in about 18,000 per 100,000 girls between the ages of 5.4 to 14.3 years based on a study of African-American girls.
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* Mostly a clinical diagnosis based on hair loss at areas of the scalp where tension on the hair is highest.
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* Early detection and switching to more loose hairstyles may reverse the condition, however, with prolonged tension on the scalp destruction of the hair follicles will occur, causing the condition to become irreversible.
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Chronic Cutaneous Lupus Erythematosus <ref>Sperling LC, Cowper SE, Knopp EA. An atlas of hair pathology with clinical correlations. 2. Informa Healthcare; 2014. [Google Scholar]</ref> <ref name="pmid24591533">{{cite journal| author=Qi J, Garza LA| title=An overview of alopecias. | journal=Cold Spring Harb Perspect Med | year= 2014 | volume= 4 | issue= 3 | pages=  | pmid=24591533 | doi=10.1101/cshperspect.a013615 | pmc=3935391 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24591533  }} </ref> 
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* Presents with an area with hair loss that gradually converts into scaly, thickened papules then into poorly-defined, variably-shaped plaques with atrophy, follicular plugging, telangiectasia, and depigmentation.
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* Black populations tend to have more serious disease.
* [[Cutaneous lupus erythematosus]] is more common in males than in females, with a ratio of about 59.4 per 100,000 versus 1.6 per 100,000.
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* [[Histological analysis]] after a [[hair pull test]] reveals a higher anagen count during active disease.
* [[Direct immunofluorescence]] may reveal granular [[C3]] and [[IgG]] at the dermo-epidermal boundary which is found in greater than 70% of cases.
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Tinea Capitis <ref name="pmid30725594">{{cite journal| author=| title=StatPearls | journal= | year= 2020 | volume=  | issue=  | pages=  | pmid=30725594 | doi= | pmc= | url= }} </ref> <ref name="pmid12431130">{{cite journal| author=Pomeranz AJ, Sabnis SS| title=Tinea capitis: epidemiology, diagnosis and management strategies. | journal=Paediatr Drugs | year= 2002 | volume= 4 | issue= 12 | pages= 779-83 | pmid=12431130 | doi=10.2165/00128072-200204120-00002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12431130  }} </ref> <ref name="pmid19502982">{{cite journal| author=Kos L, Conlon J| title=An update on alopecia areata. | journal=Curr Opin Pediatr | year= 2009 | volume= 21 | issue= 4 | pages= 475-80 | pmid=19502982 | doi=10.1097/MOP.0b013e32832db986 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19502982  }} </ref> <ref>Sperling LC, Cowper SE, Knopp EA. An atlas of hair pathology with clinical correlations. 2. Informa Healthcare; 2014. [Google Scholar]</ref> <ref name="pmid22972730">{{cite journal| author=Ponka D, Baddar F| title=Wood lamp examination. | journal=Can Fam Physician | year= 2012 | volume= 58 | issue= 9 | pages= 976 | pmid=22972730 | doi= | pmc=3440273 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22972730  }} </ref> <ref name="pmid26455063">{{cite journal| author=Vidal CI| title=Overview of Alopecia: A Dermatopathologist's Perspective. | journal=Mo Med | year= 2015 | volume= 112 | issue= 4 | pages= 308-12 | pmid=26455063 | doi= | pmc=6170065 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26455063  }} </ref>
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* Presents in diverse ways such as ordinary scaling without any obvious hair loss which is considered to be a seborrheic form, a crusted or [[pustular]] form that may be localized or diffuse, a ‘black dot’ type that is characterized by tiny black dots within regions of [[alopecia]], an inflammatory mass called [[kerion]], and a round, bald, scaly patch where the follicular ostia are filled with keratinous debris.
* A unique feature of [[tinea capita]]s is the presence of post-auricular and cervical [[lymphadenopathy]].
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* It is more common in the pediatric population.
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* [[Potassium hydroxide]] preparation can be added to skin scrapings of affected areas in order to diagnose the condition. <ref name="pmid24591533">{{cite journal| author=Qi J, Garza LA| title=An overview of alopecias. | journal=Cold Spring Harb Perspect Med | year= 2014 | volume= 4 | issue= 3 | pages=  | pmid=24591533 | doi=10.1101/cshperspect.a013615 | pmc=3935391 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24591533  }} </ref>
* Wood's light can also be used in diagnosis as majority of [[Microsporum]] spp will appear bluish-green, occasionally dull yellow (Microsporum gypseum) and dull blue ([[Trichophyton]] schoenleinii).
| style="padding: 5px 5px; background: #F5F5F5;" |
* In the U.S., under 5% of cases will show [[fluorescence]].
* Possible complications of [[tinea capita]]s are [[kerion]], an [[abscess]] in the scalp, or [[favus]], another inflammatory form in which there is honeycomb destruction of the hair shaft.  Both are severe forms of the disease and can cause permanent scarring.
 
|}
 
 
===The following lists the complete differential diagnosis of Alopecia: ===


===Non-Scarring Alopecia===
===Non-Scarring Alopecia===
Line 61: Line 166:
**[[Allopurinol]]
**[[Allopurinol]]
**[[Androgens]]
**[[Androgens]]
**[[Anticoagulants]]
**[[Anticoagulants]] <ref name="pmid27747798">{{cite journal| author=Watras MM, Patel JP, Arya R| title=Traditional Anticoagulants and Hair Loss: A Role for Direct Oral Anticoagulants? A Review of the Literature. | journal=Drugs Real World Outcomes | year= 2016 | volume= 3 | issue= 1 | pages= 1-6 | pmid=27747798 | doi=10.1007/s40801-015-0056-z | pmc=4819463 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27747798  }} </ref>
**[[Anticonvulsants]]
**[[Anticonvulsants]] <ref name="pmid29207731">{{cite journal| author=Thomson SR, Mamulpet V, Adiga S| title=Sodium Valproate Induced Alopecia: A Case Series. | journal=J Clin Diagn Res | year= 2017 | volume= 11 | issue= 9 | pages= FR01-FR02 | pmid=29207731 | doi=10.7860/JCDR/2017/28564.10658 | pmc=5713753 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29207731  }} </ref> <ref name="pmid13715510">{{cite journal| author=HOLOWACH J, SANDEN HV| title=Alopecia as a side effect of treatment of epilepsy with trimethadione. Report of two cases. | journal=N Engl J Med | year= 1960 | volume= 263 | issue=  | pages= 1187 | pmid=13715510 | doi=10.1056/NEJM196012082632308 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13715510  }} </ref>
**[[Antimycotic agents]]
**[[Antimycotic agents]]
**[[Arsenic]]
**[[Arsenic]]
**[[Azathioprine]]
**[[Azathioprine]]
**[[Beta blockers]]
**[[Beta blockers]] <ref name="pmid3979099">{{cite journal| author=Shelley ED, Shelley WB| title=Alopecia and drug eruption of the scalp associated with a new beta-blocker, nadolol. | journal=Cutis | year= 1985 | volume= 35 | issue= 2 | pages= 148-9 | pmid=3979099 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3979099  }} </ref>
**[[Borates]]
**[[Borates]]
**[[Cadmium]]
**[[Cadmium]]
Line 101: Line 206:
*[[Sarcoidosis]]
*[[Sarcoidosis]]
*[[Scleroderma]]
*[[Scleroderma]]
*[[Systemic Lupus Erythematosus]]
*[[Systemic Lupus Erythematosus]] <ref name="pmid32699719">{{cite journal| author=Forouzan P, Cohen PR| title=Systemic Lupus Erythematosus Presenting as Alopecia Areata. | journal=Cureus | year= 2020 | volume= 12 | issue= 6 | pages= e8724 | pmid=32699719 | doi=10.7759/cureus.8724 | pmc=7372242 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmedomyositis. | journal=Lancet | year= 2000 | volume= 355 | issue= 9197 | pages= 53-7 | pmid=10615903 | doi=10.1016/S0140-6736(99)05157-0 | pmc= | url=https://&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32699719  }} </ref>, [[dermatomyositis]] <ref name="pmid10615903">{{cite journal| author=Callen JP| title=Dermatwww.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10615903  }} </ref>


===Miscellaneous===
===Miscellaneous===
Line 122: Line 227:
**Pressure alopecia (alopecia after extended bed rest)
**Pressure alopecia (alopecia after extended bed rest)
**Trichotillomania (compulsion to pull out one’s own hair)
**Trichotillomania (compulsion to pull out one’s own hair)
{|
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! colspan="2" rowspan="4" |Diseases
| colspan="6" |'''Clinical manifestations'''
! colspan="4" rowspan="2" |Para-clinical findings
| colspan="1" rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Gold standard'''
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Additional findings
|-
| rowspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Age of onset'''
| colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Symptoms'''
! colspan="2" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical examination
|-
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Immunohistopathology
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |pelvic/abdominal pain or pressure
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |vaginal bleeding/discharge
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |GI dysturbance
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Fever'''
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Tenderness
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |CT scan/US
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |MRI
|-
! colspan="14" style="background: #7d7d7d; color: #FFFFFF; text-align: center;" |Gynecologic
|-
| rowspan="15" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Ovary|Ovarian]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Embryonal carcinoma]]<ref name="pmid6093440">{{cite journal| author=Krag Jacobsen G, Barlebo H, Olsen J, Schultz HP, Starklint H, Søgaard H et al.| title=Testicular germ cell tumours in Denmark 1976-1980. Pathology of 1058 consecutive cases. | journal=Acta Radiol Oncol | year= 1984 | volume= 23 | issue= 4 | pages= 239-47 | pmid=6093440 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6093440  }} </ref><ref name="IshidaHasegawa2008">{{cite journal|last1=Ishida|first1=M.|last2=Hasegawa|first2=M.|last3=Kanao|first3=K.|last4=Oyama|first4=M.|last5=Nakajima|first5=Y.|title=Non-palpable Testicular Embryonal Carcinoma Diagnosed by Ultrasound: A Case Report|journal=Japanese Journal of Clinical Oncology|volume=39|issue=2|year=2008|pages=124–126|issn=0368-2811|doi=10.1093/jjco/hyn141}}</ref><ref name="SteinWasnik2017">{{cite journal|last1=Stein|first1=Erica B.|last2=Wasnik|first2=Ashish P.|last3=Sciallis|first3=Andrew P.|last4=Kamaya|first4=Aya|last5=Maturen|first5=Katherine E.|title=MR Imaging–Pathologic Correlation in Ovarian Cancer|journal=Magnetic Resonance Imaging Clinics of North America|volume=25|issue=3|year=2017|pages=545–562|issn=10649689|doi=10.1016/j.mric.2017.03.004}}</ref><ref name="PectasidesPectasides2008">{{cite journal|last1=Pectasides|first1=D.|last2=Pectasides|first2=E.|last3=Kassanos|first3=D.|title=Germ cell tumors of the ovary|journal=Cancer Treatment Reviews|volume=34|issue=5|year=2008|pages=427–441|issn=03057372|doi=10.1016/j.ctrv.2008.02.002}}</ref><ref name="CaoGuo2009">{{cite journal|last1=Cao|first1=Dengfeng|last2=Guo|first2=Shuangping|last3=Allan|first3=Robert W.|last4=Molberg|first4=Kyle H.|last5=Peng|first5=Yan|title=SALL4 Is a Novel Sensitive and Specific Marker of Ovarian Primitive Germ Cell Tumors and Is Particularly Useful in Distinguishing Yolk Sac Tumor From Clear Cell Carcinoma|journal=The American Journal of Surgical Pathology|volume=33|issue=6|year=2009|pages=894–904|issn=0147-5185|doi=10.1097/PAS.0b013e318198177d}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*Individuals of any age, especially young adults
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |_
| style="background: #F5F5F5; padding: 5px; text-align: center;" |_
| style="background: #F5F5F5; padding: 5px; text-align: center;" |_
| style="background: #F5F5F5; padding: 5px;" |
*Elevated concentration of [[AFP|alfa-fetoprotein]] [[AFP|(AFP)]]
| style="background: #F5F5F5; padding: 5px;" |
*Decreased [[echogenicity]] on the [[ultrasound]] imaging
| style="background: #F5F5F5; padding: 5px;" |
*The [[tumor]] is large, predominantly [[solid]] and unilateral with areas of [[necrosis]] and [[hemorrhage]].
*There may be [[cystic]] areas that contains [[Mucus|mucoid]] material.
| style="background: #F5F5F5; padding: 5px;" |
*[[AFP]]
*[[Cytokeratin]] (AE1/AE3)
*Placental-like [[alkaline phosphatase]] in 50% of the individuals.
*SALL4 ([[nuclear]]) in > 90% of the cases.
*GPC3
| style="background: #F5F5F5; padding: 5px;" |
*[[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Tumor]] is usually a component of [[ovarian]] mixed [[germ cell]] [[tumors]].
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Gonadoblastoma]]<br><ref name="pmid4193741">{{cite journal| author=Scully RE| title=Gonadoblastoma. A review of 74 cases. | journal=Cancer | year= 1970 | volume= 25 | issue= 6 | pages= 1340-56 | pmid=4193741 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4193741  }} </ref><ref name="978-0-323-40067-1">{{cite book | last = Saia | first = Philip | title = Clinical gynecologic oncology | publisher = Elsevier | location = Philadelphia, PA | year = 2018 | isbn = 978-0-323-40067-1 }}</ref><ref name="EsinBaser2011">{{cite journal|last1=Esin|first1=Sertac|last2=Baser|first2=Eralp|last3=Kucukozkan|first3=Tuncay|last4=Magden|first4=Hasim Ata|title=Ovarian gonadoblastoma with dysgerminoma in a 15-year-old girl with 46, XX karyotype: case report and review of the literature|journal=Archives of Gynecology and Obstetrics|volume=285|issue=2|year=2011|pages=447–451|issn=0932-0067|doi=10.1007/s00404-011-2073-9}}</ref><ref name="LuisiriVogler1991">{{cite journal|last1=Luisiri|first1=A|last2=Vogler|first2=C|last3=Steinhardt|first3=G|last4=Silberstein|first4=M|title=Neonatal cystic testicular gonadoblastoma. Sonographic and pathologic findings.|journal=Journal of Ultrasound in Medicine|volume=10|issue=1|year=1991|pages=59–61|issn=02784297|doi=10.7863/jum.1991.10.1.59}}</ref><ref name="pmid10226831">{{cite journal |vauthors=Hatano T, Yoshino Y, Kawashima Y, Shirai H, Iizuka N, Miyazawa Y, Sakata A, Onishi T |title=Case of gonadoblastoma in a 9-year-old boy without physical abnormalities |journal=Int. J. Urol. |volume=6 |issue=3 |pages=164–6 |date=March 1999 |pmid=10226831 |doi= |url=}}</ref><ref name="CoolsStoop2006">{{cite journal|last1=Cools|first1=Martine|last2=Stoop|first2=Hans|last3=Kersemaekers|first3=Anne-Marie F.|last4=Drop|first4=Stenvert L. S.|last5=Wolffenbuttel|first5=Katja P.|last6=Bourguignon|first6=Jean-Pierre|last7=Slowikowska-Hilczer|first7=Jolanta|last8=Kula|first8=Krzysztof|last9=Faradz|first9=Sultana M. H.|last10=Oosterhuis|first10=J. Wolter|last11=Looijenga|first11=Leendert H. J.|title=Gonadoblastoma Arising in Undifferentiated Gonadal Tissue within Dysgenetic Gonads|journal=The Journal of Clinical Endocrinology & Metabolism|volume=91|issue=6|year=2006|pages=2404–2413|issn=0021-972X|doi=10.1210/jc.2005-2554}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*Individuals of any age,but more common prior to 15 years of age
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |_
| style="background: #F5F5F5; padding: 5px; text-align: center;" |_
| style="background: #F5F5F5; padding: 5px; text-align: center;" |_
| style="background: #F5F5F5; padding: 5px;" |
*Elevated concentration of [[human chorionic gonadotropin]] (hCG), in case of coexisting [[dysgerminoma]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Solid]] [[mass]] with focal or extensive [[calcification]]<nowiki/>s with or without [[ascites]]
*[[Mass]] can be complex and have a [[cystic]] component
*Increased [[echogenicity]] on the [[ultrasound]] imaging
| style="background: #F5F5F5; padding: 5px;" |
*[[Solid]] [[mass]] with focal or extensive [[Calcification|calcifications]] with or withous [[ascites]]
*[[Mass]] can be complex and have a [[cystic]] component
| style="background: #F5F5F5; padding: 5px;" |
*NA
| style="background: #F5F5F5; padding: 5px;" |
*[[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Tumor]] is [[Bilateral|bilatera]]<nowiki/>l in 50% of cases
*Focal [[calcification]] can be present in 80% of individuals
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Ovarian cyst|Follicular cysts]]<br><ref name="pmid20505067">{{cite journal |vauthors=Levine D, Brown DL, Andreotti RF, Benacerraf B, Benson CB, Brewster WR, Coleman B, Depriest P, Doubilet PM, Goldstein SR, Hamper UM, Hecht JL, Horrow M, Hur HC, Marnach M, Patel MD, Platt LD, Puscheck E, Smith-Bindman R |title=Management of asymptomatic ovarian and other adnexal cysts imaged at US: Society of Radiologists in Ultrasound Consensus Conference Statement |journal=Radiology |volume=256 |issue=3 |pages=943–54 |date=September 2010 |pmid=20505067 |doi=10.1148/radiol.10100213 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*[[Women]] in [[Reproductive system|reproductive]] age (15 -45 y/o)
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px;" |
*High level of [[estrogen]] +/–
| style="background: #F5F5F5; padding: 5px;" |
*In [[Ultrasound|US]] we may see a >3 cm simple [[cyst]] with no internal echo and with posterior acoustic enhancement
| style="background: #F5F5F5; padding: 5px;" |
*simple [[cyst]] with no internal echo or septa
| style="background: #F5F5F5; padding: 5px;" |
*NA
| style="background: #F5F5F5; padding: 5px;" |
*[[History and Physical examination|History]]/<br>[[imaging]]
| style="background: #F5F5F5; padding: 5px;" |
*It is associated with [[hyperestrogenism]] and [[endometrial hyperplasia]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Ovarian cyst|Theca lutein cysts]]<br><ref name="pmid2455880">{{cite journal |vauthors=Montz FJ, Schlaerth JB, Morrow CP |title=The natural history of theca lutein cysts |journal=Obstet Gynecol |volume=72 |issue=2 |pages=247–51 |date=August 1988 |pmid=2455880 |doi= |url=}}</ref><ref name="Southam1962">{{cite journal|last1=Southam|first1=Anna L.|title=Massive Ovarian Hyperstimulation with Clomiphene Citrate|journal=JAMA: The Journal of the American Medical Association|volume=181|issue=5|year=1962|pages=443|issn=0098-7484|doi=10.1001/jama.1962.03050310083018b}}</ref><ref name="NguyenReid1986">{{cite journal|last1=Nguyen|first1=K T|last2=Reid|first2=R L|last3=Sauerbrei|first3=E|title=Antenatal sonographic detection of a fetal theca lutein cyst: a clue to maternal diabetes mellitus.|journal=Journal of Ultrasound in Medicine|volume=5|issue=11|year=1986|pages=665–667|issn=02784297|doi=10.7863/jum.1986.5.11.665}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*[[Women]] in [[reproductive]] age (15 -45 y/o)
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px;" |
*Depends on the underlying [[etiology]]
| style="background: #F5F5F5; padding: 5px;" |
*In [[Ultrasound|US]] we may see bilaterally enlarged [[ovaries]] with multiple [[cysts]]
| style="background: #F5F5F5; padding: 5px;" |
*Multiple bilateral [[cysts]]
| style="background: #F5F5F5; padding: 5px;" |
*Theca interna cell [[Hyperplasia]]
| style="background: #F5F5F5; padding: 5px;" |
*[[History and Physical examination|History]]/<br>[[imaging]]
| style="background: #F5F5F5; padding: 5px;" |
*It is associated with [[Hydatidiform mole|hydatidiform moles]], [[choriocarcinoma]], [[diabetes mellitus]] and [[clomiphene]] intake ([[ovulation]] induction)
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Serous cystadenoma/carcinoma<br><ref name="JungLee20022">{{cite journal|last1=Jung|first1=Seung Eun|last2=Lee|first2=Jae Mun|last3=Rha|first3=Sung Eun|last4=Byun|first4=Jae Young|last5=Jung|first5=Jung Im|last6=Hahn|first6=Seong Tai|title=CT and MR Imaging of Ovarian Tumors with Emphasis on Differential Diagnosis|journal=RadioGraphics|volume=22|issue=6|year=2002|pages=1305–1325|issn=0271-5333|doi=10.1148/rg.226025033}}</ref><ref name="ImaiKiyozuka1990">{{cite journal|last1=Imai|first1=Shunsuke|last2=Kiyozuka|first2=Yasuhiko|last3=Maeda|first3=Hiroko|last4=Noda|first4=Tuneo|last5=Hosick|first5=Howard L.|title=Establishment and Characterization of a Human Ovarian Serous Cystadenocarcinoma Cell Line That Produces the Tumor Markers CA-125 and Tissue Polypeptide Antigen|journal=Oncology|volume=47|issue=2|year=1990|pages=177–184|issn=0030-2414|doi=10.1159/000226813}}</ref><ref name="pmid15087669">{{cite journal |vauthors=Malpica A, Deavers MT, Lu K, Bodurka DC, Atkinson EN, Gershenson DM, Silva EG |title=Grading ovarian serous carcinoma using a two-tier system |journal=Am. J. Surg. Pathol. |volume=28 |issue=4 |pages=496–504 |date=April 2004 |pmid=15087669 |doi= |url=}}</ref><ref name="pmid22405464">{{cite journal |vauthors=Li J, Fadare O, Xiang L, Kong B, Zheng W |title=Ovarian serous carcinoma: recent concepts on its origin and carcinogenesis |journal=J Hematol Oncol |volume=5 |issue= |pages=8 |date=March 2012 |pmid=22405464 |doi=10.1186/1756-8722-5-8 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*>55 y/o
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px;" |
*Elevated levels of [[CA-125|serum cancer antigen-125]]
| style="background: #F5F5F5; padding: 5px;" |
*In [[Ultrasound|US]] we may see simple or multiloculated [[cyst]]
*In serous cystadenocarcinoma we may see [[papillary]] projection inside the cyst
*In serous cystadenocarcinoma we may see [[ascites]]
| style="background: #F5F5F5; padding: 5px;" |
*In Serous cystadenoma we may see a simple [[cyst]] with beak sign, hypointense on T1 and hyperintense on T2
*In serous cystadenocarcinoma we may see some Solid [[malignant]] components inside the [[cyst]] with  intermediate signal on T1 and T2
| style="background: #F5F5F5; padding: 5px;" |
*[[Cyst]] wall consist of [[benign]]/[[malignant]] [[Fallopian tube|Fallopian]] [[Epithelium|epithelial]] layer
*[[Psammoma body]]
*In serous cystadenocarcinoma we may see [[papillary]] projection inside the [[cyst]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
*Most common [[ovarian neoplasm]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Mucinous cystadenoma]]/carcinoma<br><ref name="pmid9850171">{{cite journal |vauthors=Hoerl HD, Hart WR |title=Primary ovarian mucinous cystadenocarcinomas: a clinicopathologic study of 49 cases with long-term follow-up |journal=Am. J. Surg. Pathol. |volume=22 |issue=12 |pages=1449–62 |date=December 1998 |pmid=9850171 |doi= |url=}}</ref><ref name="pmid11075847">{{cite journal |vauthors=Lee KR, Scully RE |title=Mucinous tumors of the ovary: a clinicopathologic study of 196 borderline tumors (of intestinal type) and carcinomas, including an evaluation of 11 cases with 'pseudomyxoma peritonei' |journal=Am. J. Surg. Pathol. |volume=24 |issue=11 |pages=1447–64 |date=November 2000 |pmid=11075847 |doi= |url=}}</ref><ref name="JungLee2002">{{cite journal|last1=Jung|first1=Seung Eun|last2=Lee|first2=Jae Mun|last3=Rha|first3=Sung Eun|last4=Byun|first4=Jae Young|last5=Jung|first5=Jung Im|last6=Hahn|first6=Seong Tai|title=CT and MR Imaging of Ovarian Tumors with Emphasis on Differential Diagnosis|journal=RadioGraphics|volume=22|issue=6|year=2002|pages=1305–1325|issn=0271-5333|doi=10.1148/rg.226025033}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*>55 y/o
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
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*Elevated levels of [[CA-125|serum cancer antigen-125]]
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*In [[Ultrasound|US]] we may see large simple [[cyst]] with septation
*In [[mucinous cystadenocarcinoma]] we may see thickened internal septation with solid components inside the [[Cyst of urachus|cyst]]
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*Stained glass appearance due to variable signal intensity on T1 and T2
*The more [[mucin]] we have, there is more intensity on T1
*and less intensity on T2
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*[[Cyst]] wall consist of [[Columnar epithelia|columnar]] [[Endocervix|endocervical]] [[epithelium]]
*We may see gelatinous [[mucin]] inside the [[cyst]]
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*[[Biopsy]]
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*It may cause [[pseudomyxoma peritonei]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Endometrioma]]<br><ref name="pmid9848302">{{cite journal |vauthors=Mol BW, Bayram N, Lijmer JG, Wiegerinck MA, Bongers MY, van der Veen F, Bossuyt PM |title=The performance of CA-125 measurement in the detection of endometriosis: a meta-analysis |journal=Fertil. Steril. |volume=70 |issue=6 |pages=1101–8 |date=December 1998 |pmid=9848302 |doi= |url=}}</ref><ref name="KinkelFrei2005">{{cite journal|last1=Kinkel|first1=Karen|last2=Frei|first2=Kathrin A.|last3=Balleyguier|first3=Corinne|last4=Chapron|first4=Charles|title=Diagnosis of endometriosis with imaging: a review|journal=European Radiology|volume=16|issue=2|year=2005|pages=285–298|issn=0938-7994|doi=10.1007/s00330-005-2882-y}}</ref><ref name="de ZieglerBorghese2010">{{cite journal|last1=de Ziegler|first1=Dominique|last2=Borghese|first2=Bruno|last3=Chapron|first3=Charles|title=Endometriosis and infertility: pathophysiology and management|journal=The Lancet|volume=376|issue=9742|year=2010|pages=730–738|issn=01406736|doi=10.1016/S0140-6736(10)60490-4}}</ref>
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*[[Women's College Hospital|Women]] in [[reproductive]] age (15 -45 y/o)
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |
*[[Iron deficiency anemia]]
*Elevated levels of [[CA-125|serum cancer antigen-125]]
*Increased levels of [[interleukin 1]], [[chemoattractant]] protein-1, and [[Interferon-gamma|interferon gamma]]
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*Complex [[mass]] on [[Ultrasound|US]]
*Increased [[Doppler ultrasound|Doppler]] flow because of increased vascularture
*It may present with [[catamenial pneumothorax]], [[hemothorax]], and [[lung]] [[nodules]] in [[CT scan]].
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*hyperintensity on T1-weighted images and a hypointensity on T2-weighted [[images]]
*Powder burn [[hemorrhages]]
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*[[Chocolate cyst]]
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*[[Laparoscopy]]
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*It may cause [[infertility]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Teratoma]]<br><ref name="KawaiKano1992">{{cite journal|last1=Kawai|first1=Michiyasu|last2=Kano|first2=Takeo|last3=Kikkawa|first3=Fumitaka|last4=Morikawa|first4=Yoshimitsu|last5=Oguchi|first5=Hidenori|last6=Nakashima|first6=Nobuo|last7=Ishizuka|first7=Takao|last8=Kuzuya|first8=Kazuo|last9=Ohta|first9=Masahiro|last10=Arii|first10=Yoshitaro|last11=Tomoda|first11=Yutaka|title=Seven tumor markers in benign and malignant germ cell tumors of the ovary|journal=Gynecologic Oncology|volume=45|issue=3|year=1992|pages=248–253|issn=00908258|doi=10.1016/0090-8258(92)90299-X}}</ref><ref name="DunzendorferdeLAS MORENAS1999">{{cite journal|last1=Dunzendorfer|first1=Thomas|last2=deLAS MORENAS|first2=ANTONIO|last3=Kalir|first3=Tamara|last4=Levin|first4=Robert M.|title=Struma Ovarii and Hyperthyroidism|journal=Thyroid|volume=9|issue=5|year=1999|pages=499–502|issn=1050-7256|doi=10.1089/thy.1999.9.499}}</ref><ref name="OutwaterSiegelman2001">{{cite journal|last1=Outwater|first1=Eric K.|last2=Siegelman|first2=Evan S.|last3=Hunt|first3=Jennifer L.|title=Ovarian Teratomas: Tumor Types and Imaging Characteristics|journal=RadioGraphics|volume=21|issue=2|year=2001|pages=475–490|issn=0271-5333|doi=10.1148/radiographics.21.2.g01mr09475}}</ref><ref name="SabaGuerriero2009">{{cite journal|last1=Saba|first1=Luca|last2=Guerriero|first2=Stefano|last3=Sulcis|first3=Rosa|last4=Virgilio|first4=Bruna|last5=Melis|first5=GianBenedetto|last6=Mallarini|first6=Giorgio|title=Mature and immature ovarian teratomas: CT, US and MR imaging characteristics|journal=European Journal of Radiology|volume=72|issue=3|year=2009|pages=454–463|issn=0720048X|doi=10.1016/j.ejrad.2008.07.044}}</ref>
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*10-30 y/o
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| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
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*High level of [[HCG]] and [[LDH]]
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*In [[Ultrasound|US]] we may see [[cystic]] [[adnexal]] [[mass]] with mural components and echogenic [[lesion]] due to [[calcification]]
*The iceberg [[sign]]
*Dot-dash pattern
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*We may see evidence of [[fat]] components
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*All three [[Germ layer|germ layers]] [[Cell (biology)|cell]]
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*[[Biopsy]]
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*It may cause [[ovarian torsion]]
*May content [[thyroid]] [[tissue]] and cause [[hyperthyroidism]]
*In plane [[radiography]] we may see [[calcification]] due to the presence of [[tooth]] in the [[tumor]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Dysgerminoma]]<br><ref name="DganiShoham(Schwartz)1988">{{cite journal|last1=Dgani|first1=R.|last2=Shoham(Schwartz)|first2=Z.|last3=Czernobilsky|first3=B.|last4=Kaftori|first4=A.|last5=Borenstein|first5=R.|last6=Lancet|first6=M.|title=Lactic dehydrogenase, alkaline phosphatase and human chorionic gonadotropin in a pure ovarian dysgerminoma|journal=Gynecologic Oncology|volume=30|issue=1|year=1988|pages=44–50|issn=00908258|doi=10.1016/0090-8258(88)90044-3}}</ref><ref name="pmid8188914">{{cite journal |vauthors=Tanaka YO, Kurosaki Y, Nishida M, Michishita N, Kuramoto K, Itai Y, Kubo T |title=Ovarian dysgerminoma: MR and CT appearance |journal=J Comput Assist Tomogr |volume=18 |issue=3 |pages=443–8 |date=1994 |pmid=8188914 |doi= |url=}}</ref>
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*in the second to third decade of life
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px;" |
*High level of [[HCG]] and [[LDH]]
*[[Hypercalcemia]]
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*Multilobulated solid [[Mass|masses]]
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*We may see [[ovarian]] [[mass]] with septation which are hyperintense on T1 and hypo or isointense on T2 [[imaging]]
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*Sheets fried egg appearance [[Cell (biology)|cells]]
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*[[Biopsy]]
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*Same as [[male]] [[seminoma]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Yolk sac tumor]]<br><ref name="Yang2000">{{cite journal|last1=Yang|first1=Grace C.H.|title=Fine-needle aspiration cytology of Schiller-Duval bodies of yolk-sac tumor|journal=Diagnostic Cytopathology|volume=23|issue=4|year=2000|pages=228–232|issn=8755-1039|doi=10.1002/1097-0339(200010)23:4<228::AID-DC2>3.0.CO;2-M}}</ref><ref name="LevitinHaller1996">{{cite journal|last1=Levitin|first1=A|last2=Haller|first2=K D|last3=Cohen|first3=H L|last4=Zinn|first4=D L|last5=O'Connor|first5=M T|title=Endodermal sinus tumor of the ovary: imaging evaluation.|journal=American Journal of Roentgenology|volume=167|issue=3|year=1996|pages=791–793|issn=0361-803X|doi=10.2214/ajr.167.3.8751702}}</ref><ref name="TalermanHaije1974">{{cite journal|last1=Talerman|first1=A.|last2=Haije|first2=W. G.|title=Alpha-fetoprotein and germ cell tumors: A possible role of yolk sac tumor in production of alpha-fetoprotein|journal=Cancer|volume=34|issue=5|year=1974|pages=1722–1726|issn=0008-543X|doi=10.1002/1097-0142(197411)34:5<1722::AID-CNCR2820340521>3.0.CO;2-F}}</ref>
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*Young [[children]]
*[[Male]] [[infants]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |
*High levels of [[AFP]]
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*In [[Ultrasound|US]] we may see a combination of echogenic and hypoechoic components
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*[[Ovarian mass]] with [[hemorrhagic]] areas
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*Yellow appearance
*[[Hemorrhagic]]
*Schiller-Duval bodies ([[glomeruli]] like structures)
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*[[Biopsy]]
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*The other name is [[Ovarian cyst|ovarian]] [[endodermal sinus tumor]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Fibroma]]<br><ref name="pmid13148256">{{cite journal |vauthors=MEIGS JV |title=Fibroma of the ovary with ascites and hydrothorax; Meigs' syndrome |journal=Am. J. Obstet. Gynecol. |volume=67 |issue=5 |pages=962–85 |date=May 1954 |pmid=13148256 |doi= |url=}}</ref><ref name="SivanesaratnamDutta1990">{{cite journal|last1=Sivanesaratnam|first1=V.|last2=Dutta|first2=R.|last3=Jayalakshmi|first3=P.|title=Ovarian fibroma - clinical and histopathological characteristics|journal=International Journal of Gynecology & Obstetrics|volume=33|issue=3|year=1990|pages=243–247|issn=00207292|doi=10.1016/0020-7292(90)90009-A}}</ref><ref name="AbadCazorla1999">{{cite journal|last1=Abad|first1=Antonio|last2=Cazorla|first2=Eduardo|last3=Ruiz|first3=Fernando|last4=Aznar|first4=Ismael|last5=Asins|first5=Enrique|last6=Llixiona|first6=Joaquin|title=Meigs' syndrome with elevated CA125: case report and review of the literature|journal=European Journal of Obstetrics & Gynecology and Reproductive Biology|volume=82|issue=1|year=1999|pages=97–99|issn=03012115|doi=10.1016/S0301-2115(98)00174-2}}</ref>
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*>50 y/o
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*Pulling sensation in the [[groin]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px;" |
*High levels of [[CA-125]]
| style="background: #F5F5F5; padding: 5px;" |
*In [[CT scan]] we may see a unilateral [[mass]] with poor contrast enhancement
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*Low signal intensity on T1 and T2
*We may see scattered hyperintense areas due to  [[edema]] or [[cystic]] [[degeneration]]
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*Spindle-shaped [[fibroblast]]
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*[[Biopsy]]
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*It may cause [[Meigs syndrome]] ([[ovarian fibroma]], [[ascites]], and [[hydrothorax]])
*It may cause [[ovarian torsion]]
*It may cause [[pleural effusion]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Thecoma]]<br><ref name="YaghoobianPinck1983">{{cite journal|last1=Yaghoobian|first1=Jahanguir|last2=Pinck|first2=Robert L.|title=Ultrasound findings in thecoma of the ovary|journal=Journal of Clinical Ultrasound|volume=11|issue=2|year=1983|pages=91–93|issn=00912751|doi=10.1002/jcu.1870110207}}</ref><ref name="LiZhang2012">{{cite journal|last1=Li|first1=Xinchun|last2=Zhang|first2=Weidong|last3=Zhu|first3=Guangbin|last4=Sun|first4=Congpeng|last5=Liu|first5=Qingyu|last6=Shen|first6=Yuechun|title=Imaging Features and Pathologic Characteristics of Ovarian Thecoma|journal=Journal of Computer Assisted Tomography|volume=36|issue=1|year=2012|pages=46–53|issn=0363-8715|doi=10.1097/RCT.0b013e31823f6186}}</ref><ref name="ProctorGreeley1951">{{cite journal|last1=Proctor|first1=Francis E.|last2=Greeley|first2=Joseph P.|last3=Rathmell|first3=Thomas K.|title=Malignant thecoma of the ovary|journal=American Journal of Obstetrics and Gynecology|volume=62|issue=1|year=1951|pages=185–192|issn=00029378|doi=10.1016/0002-9378(51)91109-X}}</ref>
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*>50 y/o
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px;" |
*[[Postmenopausal bleeding]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px;" |
*High level of [[estrogen]]
| style="background: #F5F5F5; padding: 5px;" |
*In [[Ultrasound|US]] we may see non-specific [[ovarian]] [[mass]]
*We may see evidence of [[endometrial hyperplasia]] due to increased level of [[estrogen]]
| style="background: #F5F5F5; padding: 5px;" |
*Hyperintense on T2
*T1 intensity depends on the amount of [[fibrous tissue]] ([[fibrous tissue]] lead to hypointensity)
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*Lipid-laden [[Stromal cell|stromal cells]] with pale, vaculolated [[cytoplasm]]
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*[[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
*We may see [[endometrial cancer]] as e result of hyper-[[Estrogen|estrogenism]]
*We may see [[ovarian]] fibrothecoma (mixture of [[fibroma]] and [[thecoma]])
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Granulosa cell tumour|Granulosa cell tumor]]<br><ref name="pmid17945423">{{cite journal |vauthors=Pectasides D, Pectasides E, Psyrri A |title=Granulosa cell tumor of the ovary |journal=Cancer Treat. Rev. |volume=34 |issue=1 |pages=1–12 |date=February 2008 |pmid=17945423 |doi=10.1016/j.ctrv.2007.08.007 |url=}}</ref><ref name="StenwigHazekamp1979">{{cite journal|last1=Stenwig|first1=Jan Trygve|last2=Hazekamp|first2=Johan The.|last3=Beecham|first3=Jackson B.|title=Granulosa cell tumors of the ovary. A clinicopathological study of 118 cases with long-term follow-up|journal=Gynecologic Oncology|volume=7|issue=2|year=1979|pages=136–152|issn=00908258|doi=10.1016/0090-8258(79)90090-8}}</ref><ref name="pmid9386298">{{cite journal |vauthors=Morikawa K, Hatabu H, Togashi K, Kataoka ML, Mori T, Konishi J |title=Granulosa cell tumor of the ovary: MR findings |journal=J Comput Assist Tomogr |volume=21 |issue=6 |pages=1001–4 |date=1997 |pmid=9386298 |doi= |url=}}</ref><ref name="pmid10227493">{{cite journal |vauthors=Ko SF, Wan YL, Ng SH, Lee TY, Lin JW, Chen WJ, Kung FT, Tsai CC |title=Adult ovarian granulosa cell tumors: spectrum of sonographic and CT findings with pathologic correlation |journal=AJR Am J Roentgenol |volume=172 |issue=5 |pages=1227–33 |date=May 1999 |pmid=10227493 |doi=10.2214/ajr.172.5.10227493 |url=}}</ref>
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*50-60 y/o
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |
*[[Postmenopausal bleeding]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px;" |
*High level of [[estrogen]] and [[Progesterone|progesteron]]
*We may see [[inhibin]], [[calretinin]], and [[Ki-67]] on the surface of [[Granulosa cell|granulosa]] [[tumor]] [[Cell (biology)|cells]]
| style="background: #F5F5F5; padding: 5px;" |
*In [[Ultrasound|US]] we may see solid, [[cystic]], or multiloculated solid and [[cystic]] [[mass]]
| style="background: #F5F5F5; padding: 5px;" |
*We may see solid, [[Cystic Cytoplasm|cystic]], or multiloculated solid and [[cystic]] [[mass]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Call-Exner bodies]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
*In [[postmenopausal]] [[women]] may cause [[breast]] [[tenderness]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Sertoli-Leydig cell tumor|Sertoli-leydig cell tumor]]<br><ref name="LantzschStoerer2001">{{cite journal|last1=Lantzsch|first1=T.|last2=Stoerer|first2=S.|last3=Lawrenz|first3=K.|last4=Buchmann|first4=J.|last5=Strauss|first5=H.-G.|last6=Koelbl|first6=H.|title=Sertoli-Leydig cell tumor|journal=Archives of Gynecology and Obstetrics|volume=264|issue=4|year=2001|pages=206–208|issn=0932-0067|doi=10.1007/s004040000114}}</ref><ref name="JungRha2005">{{cite journal|last1=Jung|first1=Seung Eun|last2=Rha|first2=Sung Eun|last3=Lee|first3=Jae Mun|last4=Park|first4=Soo Youn|last5=Oh|first5=Soon Nam|last6=Cho|first6=Kyoung Sik|last7=Lee|first7=Eun Ju|last8=Byun|first8=Jae Young|last9=Hahn|first9=Seong Tai|title=CT and MRI Findings of Sex Cord–Stromal Tumor of the Ovary|journal=American Journal of Roentgenology|volume=185|issue=1|year=2005|pages=207–215|issn=0361-803X|doi=10.2214/ajr.185.1.01850207}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*15 to 35 y/o
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px;" |
*Elevated [[serum]] [[testosterone]] level
*Elevated [[alpha-fetoprotein]]
| style="background: #F5F5F5; padding: 5px;" |
*In [[Ultrasound|US]] we may see unilateral Well-defined hypoechoic [[lesion]]
| style="background: #F5F5F5; padding: 5px;" |
*Low T2 signal intensity
*areas of high signal intensity
| style="background: #F5F5F5; padding: 5px;" |
*Lydig [[Cell (biology)|cells]] (Polygonal pink [[Cell (biology)|cells]] with [[eosinophilic]] [[cytoplasm]]
*[[Sertoli cell|Sertoli cells]] (clear vacuolated [[cytoplasm]])
| style="background: #F5F5F5; padding: 5px;" |
*[[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
*It may cause [[virilization]] [[Symptom|symptoms]] and [[amenorrhea]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Brenner tumor]]<br><ref name="ShevchukFenoglio1980">{{cite journal|last1=Shevchuk|first1=Maria M.|last2=Fenoglio|first2=Cecilia M.|last3=Richart|first3=Ralph M.|title=Histogenesis of brenner tumors, I: Histology and ultrastructure|journal=Cancer|volume=46|issue=12|year=1980|pages=2607–2616|issn=0008-543X|doi=10.1002/1097-0142(19801215)46:12<2607::AID-CNCR2820461213>3.0.CO;2-Q}}</ref><ref name="OutwaterSiegelman1998">{{cite journal|last1=Outwater|first1=Eric K|last2=Siegelman|first2=Evan S|last3=Kim|first3=Bohyun|last4=Chiowanich|first4=Peerapod|last5=Blasbalg|first5=Roberto|last6=Kilger|first6=Alex|title=Ovarian Brenner tumors: MR imaging characteristics|journal=Magnetic Resonance Imaging|volume=16|issue=10|year=1998|pages=1147–1153|issn=0730725X|doi=10.1016/S0730-725X(98)00136-2}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*>55 y/o
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px;" |
:*In [[Ultrasound|US]] we may see hypoechoic solid [[Mass-to-charge ratio|mass]] and [[calcification]]
| style="background: #F5F5F5; padding: 5px;" |
*Hypointense on T2 because of [[fibrous]] content
| style="background: #F5F5F5; padding: 5px;" |
*Yellow/pale appearance
*[[Transitional cell]] [[tumor]] (resembles [[Urinary bladder|bladder]])
*Coffee bean [[nuclei]] on [[H&E stain|H&E]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
*Most of the times it's an accidental finding
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Krukenberg tumor|Krukenberg tumor]]<br><ref name="pmid8626898">{{cite journal |vauthors=Kim SH, Kim WH, Park KJ, Lee JK, Kim JS |title=CT and MR findings of Krukenberg tumors: comparison with primary ovarian tumors |journal=J Comput Assist Tomogr |volume=20 |issue=3 |pages=393–8 |date=1996 |pmid=8626898 |doi= |url=}}</ref><ref name="pmid17076540">{{cite journal |vauthors=Al-Agha OM, Nicastri AD |title=An in-depth look at Krukenberg tumor: an overview |journal=Arch. Pathol. Lab. Med. |volume=130 |issue=11 |pages=1725–30 |date=November 2006 |pmid=17076540 |doi=10.1043/1543-2165(2006)130[1725:AILAKT]2.0.CO;2 |url=}}</ref>
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*>55 y/o
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
Based on underlying [[malignancy]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
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*In case of [[Metastasis|metastatic]] [[Gastrointestinal cancer|GI cancers]] we may see [[iron deficiency anemia]]
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*Mostly bilateral, complex ovarian [[lesion]]
*In [[CT scan]] we may see evidence of concurrent [[malignancy]] in other [[organs]]
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*Mostly bilateral, complex [[Ovary|ovarian]] [[lesion]] with solid components
*Internal hyperintensity on T1 and T2 weighted [[Mri|MR]] [[images]] because of [[Mucin 17|mucin]]
*Evidence of concurrent [[malignancy]] in other [[organs]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Mucin]]-secreting [[signet cell]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Imaging]]/<br>[[biopsy]]
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*The most common [[primary tumor]] is in [[Colon (anatomy)|colon]], [[stomach]], [[breast]], [[lung]], and contralateral [[ovary]]
*Based on underlying [[malignancy]] it may cause [[pleural effusion]]
|-
| rowspan="5" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Fallopian tube|Tubal]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[tubo-ovarian abscess]]<br><ref name="LandersSweet1983">{{cite journal|last1=Landers|first1=D. V.|last2=Sweet|first2=R. L.|title=Tubo-ovarian Abscess: Contemporary Approach to Management|journal=Clinical Infectious Diseases|volume=5|issue=5|year=1983|pages=876–884|issn=1058-4838|doi=10.1093/clinids/5.5.876}}</ref><ref name="Stewart TaylorMcMillan1975">{{cite journal|last1=Stewart Taylor|first1=E.|last2=McMillan|first2=James H.|last3=Greer|first3=Benjamin E.|last4=Droegemueller|first4=William|last5=Thompson|first5=Horace E.|title=The intrauterine device and tubo-ovarian abscess|journal=American Journal of Obstetrics and Gynecology|volume=123|issue=4|year=1975|pages=338–348|issn=00029378|doi=10.1016/S0002-9378(16)33434-2}}</ref><ref name="HaLim1995">{{cite journal|last1=Ha|first1=H. K.|last2=Lim|first2=G. Y.|last3=Cha|first3=E. S.|last4=Lee|first4=H. G.|last5=Ro|first5=H. J.|last6=Kim|first6=H. S.|last7=Kim|first7=H. H.|last8=Joo|first8=S. W.|last9=Jee|first9=M. K.|title=MR Imaging of Tubo-Ovarian Abscess|journal=Acta Radiologica|volume=36|issue=5|year=1995|pages=510–514|issn=0284-1851|doi=10.1080/02841859509173418}}</ref><ref name="pmid12854857">{{cite journal |vauthors=Varras M, Polyzos D, Perouli E, Noti P, Pantazis I, Akrivis Ch |title=Tubo-ovarian abscesses: spectrum of sonographic findings with surgical and pathological correlations |journal=Clin Exp Obstet Gynecol |volume=30 |issue=2-3 |pages=117–21 |date=2003 |pmid=12854857 |doi= |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*Young [[women]] (15-30 y/o
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |
*High levels of [[Inflammation|inflammatory]] [[Marker|markers]]
*[[Leukocytosis]]
| style="background: #F5F5F5; padding: 5px;" |
*In [[Ultrasound|US]] we may see multilocular complex [[lesion]] mostly [[bilateral]] with debry inside
| style="background: #F5F5F5; padding: 5px;" |
*We may see a [[Pelvic masses|pelvic mass]] filled with [[fluid]] with thick walls
*hypointense in T1 and  heterogeneous in T2
| style="background: #F5F5F5; padding: 5px;" |
*In [[abscess]] [[aspiration]] we may see [[Anaerobic organism|anaerobic organisms]]
| style="background: #F5F5F5; padding: 5px;" |
*[[History and Physical examination|History]]/<br>[[imaging]]
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*The most common [[Risk factor|risk factors]] are previous [[PID]], [[diabetes mellitus]], [[intrauterine device]] and [[History and Physical examination|history]] of [[Uterus|uterine]] [[surgery]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Ectopic pregnancy]]<br><ref name="Barnhart2009">{{cite journal|last1=Barnhart|first1=Kurt T.|title=Ectopic Pregnancy|journal=New England Journal of Medicine|volume=361|issue=4|year=2009|pages=379–387|issn=0028-4793|doi=10.1056/NEJMcp0810384}}</ref>
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*[[Women]] in [[reproductive]] age (15 -45 y/o)
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |
*High level of [[HCG|BhCG]]
*[[Progesterone]] level ≤5 ng/ml
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*In [[Ultrasound|US]] we may see empty [[uterine cavity]], [[Fallopian tube|tubal]] ring sign, ring of fire sign ([[Doppler]]), extra-[[uterine]] [[Fetus|fetal]] [[heart rate]]
| style="background: #F5F5F5; padding: 5px;" |
*NA
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*NA
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*[[History and Physical examination|History]]/<br>[[imaging]]
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*Any [[women]] in [[reproductive]] age presenting with [[abdominal pain]] or  [[amenorrhea]] should be screened for [[ectopic pregnancy]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hydrosalpinx]]<br><ref name="KimRha2009">{{cite journal|last1=Kim|first1=Mi Young|last2=Rha|first2=Sung Eun|last3=Oh|first3=Soon Nam|last4=Jung|first4=Seung Eun|last5=Lee|first5=Young Joon|last6=Kim|first6=You Sung|last7=Byun|first7=Jae Young|last8=Lee|first8=Ahwon|last9=Kim|first9=Mee-Ran|title=MR Imaging Findings of Hydrosalpinx: A Comprehensive Review|journal=RadioGraphics|volume=29|issue=2|year=2009|pages=495–507|issn=0271-5333|doi=10.1148/rg.292085070}}</ref><ref name="pmid7938766">{{cite journal |vauthors=Atri M, Nazarnia S, Bret PM, Aldis AE, Kintzen G, Reinhold C |title=Endovaginal sonographic appearance of benign ovarian masses |journal=Radiographics |volume=14 |issue=4 |pages=747–60; discussion 761–2 |date=July 1994 |pmid=7938766 |doi=10.1148/radiographics.14.4.7938766 |url=}}</ref><ref name="ChanellesDucarme2011">{{cite journal|last1=Chanelles|first1=Olivier|last2=Ducarme|first2=Guillaume|last3=Sifer|first3=Christophe|last4=Hugues|first4=Jean-Noel|last5=Touboul|first5=Cyril|last6=Poncelet|first6=Christophe|title=Hydrosalpinx and infertility: what about conservative surgical management?|journal=European Journal of Obstetrics & Gynecology and Reproductive Biology|volume=159|issue=1|year=2011|pages=122–126|issn=03012115|doi=10.1016/j.ejogrb.2011.07.004}}</ref>
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*NA
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px;" |
*In [[Ultrasound|US]] we may see [[Fallopian tube|tubal]] longitudinal folds thickening (cogwheel appearance)
*In [[CT scan]] we may see tubular [[Adnexa|adnexal]] [[lesion]] with [[fluid]] attenuation
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*Dilated [[Fallopian tube]] with [[fluid]] signal intensity
| style="background: #F5F5F5; padding: 5px;" |
*NA
| style="background: #F5F5F5; padding: 5px;" |
*[[Imaging]]
| style="background: #F5F5F5; padding: 5px;" |
*It is associated with [[endometriosis]] (haematosalpinx), [[ovulation]] induction, [[pelvic inflammatory disease]], post-[[hysterectomy]], [[tubal ligation]], and tubal [[malignancy]]
*It may cause [[infertility]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Salpingitis]]<br><ref name="pmid7976247">{{cite journal |vauthors=Czerwenka K, Heuss F, Hosmann J, Manavi M, Jelincic D, Kubista E |title=Salpingitis caused by Chlamydia trachomatis and its significance for infertility |journal=Acta Obstet Gynecol Scand |volume=73 |issue=9 |pages=711–5 |date=October 1994 |pmid=7976247 |doi= |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*[[Women]] of [[reproductive]] age
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |
*[[Leukocytosis (patient information)|Leukocytosis]]
| style="background: #F5F5F5; padding: 5px;" |
*In [[Ultrasound|US]] we may see , [[Edema|edematous]] and thickened endosalpingeal folds
| style="background: #F5F5F5; padding: 5px;" |
*NA
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*NA
| style="background: #F5F5F5; padding: 5px;" |
*[[History and Physical examination|History/<br>physical<br>exam]]
| style="background: #F5F5F5; padding: 5px;" |
*It may cause  [[infertility]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Fallopian tube cancer|Fallopian tube carcinoma]]<br><ref name="NiloffKlug1984">{{cite journal|last1=Niloff|first1=Jonathan M.|last2=Klug|first2=Thomas L.|last3=Schaetzl|first3=Elena|last4=Zurawski|first4=Vincent R.|last5=Knapp|first5=Robert C.|last6=Bast|first6=Robert C.|title=Elevation of serum CA125 in carcinomas of the fallopian tube, endometrium, and endocervix|journal=American Journal of Obstetrics and Gynecology|volume=148|issue=8|year=1984|pages=1057–1058|issn=00029378|doi=10.1016/S0002-9378(84)90444-7}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*>60 y/o
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px;" |
*High levels of [[CA-125|CA125]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Ultrasound|US]] findings are non specific (complex [[Mass–energy equivalence|mass]] on [[Fallopian tube]]
*We may see [[papillary]] projections
| style="background: #F5F5F5; padding: 5px;" |
*Low signal on T1
*In case of [[hemorrhage]] inside the [[tumor]] we may see high signal intensity on T1
*Low or of intermediate signal on T2
*In case of [[serous fluid]] inside the [[tumor]] we may see high signal intensity on T2
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*Based on the [[Tumor suppressor gene|tumor]] type we may have different [[biopsy]] finding
| style="background: #F5F5F5; padding: 5px;" |
*[[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
*We may see Latzko triad ([[abdominal pain]], [[Vagina|vaginal]] discgarge, [[Pelvic masses|pelvic mass]])
*It may cause [[Pleural effusion (patient information)|pleural effusion]]
|-
| rowspan="4" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Uterus|Uterine]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Leiomyoma]]<br><ref name="BullettiDe Ziegler1999">{{cite journal|last1=Bulletti|first1=Carlo|last2=De Ziegler|first2=Dominique|last3=Polli|first3=Valeria|last4=Flamigni|first4=Carlo|title=The role of leiomyomas in infertility|journal=The Journal of the American Association of Gynecologic Laparoscopists|volume=6|issue=4|year=1999|pages=441–445|issn=10743804|doi=10.1016/S1074-3804(99)80008-5}}</ref><ref name="MuraseSiegelman1999">{{cite journal|last1=Murase|first1=Eiko|last2=Siegelman|first2=Evan S.|last3=Outwater|first3=Eric K.|last4=Perez-Jaffe|first4=Liza A.|last5=Tureck|first5=Richard W.|title=Uterine Leiomyomas: Histopathologic Features, MR Imaging Findings, Differential Diagnosis, and Treatment|journal=RadioGraphics|volume=19|issue=5|year=1999|pages=1179–1197|issn=0271-5333|doi=10.1148/radiographics.19.5.g99se131179}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*[[Women]] of [[reproductive]] age
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px;" |
*In [[chronic]] cases, we may see mild [[anemia]]
| style="background: #F5F5F5; padding: 5px;" |
*In [[Ultrasound|US]] we may see hypoechoic [[Mass-independent fractionation|mass]] with [[calcification]] and [[Cyst|cystic]] areas of [[necrosis]] or [[degeneration]] may
| style="background: #F5F5F5; padding: 5px;" |
*Low to intermediate signal intensity on T1 and T2
*In case of [[necrosis]] inside the [[mass]], there might be some high signal [[Lesion|lesions]] on T2
| style="background: #F5F5F5; padding: 5px;" |
*[[Smooth muscle]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Imaging]]
| style="background: #F5F5F5; padding: 5px;" |
*It may cause  [[infertility]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Choriocarcinoma]]<br><ref name="SecklFisher2000">{{cite journal|last1=Seckl|first1=Michael J|last2=Fisher|first2=Rosemary A|last3=Salerno|first3=Giovanni|last4=Rees|first4=Helene|last5=Paradinas|first5=Fernando J|last6=Foskett|first6=Marianne|last7=Newlands|first7=Edward S|title=Choriocarcinoma and partial hydatidiform moles|journal=The Lancet|volume=356|issue=9223|year=2000|pages=36–39|issn=01406736|doi=10.1016/S0140-6736(00)02432-6}}</ref><ref name="NishikawaKaseki1985">{{cite journal|last1=Nishikawa|first1=Yoshiki|last2=Kaseki|first2=Shigeaki|last3=Tomoda|first3=Yutaka|last4=Ishizuka|first4=Takao|last5=Asai|first5=Yasumasa|last6=Suzuki|first6=Toshio|last7=Ushijima|first7=Hiroshi|title=Histopathologic classification of uterine choriocarcinoma|journal=Cancer|volume=55|issue=5|year=1985|pages=1044–1051|issn=0008-543X|doi=10.1002/1097-0142(19850301)55:5<1044::AID-CNCR2820550520>3.0.CO;2-7}}</ref><ref name="pmid558566">{{cite journal |vauthors=Libshitz HI, Baber CE, Hammond CB |title=The pulmonary metastases of choriocarcinoma |journal=Obstet Gynecol |volume=49 |issue=4 |pages=412–6 |date=April 1977 |pmid=558566 |doi= |url=}}</ref><ref name="pmid16114202">{{cite journal |vauthors=Diouf A, Cissé ML, Laïco A, Ndiaye D, Moreau JC, Diadhiou F |title=[Sonographic features of gestational choriocarcinoma] |language=French |journal=J Radiol |volume=86 |issue=5 Pt 1 |pages=469–73 |date=May 2005 |pmid=16114202 |doi= |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*[[Women]] in [[reproductive]] age (15 -45 y/o)
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |
*High level of [[HCG|B-hCG]]
| style="background: #F5F5F5; padding: 5px;" |
*In [[Ultrasound|US]] we may see heterogeneous mass infiltrating [[myometrium]]
*Enlarged [[uterus]]
*[[Necrosis]] +
*[[Hemorrhage]] +
*In [[CT scan]] we may see evidence of [[metastasis]] to [[brain]], [[lung]] and other organs
| style="background: #F5F5F5; padding: 5px;" |
*We may see an infiltrative [[Uterine Cancer|uterine]] mass and  thickening of [[Uterus|uterine]] wall
| style="background: #F5F5F5; padding: 5px;" |
*[[Trophoblast]]<nowiki/>ic [[tissue]] origin
*columns and sheets of [[trophoblast]]<nowiki/>ic tissue invading uterine [[Myotome|muscle]] and [[blood vessels]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
*It is associated with bilateral [[Ovarian cyst|theca lutein cysts]]
*Cannonball [[Metastasis|metastases]] to the [[lungs]]
*May cause [[hemoptysis]]
*We may see passing of grapes like tissue from the [[vagina]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Leiomyosarcoma]]<br><ref name="SekiHoshihara1992">{{cite journal|last1=Seki|first1=K.|last2=Hoshihara|first2=T.|last3=Nagata|first3=I.|title=Leiomyosarcoma of the Uterus: Ultrasonography and Serum Lactate Dehydrogenase Level|journal=Gynecologic and Obstetric Investigation|volume=33|issue=2|year=1992|pages=114–118|issn=1423-002X|doi=10.1159/000294861}}</ref><ref name="pmid17009628">{{cite journal |vauthors=Juang CM, Yen MS, Horng HC, Twu NF, Yu HC, Hsu WL |title=Potential role of preoperative serum CA125 for the differential diagnosis between uterine leiomyoma and uterine leiomyosarcoma |journal=Eur. J. Gynaecol. Oncol. |volume=27 |issue=4 |pages=370–4 |date=2006 |pmid=17009628 |doi= |url=}}</ref><ref name="PattaniKier1995">{{cite journal|last1=Pattani|first1=Sita J.|last2=Kier|first2=Ruben|last3=Deal|first3=Robert|last4=Luchansky|first4=Edward|title=MRI of uterine leiomyosarcoma|journal=Magnetic Resonance Imaging|volume=13|issue=2|year=1995|pages=331–333|issn=0730725X|doi=10.1016/0730-725X(95)93813-5}}</ref><ref name="McLeodZornoza1984">{{cite journal|last1=McLeod|first1=A J|last2=Zornoza|first2=J|last3=Shirkhoda|first3=A|title=Leiomyosarcoma: computed tomographic findings.|journal=Radiology|volume=152|issue=1|year=1984|pages=133–136|issn=0033-8419|doi=10.1148/radiology.152.1.6729102}}</ref><ref name="RobboyBentley2000">{{cite journal|last1=Robboy|first1=Stanley J.|last2=Bentley|first2=Rex C.|last3=Butnor|first3=Kelly|last4=Anderson|first4=Malcolm C.|title=Pathology and Pathophysiology of Uterine Smooth-Muscle Tumors|journal=Environmental Health Perspectives|volume=108|year=2000|pages=779|issn=00916765|doi=10.2307/3454306}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*>55 y/o
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px;" |
*In some cases we may see elevated levels of [[CA-125]] [[lactate dehydrogenase]]
| style="background: #F5F5F5; padding: 5px;" |
*Heterogeneous mass with central low attenuation ([[necrosis]]) and  [[calcification]].
| style="background: #F5F5F5; padding: 5px;" |
*Increased [[uterine]] size
*Irregular central zones of low signal intensity (tumor [[necrosis]])
| style="background: #F5F5F5; padding: 5px;" |
*We may see [[Atypia|atypical cells]], high [[mitotic]] rate, geographic areas of [[coagulative necrosis]] separated from viable [[neoplasm]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
*In case of rapid [[uterine]] growth in post [[Menopause|menopausal]] [[women]] we may suspect [[uterine sarcoma]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pregnancy]]<br><ref name="CacctatoreTttttnen1990">{{cite journal|last1=Cacctatore|first1=Bruno|last2=Tttttnen|first2=Atla|last3=Stenman|first3=Ulf-Hakan|last4=Ylostalo|first4=Pekka|title=Normal early pregnancy: serum hCG levels and vaginal ultrasonography findings|journal=BJOG: An International Journal of Obstetrics and Gynaecology|volume=97|issue=10|year=1990|pages=899–903|issn=1470-0328|doi=10.1111/j.1471-0528.1990.tb02444.x}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*[[Women]] in [[reproductive]] age (15 -45 y/o)
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px;" |
*High level of [[HCG|BhCG]]
| style="background: #F5F5F5; padding: 5px;" |
*In [[Ultrasound|US]] we may see [[gestational sac]], [[yolk sac]], double bleb sign and [[fetal]] pore
*In [[CT scan]] we may see [[cystic]] structure filled with fluid, curvilinear enhancing structure ([[placenta]]) and [[fetal]] pore
| style="background: #F5F5F5; padding: 5px;" |
*[[Cystic]] structure filled with fluid
*Curvilinear enhancing structure ([[placenta]])
*[[Fetal]] pore
| style="background: #F5F5F5; padding: 5px;" |
*NA
| style="background: #F5F5F5; padding: 5px;" |
*[[History and Physical examination|History]]/<br>[[laboratory]]<br>findings
| style="background: #F5F5F5; padding: 5px;" |
*We do not perform [[CT scan]] and [[MRI]] in [[pregnancy]] but We may unintentionally image the [[pregnancy]] with [[CT scan]] and [[MRI]].
|-
! colspan="14" style="background: #7d7d7d; color: #FFFFFF; text-align: center;" |Non-gynecologic
|-
| rowspan="4" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Gastrointestinal tract|GIT]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Appendix|Appendiceal]] [[abscess]]<br><ref name="pmid16037513">{{cite journal |vauthors=Pinto Leite N, Pereira JM, Cunha R, Pinto P, Sirlin C |title=CT evaluation of appendicitis and its complications: imaging techniques and key diagnostic findings |journal=AJR Am J Roentgenol |volume=185 |issue=2 |pages=406–17 |date=August 2005 |pmid=16037513 |doi=10.2214/ajr.185.2.01850406 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*NA
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |
*[[Leukocytosis]]
| style="background: #F5F5F5; padding: 5px;" |
*Fluid collection in the [[appendicular]] region
*[[appendicolith]] may be visualized.
| style="background: #F5F5F5; padding: 5px;" |
*Fluid collection in the [[appendicular]] region
*[[appendicolith]] may be visualized.
| style="background: #F5F5F5; padding: 5px;" |
*NA
| style="background: #F5F5F5; padding: 5px;" |
*[[Imaging]]/<br>[[History and Physical examination|history]]
| style="background: #F5F5F5; padding: 5px;" |
*The most common [[complication]] of [[acute appendicitis]]
*It may cause pleural effusion
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Appendix cancer|Appendiceal  neoplasm]]<br><ref name="WHO">Chapter 5: Tumours of the Appendix - IARC. https://www.iarc.fr/en/publications/pdfs-online/pat-gen/bb2/bb2-chap5.pdf Accessed on January 15, 2019</ref><ref name="GoedeCaplin2003">{{cite journal|last1=Goede|first1=A. C.|last2=Caplin|first2=M. E.|last3=Winslet|first3=M. C.|title=Carcinoid tumour of the appendix|journal=British Journal of Surgery|volume=90|issue=11|year=2003|pages=1317–1322|issn=0007-1323|doi=10.1002/bjs.4375}}</ref><ref name="Pablo CarmignaniHampton2004">{{cite journal|last1=Pablo Carmignani|first1=C.|last2=Hampton|first2=Regina|last3=E. Sugarbaker|first3=Christina|last4=Chang|first4=David|last5=H. Sugarbaker|first5=Paul|title=Utility of CEA and CA 19-9 tumor markers in diagnosis and prognostic assessment of mucinous epithelial cancers of the appendix|journal=Journal of Surgical Oncology|volume=87|issue=4|year=2004|pages=162–166|issn=0022-4790|doi=10.1002/jso.20107}}</ref><ref name="pmid20587792">{{cite journal |vauthors=Limsui D, Vierkant RA, Tillmans LS, Wang AH, Weisenberger DJ, Laird PW, Lynch CF, Anderson KE, French AJ, Haile RW, Harnack LJ, Potter JD, Slager SL, Smyrk TC, Thibodeau SN, Cerhan JR, Limburg PJ |title=Cigarette smoking and colorectal cancer risk by molecularly defined subtypes |journal=J. Natl. Cancer Inst. |volume=102 |issue=14 |pages=1012–22 |date=July 2010 |pmid=20587792 |pmc=2915616 |doi=10.1093/jnci/djq201 |url=}}</ref><ref name="pmid2886072">{{cite journal |vauthors=Duh QY, Hybarger CP, Geist R, Gamsu G, Goodman PC, Gooding GA, Clark OH |title=Carcinoids associated with multiple endocrine neoplasia syndromes |journal=Am. J. Surg. |volume=154 |issue=1 |pages=142–8 |date=July 1987 |pmid=2886072 |doi= |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*60-70 y/o for [[adenocarcinoma]],
*30-50 y/o for [[Carcinoid cancer|carcinoid]] tumors
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px;" |
*In [[adenocarcinoma]] type we may have high levels of [[CEA]] and [[CA 19-9]]
*In [[Carcinoid cancer|carcinoid]] type we may see high levels of [[chromogranin A]], [[5-HIAA]] and Ki67
| style="background: #F5F5F5; padding: 5px;" |
*In [[CT scan]] we may see:
**[[Soft tissue]] thickening and Cystic lesion with Internal septation
**Wall irregularity
**[[Calcification]]
**Peri-[[Appendix|appendiceal]] fat stranding
| style="background: #F5F5F5; padding: 5px;" |
*Soft tissue mass in the [[appendix]]
*We may see invasion to other structures
| style="background: #F5F5F5; padding: 5px;" |
*Gray/yellowi color
*Cystic structures with angiolymphatic invasion
*
| style="background: #F5F5F5; padding: 5px;" |
*[[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
*It is associated with:
**[[MEN1 syndrome]]
**[[Ulcerative colitis]]
**[[Neurofibromatosis type 1]]
**[[HNPCC]]
**[[Smoking]]
*It may cause pleural effusion
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Diverticular abscess]]<br><ref>{{cite journal|last1=Hulnick|first1=D H|last2=Megibow|first2=A J|last3=Balthazar|first3=E J|last4=Naidich|first4=D P|last5=Bosniak|first5=M A|title=Computed tomography in the evaluation of diverticulitis.|journal=Radiology|volume=152|issue=2|year=1984|pages=491–495|issn=0033-8419|doi=10.1148/radiology.152.2.6739821}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*>50 y/o
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |
*[[Leukocytosis]]
| style="background: #F5F5F5; padding: 5px;" |
*Ill-defined lesion with air and fluid inside
*Adjacent [[bowel]] loop wall thickening
*Smudged [[mesenteric]] fat
| style="background: #F5F5F5; padding: 5px;" |
*We may see a [[lesion]] with air and fluid inside
| style="background: #F5F5F5; padding: 5px;" |
*NA
| style="background: #F5F5F5; padding: 5px;" |
*[[Imaging]]/<br>[[History and Physical examination|history]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Diverticular abscess]] happens in almost 30-40% of patients with [[diverticulitis]]
*It may cause pleural effusion
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Colorectal cancer]]<br><ref name="ZhuKaneshiro2010">{{cite journal|last1=Zhu|first1=Amy|last2=Kaneshiro|first2=Marc|last3=Kaunitz|first3=Jonathan D.|title=Evaluation and Treatment of Iron Deficiency Anemia: A Gastroenterological Perspective|journal=Digestive Diseases and Sciences|volume=55|issue=3|year=2010|pages=548–559|issn=0163-2116|doi=10.1007/s10620-009-1108-6}}</ref><ref name="pmid10528904">{{cite journal| author=Macdonald JS| title=Carcinoembryonic antigen screening: pros and cons. | journal=Semin Oncol | year= 1999 | volume= 26 | issue= 5 | pages= 556-60 | pmid=10528904 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10528904  }}</ref><ref name="pmid21037809">{{cite journal |vauthors=Haggar FA, Boushey RP |title=Colorectal cancer epidemiology: incidence, mortality, survival, and risk factors |journal=Clin Colon Rectal Surg |volume=22 |issue=4 |pages=191–7 |date=November 2009 |pmid=21037809 |pmc=2796096 |doi=10.1055/s-0029-1242458 |url=}}</ref><ref name="pmid2014406">{{cite journal| author=Taylor AJ, Youker JE| title=Imaging in colorectal carcinoma. | journal=Semin Oncol | year= 1991 | volume= 18 | issue= 2 | pages= 99-110 | pmid=2014406 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2014406  }}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*>50 y/o
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/–
| style="background: #F5F5F5; padding: 5px;" |
*[[Anemia]]
*Positive [[Fecal occult blood test]]
*High levels of [[CEA]] and [[CA 19-9]]
| style="background: #F5F5F5; padding: 5px;" |
*In [[CT scan]] we may see luminal narrowing, [[intestinal]] wall thickening,[[intussusception]], [[bowel obstruction]], [[Metastases|hepatic metastases]], intestinal perforation,[[enlarged lymph nodes]]
| style="background: #F5F5F5; padding: 5px;" |
*We may see [[tumor]] mass and the extension of [[tumor]] to other structures
*We may see [[metastasis]] to the [[liver]], [[lung]] and [[brain]]
| style="background: #F5F5F5; padding: 5px;" |
*Based on the sub-type we may have different [[histopathological]] feature (for more information [[Colorectal cancer|click here]])
| style="background: #F5F5F5; padding: 5px;" |
*[[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
*It is associated with [[smoking]], positive [[family history]], processed meat, low [[Dietary fiber|fiber]] diet, [[Hereditary nonpolyposis colorectal cancer|lynch Syndrome]] and [[familial adenomatous polyposis]]
*They have apple core lesion on [[barium enema]] [[X-ray|xray]]
|-
| rowspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Renal]]
[[Bladder]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pelvic kidney]]<br><ref name="WeizerSpringhart2005">{{cite journal|last1=Weizer|first1=Alon Z.|last2=Springhart|first2=W. Patrick|last3=Ekeruo|first3=Wesley O.|last4=Matlaga|first4=Brian R.|last5=Tan|first5=Yeh H.|last6=Assimos|first6=Dean G.|last7=Preminger|first7=Glenn M.|title=Ureteroscopic management of renal calculi in anomalous kidneys|journal=Urology|volume=65|issue=2|year=2005|pages=265–269|issn=00904295|doi=10.1016/j.urology.2004.09.055}}</ref><ref name="RossKay1998">{{cite journal|last1=Ross|first1=Jonathan H.|last2=Kay|first2=Robert|title=URETEROPELVIC JUNCTION OBSTRUCTION IN ANOMALOUS KIDNEYS|journal=Urologic Clinics of North America|volume=25|issue=2|year=1998|pages=219–225|issn=00940143|doi=10.1016/S0094-0143(05)70010-0}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*NA
| style="background: #F5F5F5; padding: 5px; text-align: center;" |−/+
In case of sever [[hydronephrosis]] or [[renal stone]] we may have [[pelvic]] [[pain]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
| style="background: #F5F5F5; padding: 5px;" |
*In [[sonography]] we may see normal appearing [[kidney]] in [[Pelvis|pelvic]] position
*We may see [[renal calculi]]
| style="background: #F5F5F5; padding: 5px;" |
*We may see normal [[kidney]] structure
*[[Renal calculi]]
| style="background: #F5F5F5; padding: 5px;" |
*NA
| style="background: #F5F5F5; padding: 5px;" |
*[[Imaging]]
| style="background: #F5F5F5; padding: 5px;" |
*It may cause [[hypertension]]
*It may cause tract infection ([[Urinary tract infection|UTI]]), obstruction, and [[renal calculi]].
*It may be associated with [[RCC]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Bladder cancer]]<br><ref name="pmid8797968">{{cite journal |vauthors=Barentsz JO, Jager GJ, Witjes JA, Ruijs JH |title=Primary staging of urinary bladder carcinoma: the role of MRI and a comparison with CT |journal=Eur Radiol |volume=6 |issue=2 |pages=129–33 |date=1996 |pmid=8797968 |doi= |url=}}</ref><ref name="pmid18660854">{{cite journal |vauthors=Shariat SF, Karam JA, Lotan Y, Karakiewizc PI |title=Critical evaluation of urinary markers for bladder cancer detection and monitoring |journal=Rev Urol |volume=10 |issue=2 |pages=120–35 |date=2008 |pmid=18660854 |pmc=2483317 |doi= |url=}}</ref><ref name="pmid10918764">{{cite journal |vauthors=Metts MC, Metts JC, Milito SJ, Thomas CR |title=Bladder cancer: a review of diagnosis and management |journal=J Natl Med Assoc |volume=92 |issue=6 |pages=285–94 |date=June 2000 |pmid=10918764 |pmc=2640522 |doi= |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*≥65 y/o
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px;" |
*Low [[red blood cell]] count
*Elevated [[alkaline phosphatase]]
*Positive [[Tumor marker|tumor markers]] such as BTA, NMP, and [[CEA]]
| style="background: #F5F5F5; padding: 5px;" |
*In [[CT scan]] we may see masses protruding into the [[bladder]] lumen or asymmetric thickening of the [[bladder]]
*[[Calcification|calcifications]]
*Nodal [[metastases]]
| style="background: #F5F5F5; padding: 5px;" |
*isointense compared to [[muscle]] in T1
*slightly hyperintense compared to [[muscle]] in T2
| style="background: #F5F5F5; padding: 5px;" |
*Based on the sub-type we may have different [[Histopathology|histopathological]] feature (for more information [[Bladder cancer|click here]])
| style="background: #F5F5F5; padding: 5px;" |
*[[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
*It may presents with [[hematuria]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Others
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Retroperitoneum|Retroperitoneal]] [[sarcoma]]<br><ref name="pmid2064467">{{cite journal |vauthors=Storm FK, Mahvi DM |title=Diagnosis and management of retroperitoneal soft-tissue sarcoma |journal=Ann. Surg. |volume=214 |issue=1 |pages=2–10 |date=July 1991 |pmid=2064467 |pmc=1358407 |doi= |url=}}</ref><ref name="pmid16154826">{{cite journal |vauthors=Francis IR, Cohan RH, Varma DG, Sondak VK |title=Retroperitoneal sarcomas |journal=Cancer Imaging |volume=5 |issue= |pages=89–94 |date=August 2005 |pmid=16154826 |doi=10.1102/1470-7330.2005.0019 |url=}}</ref><ref name="SilversteinWakim1964">{{cite journal|last1=Silverstein|first1=Murray N.|last2=Wakim|first2=Khalil G.|last3=Bahn|first3=Robert C.|title=Hypoglycemia associated with neoplasia|journal=The American Journal of Medicine|volume=36|issue=3|year=1964|pages=415–423|issn=00029343|doi=10.1016/0002-9343(64)90168-8}}</ref><ref name="pmid20644672">{{cite journal |vauthors=Storm FK, Mahvi DM |title=Diagnosis and management of retroperitoneal soft-tissue sarcoma |journal=Ann. Surg. |volume=214 |issue=1 |pages=2–10 |date=July 1991 |pmid=2064467 |pmc=1358407 |doi= |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*40-50 y/o
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
| style="background: #F5F5F5; padding: 5px;" |
*Mild [[leukocytosis]].
*It may cause [[hypoglycemia]] because of production of [[Insulin-like growth factor|insulinlike]] substances
| style="background: #F5F5F5; padding: 5px;" |
*We may see irregular solid, semisolid, [[Liquefactive necrosis|liquefactive]] areas and patchy [[necrosis]] on [[CT scan]]
| style="background: #F5F5F5; padding: 5px;" |
*We may see [[Retroperitoneum|retroperitoneal]] involvement and degree of [[tumor]] extension
*We may see [[liver]] and [[lung]] [[metastasis]]
| style="background: #F5F5F5; padding: 5px;" |
*There are two types:  [[liposarcoma]] and [[leiomyosarcoma]]
*In [[Liposarcoma|liposarcomas]] we may see background of [[Adipocyte|adipocytes]] with scattered lipoblasts, and [[Inflammatory cells|inflammatory cell]] infiltrate
*In [[leiomyosarcoma]] we may see smooth [[muscle cells]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
*May cause [[lower extremity]] [[edema]], Serous [[ascites]]
*we should perform [[chest]] [[CT scan]] to rule out [[pulmonary]] [[metastases]]
|}
'''ABBREVIATIONS'''
BTA=Bladder tumor associated antigen, NMP= Nuclear matrix proteins, [[CEA]]= [[Carcinoembryonic antigen]], [[Ultrasound|US]]= [[Ultrasound]], [[Human chorionic gonadotropin|HCG]]= [[Human chorionic gonadotropin]], [[Lactate dehydrogenase|LDH]]= [[Lactate dehydrogenase]], [[AFP]]= [[AFP|Alpha fitoprotein]], [[CA125]]= [[CA125|Cancer antigen 125]], [[H&E]]= [[Hematoxylin and eosin stain|Hematoxylin and eosin]], [[MRI]]= [[Magnetic resonance imaging]], [[GI]]= [[Gastrointestinal tract]], [[PID]]= [[Pelvic inflammatory disease]], [[CA19-9]]= [[CA-19-9|Carbohydrate antigen 19-9]], [[5-hydroxyindoleacetic acid|5HIAA]]= [[5-Hydroxyindoleacetic acid|5-hydroxyindoleacetic acid]], [[MEN syndromes|MEN syndrome]]= [[Multiple endocrine neoplasia|Multiple endocrine neoplasia syndrome]], [[HNPCC]]= [[Hereditary nonpolyposis colorectal cancer]], [[UTI]]= [[Urinary tract infection]], [[RCC]]= [[Renal cell carcinoma]]


==References==
==References==

Latest revision as of 10:37, 25 May 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Ogechukwu Hannah Nnabude, MD

Overview

There is a very wide list of diseases and conditions that can lead to alopecia. Proper history taking and physical examination, along with laboratory, microbiology, and in some cases, imaging studies, are helpful in narrowing down the diagnosis. Alopecia can be caused by many different diseases. Some of the most well known and common causes are: androgenetic alopecia, alopecia areata, telogen effluvium, anagen effluvium, traction alopecia, and trichotillomania. Endocrine disorders such as hypothyroidism, hypoparathyroidism and Cushing's syndrome as well as malnutrition and medications are also possible causes of alopecia.

Differentiating Alopecia from Other Diseases
Disease/Condition Clinical presentation Demographics/History Diagnosis Other notes
Androgenetic Alopecia [1] [2] [3]
  • Male pattern: The frontal hairline is thinner, hair loss occurs at the crown of the scalp, hair recession is seen at the temporal aspects of the scalp; Female pattern: Hair loss occurs at the crown of the scalp, however, the frontal hairline remains preserved.
  • Androgenetic alopecia is believed to have a worldwide prevalence of about 50,000 per 100,000 men and 15,000 per 100,000 women with post-menopausal women making up the majority.
  • Diagnosis is mostly clinical and is based on the pattern and absence of other explanations.
  • Unlike in telogen effluvium, hair pull test shows a less than 20% telogen count.
  • It is the most common cause of hair loss.
Alopecia Areata [1] [4] [5] [6] [3] [7] [8] [9]
  • It presents with round patches of total hair loss with retained follicular ostia with the beard and scalp being the most frequently affected areas.
  • Alopecia areata has a prevalence of 100-200 per 100,000 individuals, and a risk of about 2% over an individual's life. The mean age for diagnosis of alopecia areata is about 32 years in males and 36 years in females.
  • Close observation reveals the characteristic exclamation mark hairs. A hair pull test followed by trichogram shows telogen and pencil point shafts.
Telogen Effluvium [10] [11] [3]
  • There is a massive amount of hair shedding that is triggered by physiologic or psychologic stress.
  • Although considered to be a relatively common condition, the precise prevalence of telogen effluvium remains unknown. However, it is believed that it is more commonly seen in females than in males
  • Hair pull test followed by trichogram reveals numerous clubbed-shaped hairs; telogen count must exceed 20% for diagnosis.
  • It could be an acute self-limiting form triggered by stressors such as crash diets, childbirth, febrile illness, or psychological stress.
  • It may be chronic and present in association with female pattern hair loss.
Anagen Effluvium [1]
  • There is diffuse hair loss and it is characterized by hair breakage that takes place in the anagen phase.
  • Trichoscopy would reveal the characteristic narrowing, fractured hair shafts with an absence of bulbs.

-

Trichotillomania [12] [13] [14] [15] [16] [1] [17] [18]
  • Presents with uneven broken hairs in the most frequently selected areas which are the scalp, eyebrows, eyelashes, body hair, facial hair, and pubic hair.
  • Based on the limited studies that have been done to determine the prevalence of trichotillomania among U.S. university students, Israeli adolescents, and older adults within the same community, the prevalence was shown to be between 500 per 100,000 to 2000 per 100,000.
  • It usually starts around the age of 12–13 years
  • It is more common in males during the childhood years while it is more common in females in the adult years.
  • Scalp inspection reveals uneven patches of hair loss with broken hairs that remain well attached to the skin.
  • A characteristic finding that distinguishes trichotillomania from alopecia areata is that the affected areas are not totally devoid of hair shafts.
  • It occurs as a result of a lack of impulse control in which an individual pulls on hair.
Traction Alopecia [19] [1] [20] [21] [20]
  • Hair loss at regions of the scalp exposed to tension on hair follicles for a prolonged period of time in people who make tight hairstyles.
  • Traction alopecia is more commonly seen among black populations with females being affected more often than males at a rate of about 31,000-32,000 per 100,000 women compared to about 2,300 per 100,000 men.
  • Traction alopecia is seen in about 18,000 per 100,000 girls between the ages of 5.4 to 14.3 years based on a study of African-American girls.
  • Mostly a clinical diagnosis based on hair loss at areas of the scalp where tension on the hair is highest.
  • Early detection and switching to more loose hairstyles may reverse the condition, however, with prolonged tension on the scalp destruction of the hair follicles will occur, causing the condition to become irreversible.
Chronic Cutaneous Lupus Erythematosus [22] [1]
  • Presents with an area with hair loss that gradually converts into scaly, thickened papules then into poorly-defined, variably-shaped plaques with atrophy, follicular plugging, telangiectasia, and depigmentation.
  • Black populations tend to have more serious disease.
  • Cutaneous lupus erythematosus is more common in males than in females, with a ratio of about 59.4 per 100,000 versus 1.6 per 100,000.

-

Tinea Capitis [23] [24] [25] [26] [27] [3]
  • Presents in diverse ways such as ordinary scaling without any obvious hair loss which is considered to be a seborrheic form, a crusted or pustular form that may be localized or diffuse, a ‘black dot’ type that is characterized by tiny black dots within regions of alopecia, an inflammatory mass called kerion, and a round, bald, scaly patch where the follicular ostia are filled with keratinous debris.
  • A unique feature of tinea capitas is the presence of post-auricular and cervical lymphadenopathy.
  • It is more common in the pediatric population.
  • Potassium hydroxide preparation can be added to skin scrapings of affected areas in order to diagnose the condition. [1]
  • Wood's light can also be used in diagnosis as majority of Microsporum spp will appear bluish-green, occasionally dull yellow (Microsporum gypseum) and dull blue (Trichophyton schoenleinii).
  • In the U.S., under 5% of cases will show fluorescence.
  • Possible complications of tinea capitas are kerion, an abscess in the scalp, or favus, another inflammatory form in which there is honeycomb destruction of the hair shaft. Both are severe forms of the disease and can cause permanent scarring.


The following lists the complete differential diagnosis of Alopecia:

Non-Scarring Alopecia

Scarring Alopecia

Miscellaneous

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Qi J, Garza LA (2014). "An overview of alopecias". Cold Spring Harb Perspect Med. 4 (3). doi:10.1101/cshperspect.a013615. PMC 3935391. PMID 24591533.
  2. ↑ Rinaldi F, Marzani B, Pinto D, Sorbellini E (2019). "Randomized controlled trial on a PRP-like cosmetic, biomimetic peptides based, for the treatment of alopecia areata". J Dermatolog Treat. 30 (6): 588–593. doi:10.1080/09546634.2018.1544405. PMID 30513014.
  3. ↑ 3.0 3.1 3.2 3.3 Vidal CI (2015). "Overview of Alopecia: A Dermatopathologist's Perspective". Mo Med. 112 (4): 308–12. PMC 6170065. PMID 26455063.
  4. ↑ Strazzulla LC, Wang EHC, Avila L, Lo Sicco K, Brinster N, Christiano AM; et al. (2018). "Alopecia areata: Disease characteristics, clinical evaluation, and new perspectives on pathogenesis". J Am Acad Dermatol. 78 (1): 1–12. doi:10.1016/j.jaad.2017.04.1141. PMID 29241771.
  5. ↑ Safavi KH, Muller SA, Suman VJ, Moshell AN, Melton LJ (1995). "Incidence of alopecia areata in Olmsted County, Minnesota, 1975 through 1989". Mayo Clin Proc. 70 (7): 628–33. doi:10.4065/70.7.628. PMID 7791384.
  6. ↑ Mirzoyev SA, Schrum AG, Davis MDP, Torgerson RR (2014). "Lifetime incidence risk of alopecia areata estimated at 2.1% by Rochester Epidemiology Project, 1990-2009". J Invest Dermatol. 134 (4): 1141–1142. doi:10.1038/jid.2013.464. PMC 3961558. PMID 24202232.
  7. ↑ Villasante Fricke AC, Miteva M (2015). "Epidemiology and burden of alopecia areata: a systematic review". Clin Cosmet Investig Dermatol. 8: 397–403. doi:10.2147/CCID.S53985. PMC 4521674. PMID 26244028.
  8. ↑ Chu SY, Chen YJ, Tseng WC, Lin MW, Chen TJ, Hwang CY; et al. (2011). "Comorbidity profiles among patients with alopecia areata: the importance of onset age, a nationwide population-based study". J Am Acad Dermatol. 65 (5): 949–56. doi:10.1016/j.jaad.2010.08.032. PMID 21616562.
  9. ↑ Chen CH, Wang KH, Lin HC, Chung SD (2016) Follow-up study on the relationship between alopecia areata and risk of autoimmune diseases. J Dermatol 43 (2):228-9. DOI:10.1111/1346-8138.13165 PMID: 26499292
  10. ↑ Sperling LC, Cowper SE, Knopp EA. An atlas of hair pathology with clinical correlations. 2. Informa Healthcare; 2014. [Google Scholar]
  11. ↑ Sant'Anna Addor FA, Donato LC, Melo CSA (2018). "Comparative evaluation between two nutritional supplements in the improvement of telogen effluvium". Clin Cosmet Investig Dermatol. 11: 431–436. doi:10.2147/CCID.S173082. PMC 6136400. PMID 30237729.
  12. ↑ Sperling LC, Cowper SE, Knopp EA. An atlas of hair pathology with clinical correlations. 2. Informa Healthcare; 2014. [Google Scholar]
  13. ↑ Christenson GA, Pyle RL, Mitchell JE (1991). "Estimated lifetime prevalence of trichotillomania in college students". J Clin Psychiatry. 52 (10): 415–7. PMID 1938977.
  14. ↑ King RA, Zohar AH, Ratzoni G, Binder M, Kron S, Dycian A; et al. (1995). "An epidemiological study of [[trichotillomania]] in Israeli adolescents". J Am Acad Child Adolesc Psychiatry. 34 (9): 1212–5. doi:10.1097/00004583-199509000-00019. PMID 7559316. URL–wikilink conflict (help)
  15. ↑ Duke DC, Keeley ML, Geffken GR, Storch EA (2010). "Trichotillomania: A current review". Clin Psychol Rev. 30 (2): 181–93. doi:10.1016/j.cpr.2009.10.008. PMID 19926375.
  16. ↑ Quercetani R, Rebora AE, Fedi MC, Carelli G, Mei S, Chelli A; et al. (2011). "Patients with profuse hair shedding may reveal anagen hair dystrophy: a diagnostic clue of alopecia areata incognita". J Eur Acad Dermatol Venereol. 25 (7): 808–10. doi:10.1111/j.1468-3083.2010.03869.x. PMID 20946585.
  17. ↑ Habif TP 2010. Hair diseases. In Clinical dermatology, 5th ed Mosby, Maryland Heights, MO [Google Scholar]
  18. ↑ Otberg N, Shapiro J 2012. Hair growth disorders. In Fitzpatrick’s dermatology in general medicine, 8th ed (ed. Goldsmith LA, et al.). McGraw-Hill, New York [Google Scholar]
  19. ↑ Otberg N, Shapiro J 2012. Hair growth disorders. In Fitzpatrick’s dermatology in general medicine, 8th ed (ed. Goldsmith LA, et al.). McGraw-Hill, New York [Google Scholar]
  20. ↑ 20.0 20.1 Callender VD, McMichael AJ, Cohen GF (2004). "Medical and surgical therapies for alopecias in black women". Dermatol Ther. 17 (2): 164–76. doi:10.1111/j.1396-0296.2004.04017.x. PMID 15113284.
  21. ↑ Aguado Lobo M, Jiménez-Reyes J (2018). dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29265342 "Traction alopecia" Check |url= value (help). Int J Dermatol. 57 (2): 231–232. doi:10.1111/ijd.13846. PMID 29265342.
  22. ↑ Sperling LC, Cowper SE, Knopp EA. An atlas of hair pathology with clinical correlations. 2. Informa Healthcare; 2014. [Google Scholar]
  23. ↑ "StatPearls". 2020. PMID 30725594.
  24. ↑ Pomeranz AJ, Sabnis SS (2002). "Tinea capitis: epidemiology, diagnosis and management strategies". Paediatr Drugs. 4 (12): 779–83. doi:10.2165/00128072-200204120-00002. PMID 12431130.
  25. ↑ Kos L, Conlon J (2009). "An update on alopecia areata". Curr Opin Pediatr. 21 (4): 475–80. doi:10.1097/MOP.0b013e32832db986. PMID 19502982.
  26. ↑ Sperling LC, Cowper SE, Knopp EA. An atlas of hair pathology with clinical correlations. 2. Informa Healthcare; 2014. [Google Scholar]
  27. ↑ Ponka D, Baddar F (2012). "Wood lamp examination". Can Fam Physician. 58 (9): 976. PMC 3440273. PMID 22972730.
  28. ↑ Watras MM, Patel JP, Arya R (2016). "Traditional Anticoagulants and Hair Loss: A Role for Direct Oral Anticoagulants? A Review of the Literature". Drugs Real World Outcomes. 3 (1): 1–6. doi:10.1007/s40801-015-0056-z. PMC 4819463. PMID 27747798.
  29. ↑ Thomson SR, Mamulpet V, Adiga S (2017). "Sodium Valproate Induced Alopecia: A Case Series". J Clin Diagn Res. 11 (9): FR01–FR02. doi:10.7860/JCDR/2017/28564.10658. PMC 5713753. PMID 29207731.
  30. ↑ HOLOWACH J, SANDEN HV (1960). "Alopecia as a side effect of treatment of epilepsy with trimethadione. Report of two cases". N Engl J Med. 263: 1187. doi:10.1056/NEJM196012082632308. PMID 13715510.
  31. ↑ Shelley ED, Shelley WB (1985). "Alopecia and drug eruption of the scalp associated with a new beta-blocker, nadolol". Cutis. 35 (2): 148–9. PMID 3979099.
  32. ↑ Forouzan P, Cohen PR (2000). "Systemic Lupus Erythematosus Presenting as Alopecia Areata" Check |url= value (help). Lancet. 355 (9197): 53–7. doi:10.1016/S0140-6736(99)05157-0. PMID 10615903.
  33. ↑ Callen JP. "Dermatwww.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10615903".
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