Colorectal cancer differential diagnosis: Difference between revisions

Jump to navigation Jump to search
No edit summary
No edit summary
 
(41 intermediate revisions by 3 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Colon cancer}}
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Colorectal_cancer]]
To view the differential diagnosis of familial adenomatous polyposis (FAP), click [[Familial adenomatous polyposis differential diagnosis|'''here''']]<br>
To view the differential diagnosis of familial adenomatous polyposis (FAP), click [[Familial adenomatous polyposis differential diagnosis|'''here''']]<br>
To view the differential diagnosis of hereditary nonpolyposis colorectal cancer (HNPCC), click [[Hereditary nonpolyposis colorectal cancer differential diagnosis|'''here''']]<br><br>
To view the differential diagnosis of hereditary nonpolyposis colorectal cancer (HNPCC), click [[Hereditary nonpolyposis colorectal cancer differential diagnosis|'''here''']]<br><br>
{{CMG}} {{AE}}  
{{CMG}}: {{AE}} {{Trusha}}, {{Qurrat}}


==Overview==
==Overview==
Line 10: Line 10:
==Colorectal Cancer Differential Diagnosis==
==Colorectal Cancer Differential Diagnosis==
*Colorectal cancer must be differentiated from other diseases that cause [[Abdominal pain|lower abdominal pain]] and [[fever]] like [[appendicitis]], [[diverticulitis]], [[inflammatory bowel disease]], [[cystitis]], and [[endometritis]].<ref name="pmid17573742">{{cite journal| author=Laurell H, Hansson LE, Gunnarsson U| title=Acute diverticulitis--clinical presentation and differential diagnostics. | journal=Colorectal Dis | year= 2007 | volume= 9 | issue= 6 | pages= 496-501; discussion 501-2 | pmid=17573742 | doi=10.1111/j.1463-1318.2006.01162.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17573742  }} </ref><ref>Hardin, M. Acute Appendicitis: Review and Update. ''Am Fam Physician".1999, Nov 1;60(7):2027-2034''</ref><ref name="pmid8596552">{{cite journal| author=Hanauer SB| title=Inflammatory bowel disease. | journal=N Engl J Med | year= 1996 | volume= 334 | issue= 13 | pages= 841-8 | pmid=8596552 | doi=10.1056/NEJM199603283341307 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8596552  }} </ref><ref name="hhh">Cystitis-acute. MedlinePlus.https://www.nlm.nih.gov/medlineplus/ency/article/000526.htm Accessed on February 9, 2016</ref><ref name="nlm">Prostatitis - bacterial. NLM Medline Plus 2016. https://www.nlm.nih.gov/medlineplus/ency/article/000519.htm. Accessed on March 2, 2016</ref><ref name="pmid27107781">{{cite journal |vauthors=Ford GW, Decker CF |title=Pelvic inflammatory disease |journal=Dis Mon |volume=62 |issue=8 |pages=301–5 |year=2016 |pmid=27107781 |doi=10.1016/j.disamonth.2016.03.015 |url=}}</ref>
*Colorectal cancer must be differentiated from other diseases that cause [[Abdominal pain|lower abdominal pain]] and [[fever]] like [[appendicitis]], [[diverticulitis]], [[inflammatory bowel disease]], [[cystitis]], and [[endometritis]].<ref name="pmid17573742">{{cite journal| author=Laurell H, Hansson LE, Gunnarsson U| title=Acute diverticulitis--clinical presentation and differential diagnostics. | journal=Colorectal Dis | year= 2007 | volume= 9 | issue= 6 | pages= 496-501; discussion 501-2 | pmid=17573742 | doi=10.1111/j.1463-1318.2006.01162.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17573742  }} </ref><ref>Hardin, M. Acute Appendicitis: Review and Update. ''Am Fam Physician".1999, Nov 1;60(7):2027-2034''</ref><ref name="pmid8596552">{{cite journal| author=Hanauer SB| title=Inflammatory bowel disease. | journal=N Engl J Med | year= 1996 | volume= 334 | issue= 13 | pages= 841-8 | pmid=8596552 | doi=10.1056/NEJM199603283341307 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8596552  }} </ref><ref name="hhh">Cystitis-acute. MedlinePlus.https://www.nlm.nih.gov/medlineplus/ency/article/000526.htm Accessed on February 9, 2016</ref><ref name="nlm">Prostatitis - bacterial. NLM Medline Plus 2016. https://www.nlm.nih.gov/medlineplus/ency/article/000519.htm. Accessed on March 2, 2016</ref><ref name="pmid27107781">{{cite journal |vauthors=Ford GW, Decker CF |title=Pelvic inflammatory disease |journal=Dis Mon |volume=62 |issue=8 |pages=301–5 |year=2016 |pmid=27107781 |doi=10.1016/j.disamonth.2016.03.015 |url=}}</ref>
{| class="wikitable"
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
| colspan="4" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Clinical manifestations'''
! colspan="7" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |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;" |Comments
|-
| colspan="4" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Symptoms'''
|-
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Constipation/Diarrhea
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Blood in stool
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Abdominal pain
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other symptoms
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Anemia
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Tumor marker
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Endoscopy
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |CT scan
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other
diagnostic
study
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Adenocarcinoma
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| colspan="2" style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Arteriovenous malformation]]<ref name="pmid28139503">{{cite journal |vauthors=Lee HH, Kwon HM, Gil S, Kim YS, Cho M, Seo KJ, Chae HS, Cho YS |title=Endoscopic resection of asymptomatic, colonic, polypoid arteriovenous malformations: Two case reports and a literature review |journal=Saudi J Gastroenterol |volume=23 |issue=1 |pages=67–70 |date=2017 |pmid=28139503 |pmc=5329980 |doi=10.4103/1319-3767.199111 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | +
| colspan="2" style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* Bright red, flat lesions
* Rarely, polypoid
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* Aberrant vessels with thickened, hypertrophic walls in the mucosa and the submucosa.
* Arteries directly connected to veins without capillary beds
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Diverticular disease|Diverticular diseases]]<ref name="pmid16187597">{{cite journal |vauthors=Shen SH, Chen JD, Tiu CM, Chou YH, Chiang JH, Chang CY, Lee CH |title=Differentiating colonic diverticulitis from colon cancer: the value of computed tomography in the emergency setting |journal=J Chin Med Assoc |volume=68 |issue=9 |pages=411–8 |date=September 2005 |pmid=16187597 |doi=10.1016/S1726-4901(09)70156-X |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
* [[Constipation]]
and/or
* [[Diarrhea]]<ref name="ShenChen2005">{{cite journal|last1=Shen|first1=Shu-Huei|last2=Chen|first2=Jen-Dar|last3=Tiu|first3=Chui-Mei|last4=Chou|first4=Yi-Hong|last5=Chiang|first5=Jen-Huei|last6=Chang|first6=Cheng-Yen|last7=Lee|first7=Chen-Hsen|title=Differentiating Colonic Diverticulitis from Colon Cancer: The Value of Computed Tomography in the Emergency Setting|journal=Journal of the Chinese Medical Association|volume=68|issue=9|year=2005|pages=411–418|issn=17264901|doi=10.1016/S1726-4901(09)70156-X}}</ref>
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
* [[Fever]], [[Rigor|chills]]<ref name="ShenChen2005">{{cite journal|last1=Shen|first1=Shu-Huei|last2=Chen|first2=Jen-Dar|last3=Tiu|first3=Chui-Mei|last4=Chou|first4=Yi-Hong|last5=Chiang|first5=Jen-Huei|last6=Chang|first6=Cheng-Yen|last7=Lee|first7=Chen-Hsen|title=Differentiating Colonic Diverticulitis from Colon Cancer: The Value of Computed Tomography in the Emergency Setting|journal=Journal of the Chinese Medical Association|volume=68|issue=9|year=2005|pages=411–418|issn=17264901|doi=10.1016/S1726-4901(09)70156-X}}</ref>
* [[Nausea and vomiting|Nausea/vomiting(N/V)]]
| style="background: #F5F5F5; padding: 5px;" | -
| colspan="2" style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |Not recommended <ref name="ShenChen2005">{{cite journal|last1=Shen|first1=Shu-Huei|last2=Chen|first2=Jen-Dar|last3=Tiu|first3=Chui-Mei|last4=Chou|first4=Yi-Hong|last5=Chiang|first5=Jen-Huei|last6=Chang|first6=Cheng-Yen|last7=Lee|first7=Chen-Hsen|title=Differentiating Colonic Diverticulitis from Colon Cancer: The Value of Computed Tomography in the Emergency Setting|journal=Journal of the Chinese Medical Association|volume=68|issue=9|year=2005|pages=411–418|issn=17264901|doi=10.1016/S1726-4901(09)70156-X}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
* Outpouchings of the colonic wall (Diverticula)<ref name="ShenChen2005">{{cite journal|last1=Shen|first1=Shu-Huei|last2=Chen|first2=Jen-Dar|last3=Tiu|first3=Chui-Mei|last4=Chou|first4=Yi-Hong|last5=Chiang|first5=Jen-Huei|last6=Chang|first6=Cheng-Yen|last7=Lee|first7=Chen-Hsen|title=Differentiating Colonic Diverticulitis from Colon Cancer: The Value of Computed Tomography in the Emergency Setting|journal=Journal of the Chinese Medical Association|volume=68|issue=9|year=2005|pages=411–418|issn=17264901|doi=10.1016/S1726-4901(09)70156-X}}</ref>
* Inflamed diverticula
* Abscess formation
* Intraperitoneal free air (microperforation)
| style="background: #F5F5F5; padding: 5px;" |
* Barium enema: Circumferential narrowing<ref name="SheimanLevine20082">{{cite journal|last1=Sheiman|first1=Laura|last2=Levine|first2=Marc S.|last3=Levin|first3=Alicia A.|last4=Hogan|first4=Jonathan|last5=Rubesin|first5=Stephen E.|last6=Furth|first6=Emma E.|last7=Laufer|first7=Igor|title=Chronic Diverticulitis: Clinical, Radiographic, and Pathologic Findings|journal=American Journal of Roentgenology|volume=191|issue=2|year=2008|pages=522–528|issn=0361-803X|doi=10.2214/AJR.07.3597}}</ref>
* Spiculated contour and tapered margins
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hemorrhoids]]<ref name="JacobsSolomon2014">{{cite journal|last1=Jacobs|first1=Danny|last2=Solomon|first2=Caren G.|title=Hemorrhoids|journal=New England Journal of Medicine|volume=371|issue=10|year=2014|pages=944–951|issn=0028-4793|doi=10.1056/NEJMcp1204188}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
* [[Constipation]]
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* Perianal Itching
* Pain with [[defecation]]
* Painful, hard lump in anus
| style="background: #F5F5F5; padding: 5px;" | +
| colspan="2" style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* [[Anoscopy]]: Protruding mass from the [[anus]]
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* DRE: Palpable mass, tender if thrombosed
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Anal fissure]]<ref name="pmid27041801">{{cite journal |vauthors=Schlichtemeier S, Engel A |title=Anal fissure |journal=Aust Prescr |volume=39 |issue=1 |pages=14–7 |year=2016 |pmid=27041801 |pmc=4816871 |doi=10.18773/austprescr.2016.007 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* Painful [[defecation]]
* [[Itching]]
* [[Irritation]]
| style="background: #F5F5F5; padding: 5px;" | +/-
| colspan="2" | -
| style="background: #F5F5F5; padding: 5px;" |
* [[Anoscopy]]: Anal wall laceration
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Infectious colitis]]<ref name="pmid22080825">{{cite journal |vauthors=DuPont HL |title=Approach to the patient with infectious colitis |journal=Curr. Opin. Gastroenterol. |volume=28 |issue=1 |pages=39–46 |date=January 2012 |pmid=22080825 |doi=10.1097/MOG.0b013e32834d3208 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
* [[Diarrhea]]
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
* [[Fever]], [[Rigor|chills]]
* [[Nausea and vomiting|N/V]]
* [[Bloating]]
| style="background: #F5F5F5; padding: 5px;" | -
| colspan="2" style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* Patchy or diffuse [[Erythematous|erythematous mucosa]]
* Edema, [[hemorrhage]], with or without [[ulcers]] of mucosa
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* [[Stool culture|Stool cultures]] in adequate [[culture media]]
* Stool analysis: Leukocytosis
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
|-


'''Other conditions that can be mistaken for colorectal cancer include the following:'''
'''Other conditions that can be mistaken for colorectal cancer include the following:'''
*Benign colon polyps
*Benign colon polyps
*[[Ischemic colitis]]
*[[Infectious colitis]]
*[[Infectious colitis]]
*[[Arteriovenous malformation]] ([[AVM]])
*[[Arteriovenous malformation]] ([[AVM]])
Line 165: Line 18:
*[[Small intestine]] carcinomas
*[[Small intestine]] carcinomas
*Gastrointestinal lymphoma
*Gastrointestinal lymphoma
*[[Ileus]]
*[[Pregnancy]]
*[[Pregnancy]]
*[[Appendicitis]]
*[[Appendicitis]]
Line 173: Line 25:
*[[Ulcer]]
*[[Ulcer]]
*[[Cholecystitis]]
*[[Cholecystitis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Peutz-Jeghers syndrome]]<ref name="pmid27298573">{{cite journal |vauthors=Zhong ME, Niu BZ, Ji WY, Wu B |title=Laparoscopic restorative proctocolectomy with ileal pouch-anal anastomosis for Peutz-Jeghers syndrome with synchronous rectal cancer |journal=World J. Gastroenterol. |volume=22 |issue=22 |pages=5293–6 |date=June 2016 |pmid=27298573 |doi=10.3748/wjg.v22.i22.5293 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
* [[Mucocutaneous]]  [[hyperpigmentation]] (mouth, hands, and feet)<ref name="KopacovaTacheci20092">{{cite journal|last1=Kopacova|first1=Marcela|last2=Tacheci|first2=Ilja|last3=Rejchrt|first3=Stanislav|last4=Bures|first4=Jan|title=Peutz-Jeghers syndrome: Diagnostic and therapeuticapproach|journal=World Journal of Gastroenterology|volume=15|issue=43|year=2009|pages=5397|issn=1007-9327|doi=10.3748/wjg.15.5397}}</ref><ref name="GiardielloTrimbath2006">{{cite journal|last1=Giardiello|first1=F|last2=Trimbath|first2=J|title=Peutz-Jeghers Syndrome and Management Recommendations|journal=Clinical Gastroenterology and Hepatology|volume=4|issue=4|year=2006|pages=408–415|issn=15423565|doi=10.1016/j.cgh.2005.11.005}}</ref><ref name="urlPeutz-Jeghers syndrome | Genetic and Rare Diseases Information Center (GARD) – an NCATS Program">{{cite web |url=https://rarediseases.info.nih.gov/diseases/7378/peutz-jeghers-syndrome#ref_8500 |title=Peutz-Jeghers syndrome &#124; Genetic and Rare Diseases Information Center (GARD) – an NCATS Program |format= |work= |accessdate=}}</ref>
* [[Fatigue]]
* [[Weight loss]]
* [[Rectal prolapse]]
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" |
* [[Hamartomatous intestinal polyposis|Multiple polyps]] <ref name="urlPeutz-Jeghers Syndrome - GeneReviews® - NCBI Bookshelf2">{{cite web |url=https://www.ncbi.nlm.nih.gov/books/NBK1266/#pjs.Diagnosis |title=Peutz-Jeghers Syndrome - GeneReviews® - NCBI Bookshelf |format= |work= |accessdate=}}</ref>
* [[mucocutaneous]] [[pigmentation]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Polyps|Multiple polyps]]
*[[Intussusception]]
*[[Bowel obstruction]]<ref name="urlPeutz-Jeghers syndrome | Radiology Reference Article | Radiopaedia.org">{{cite web |url=https://radiopaedia.org/articles/peutz-jeghers-syndrome-2 |title=Peutz-Jeghers syndrome &#124; Radiology Reference Article &#124; Radiopaedia.org |format= |work= |accessdate=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
* [[Barium enema]]
* [[PET scan|PET-CT]]
* [[MRI]]
| style="background: #F5F5F5; padding: 5px;" |
* Multiple [[hamartomatous]] [[polyps]] on [[Histological|histological analysis]]<ref name="urlPeutz-Jeghers Syndrome - GeneReviews® - NCBI Bookshelf">{{cite web |url=https://www.ncbi.nlm.nih.gov/books/NBK1266/#pjs.Diagnosis |title=Peutz-Jeghers Syndrome - GeneReviews® - NCBI Bookshelf |format= |work= |accessdate=}}</ref><ref name="BeggsLatchford2010">{{cite journal|last1=Beggs|first1=A. D.|last2=Latchford|first2=A. R.|last3=Vasen|first3=H. F. A.|last4=Moslein|first4=G.|last5=Alonso|first5=A.|last6=Aretz|first6=S.|last7=Bertario|first7=L.|last8=Blanco|first8=I.|last9=Bulow|first9=S.|last10=Burn|first10=J.|last11=Capella|first11=G.|last12=Colas|first12=C.|last13=Friedl|first13=W.|last14=Moller|first14=P.|last15=Hes|first15=F. J.|last16=Jarvinen|first16=H.|last17=Mecklin|first17=J.-P.|last18=Nagengast|first18=F. M.|last19=Parc|first19=Y.|last20=Phillips|first20=R. K. S.|last21=Hyer|first21=W.|last22=Ponz de Leon|first22=M.|last23=Renkonen-Sinisalo|first23=L.|last24=Sampson|first24=J. R.|last25=Stormorken|first25=A.|last26=Tejpar|first26=S.|last27=Thomas|first27=H. J. W.|last28=Wijnen|first28=J. T.|last29=Clark|first29=S. K.|last30=Hodgson|first30=S. V.|title=Peutz-Jeghers syndrome: a systematic review and recommendations for management|journal=Gut|volume=59|issue=7|year=2010|pages=975–986|issn=0017-5749|doi=10.1136/gut.2009.198499}}</ref>
| style="background: #F5F5F5; padding: 5px;" |


*[[Genetic testing]] for [[STK11]]
<small>
*[[Colonoscopy]] <ref name="KopacovaTacheci20093">{{cite journal|last1=Kopacova|first1=Marcela|last2=Tacheci|first2=Ilja|last3=Rejchrt|first3=Stanislav|last4=Bures|first4=Jan|title=Peutz-Jeghers syndrome: Diagnostic and therapeuticapproach|journal=World Journal of Gastroenterology|volume=15|issue=43|year=2009|pages=5397|issn=1007-9327|doi=10.3748/wjg.15.5397}}</ref>
<div style="width: 80%;">
| style="background: #F5F5F5; padding: 5px;" |
{|
| colspan="12" |'''<small>ABBREVIATIONS''':'''N/A''': Not available , '''N/V''': Nausea/vomiting, '''M/C''': Most common, '''DRE''': Digital rectal exam, '''RLQ''': Right lower quadrant, '''LLQ''': Left lower quadrant </small><small><nowiki/></small><small><nowiki/></small>
|-
|-
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
| colspan="4" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Clinical manifestations'''
| colspan="5" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Clinical manifestations'''
! colspan="6" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Para-clinical findings
! colspan="5" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Para-clinical findings
| colspan="1" rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Gold standard'''
| colspan="1" rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Gold standard'''
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Comments
|-
|-
| colspan="4" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Symptoms'''
| colspan="5" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Symptoms'''
|-
|-
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
|-  
|-  
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Constipation/Diarrhea
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bowel frequency
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Blood in stool
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Blood in stool
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Abdominal pain
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Abdominal pain
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Tenesmus
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other symptoms
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other symptoms
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Anemia
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Anemia
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Tumor Markers
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Colonoscopy
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Colonoscopy
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |CT scan
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |CT scan
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other imaging
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other diagnostic study
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Carcinoid|Carcinoids]]<ref name="pmid20011309">{{cite journal |vauthors=Chung TP, Hunt SR |title=Carcinoid and neuroendocrine tumors of the colon and rectum |journal=Clin Colon Rectal Surg |volume=19 |issue=2 |pages=45–8 |date=May 2006 |pmid=20011309 |pmc=2780103 |doi=10.1055/s-2006-942343 |url=}}</ref>
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Colorectal carcinoma ([[Adenocarcinoma]])<ref name="pmid8265100">{{cite journal |vauthors=Secco GB, Fardelli R, Campora E, Lapertosa G, Gentile R, Zoli S, Prior C |title=Primary mucinous adenocarcinomas and signet-ring cell carcinomas of colon and rectum |journal=Oncology |volume=51 |issue=1 |pages=30–4 |date=1994 |pmid=8265100 |doi=10.1159/000227306 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |[[Diarrhea]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" |↑ or ↓
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |
*[[Weight loss]]
*[[Fatigue]]
*Low caliber of stools
*[[Mucus]] in stools
| style="background: #F5F5F5; padding: 5px; text-align: center; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |
*[[Polyp|Polyps]] (villous, tubular, tubulo-villous)
*[[Ulcer|Ulcerating polyps]]
*[[Cancerous]] [[lesions]]
| style="background: #F5F5F5; padding: 5px;" |
*Luminal narrowing
*[[Bowel obstruction]]
*Thickening of the bowel wall
*[[Lymphadenopathy]]
*[[Metastases]]
| style="background: #F5F5F5; padding: 5px;" |'''PET scans'''
*[[Metastasis]]
'''Barium enema'''
*[[Cancer]] or [[Premalignant condition|precancerous]] [[polyp]]
| style="background: #F5F5F5; padding: 5px;" |
* Different grades of differentiation of [[glandular]] structures
** Sheets or cords of [[malignant]] cells
**[[Cellular]] [[atypia]] and [[pleomorphism]]
**High [[Mitosis|mitotic]] rate
* [[Necrosis|Necrotic]] debris in [[Glandular tissue|glandular lumina]]
* [[Desmoplastic|Desmoplastic reaction (sign of invasion)]]
| style="background: #F5F5F5; padding: 5px;" |[[Biopsy]], [[genetic testing]], and [[histopathological]] analysis
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Peutz-Jeghers syndrome]]<br><ref name="pmid27298573">{{cite journal |vauthors=Zhong ME, Niu BZ, Ji WY, Wu B |title=Laparoscopic restorative proctocolectomy with ileal pouch-anal anastomosis for Peutz-Jeghers syndrome with synchronous rectal cancer |journal=World J. Gastroenterol. |volume=22 |issue=22 |pages=5293–6 |date=June 2016 |pmid=27298573 |doi=10.3748/wjg.v22.i22.5293 |url=}}</ref><ref name="KopacovaTacheci20092">{{cite journal|last1=Kopacova|first1=Marcela|last2=Tacheci|first2=Ilja|last3=Rejchrt|first3=Stanislav|last4=Bures|first4=Jan|title=Peutz-Jeghers syndrome: Diagnostic and therapeuticapproach|journal=World Journal of Gastroenterology|volume=15|issue=43|year=2009|pages=5397|issn=1007-9327|doi=10.3748/wjg.15.5397}}</ref><ref name="GiardielloTrimbath2006">{{cite journal|last1=Giardiello|first1=F|last2=Trimbath|first2=J|title=Peutz-Jeghers Syndrome and Management Recommendations|journal=Clinical Gastroenterology and Hepatology|volume=4|issue=4|year=2006|pages=408–415|issn=15423565|doi=10.1016/j.cgh.2005.11.005}}</ref><ref name="BeggsLatchford2010">{{cite journal|last1=Beggs|first1=A. D.|last2=Latchford|first2=A. R.|last3=Vasen|first3=H. F. A.|last4=Moslein|first4=G.|last5=Alonso|first5=A.|last6=Aretz|first6=S.|last7=Bertario|first7=L.|last8=Blanco|first8=I.|last9=Bulow|first9=S.|last10=Burn|first10=J.|last11=Capella|first11=G.|last12=Colas|first12=C.|last13=Friedl|first13=W.|last14=Moller|first14=P.|last15=Hes|first15=F. J.|last16=Jarvinen|first16=H.|last17=Mecklin|first17=J.-P.|last18=Nagengast|first18=F. M.|last19=Parc|first19=Y.|last20=Phillips|first20=R. K. S.|last21=Hyer|first21=W.|last22=Ponz de Leon|first22=M.|last23=Renkonen-Sinisalo|first23=L.|last24=Sampson|first24=J. R.|last25=Stormorken|first25=A.|last26=Tejpar|first26=S.|last27=Thomas|first27=H. J. W.|last28=Wijnen|first28=J. T.|last29=Clark|first29=S. K.|last30=Hodgson|first30=S. V.|title=Peutz-Jeghers syndrome: a systematic review and recommendations for management|journal=Gut|volume=59|issue=7|year=2010|pages=975–986|issn=0017-5749|doi=10.1136/gut.2009.198499}}</ref><ref name="KopacovaTacheci20093">{{cite journal|last1=Kopacova|first1=Marcela|last2=Tacheci|first2=Ilja|last3=Rejchrt|first3=Stanislav|last4=Bures|first4=Jan|title=Peutz-Jeghers syndrome: Diagnostic and therapeuticapproach|journal=World Journal of Gastroenterology|volume=15|issue=43|year=2009|pages=5397|issn=1007-9327|doi=10.3748/wjg.15.5397}}</ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" |↑ or ↓
| 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;" |
* [[Weight loss]]
* [[Fatigue]]
* [[Hyperpigmentation|Mucocutaneous  hyperpigmentation]]
* [[Rectal prolapse]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |
* [[Hamartomatous intestinal polyposis|Multiple polyps]]
* [[Mucocutaneous]] [[pigmentation]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Polyps|Multiple polyps]]
*[[Intussusception]]
*[[Bowel obstruction]]
| style="background: #F5F5F5; padding: 5px;" |'''Barium enema'''
* Multiple [[Polyp|polyps]]
'''MRI'''
* Multiple [[Hamartoma|hamartomatous]] [[Polyp|polyps]]
| style="background: #F5F5F5; padding: 5px;" |
* [[Hamartoma|Hamartomatous]] [[Polyps|mucosal polyps]] with core of [[smooth muscle]] associated with [[Mucous membrane|mucosa]]
* Smaller [[Polyp|polyps]] lack the prominent arborizing [[smooth muscle]]
| style="background: #F5F5F5; padding: 5px;" |[[Genetic testing]] for [[STK11]] and [[colonoscopy]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Carcinoid|Carcinoids]]<br><ref name="pmid20011309">{{cite journal |vauthors=Chung TP, Hunt SR |title=Carcinoid and neuroendocrine tumors of the colon and rectum |journal=Clin Colon Rectal Surg |volume=19 |issue=2 |pages=45–8 |date=May 2006 |pmid=20011309 |pmc=2780103 |doi=10.1055/s-2006-942343 |url=}}</ref><ref name="diagnostics">Diagnostics: Biochemical Markers, Imaging, and Approach. National cancer institute. http://www.cancer.gov/types/gi-carcinoid-tumors/hp/gi-carcinoid-treatment-pdq</ref><ref name="pmid22525418">{{cite journal |vauthors=Rindi G, Falconi M, Klersy C, Albarello L, Boninsegna L, Buchler MW, Capella C, Caplin M, Couvelard A, Doglioni C, Delle Fave G, Fischer L, Fusai G, de Herder WW, Jann H, Komminoth P, de Krijger RR, La Rosa S, Luong TV, Pape U, Perren A, Ruszniewski P, Scarpa A, Schmitt A, Solcia E, Wiedenmann B |title=TNM staging of neoplasms of the endocrine pancreas: results from a large international cohort study |journal=J. Natl. Cancer Inst. |volume=104 |issue=10 |pages=764–77 |date=May 2012 |pmid=22525418 |doi=10.1093/jnci/djs208 |url=}}</ref><ref name="pmid28637502">{{cite journal |vauthors=Fang C, Wang W, Zhang Y, Feng X, Sun J, Zeng Y, Chen Y, Li Y, Chen M, Zhou Z, Chen J |title=Clinicopathologic characteristics and prognosis of gastroenteropancreatic neuroendocrine neoplasms: a multicenter study in South China |journal=Chin J Cancer |volume=36 |issue=1 |pages=51 |date=June 2017 |pmid=28637502 |pmc=5480192 |doi=10.1186/s40880-017-0218-3 |url=}}</ref><ref name="symptoms">Signs and symptoms of carcinoid syndrome. National Cancer Institute. http://www.cancer.gov/types/gi-carcinoid-tumors/patient/gi-carcinoid-treatment-pdq</ref>
| 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;" |
| style="background: #F5F5F5; padding: 5px;" |
*[[Flushing (physiology)|Flushing]]<ref name="symptoms">Signs and symptoms of carcinoid syndrome. National Cancer Institute. http://www.cancer.gov/types/gi-carcinoid-tumors/patient/gi-carcinoid-treatment-pdq</ref>
*[[Weight gain|Weight loss]]
*[[Weakness]]
*[[Flushing (physiology)|Flushing]]
*[[Wheezing]]
*[[Wheezing]]
*[[Shortness of breath]]
*[[Shortness of breath]]
*[[Palpitations]]
*[[Palpitations]]
*[[Weight gain]]
*[[Hirsutism]]
*[[Weakness]]
*[[Leg edema]]
*[[Leg edema]]
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |
* Urinary [[5-hydroxyindoleacetic acid]] (5-HIAA)<ref name="diagnostics">Diagnostics: Biochemical Markers, Imaging, and Approach. National cancer institute. http://www.cancer.gov/types/gi-carcinoid-tumors/hp/gi-carcinoid-treatment-pdq</ref>
* Chromogranin A (CgA)
* Other biochemical markers include:
**[[Substance P]]
**[[Neurotensin]]
**[[Bradykinin]]
**[[Human chorionic gonadotropin]]
**Neuropeptide L
**[[Pancreatic polypeptide]]
| style="background: #F5F5F5; padding: 5px;" |
* Infiltrating, ulcerating or fungating lesions in the wall of colon
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Well-defined single or multiple lesions
* [[Infiltration (medical)|Infiltrating]], [[Ulceration|ulcerating]] or fungating lesions in the [[Colon (anatomy)|wall of colon]]
* Round or ovoid in shape
* Variable in size ranges between 2-5 cm
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[PET scan]]
* Well-defined single/multiple lesions
* [[MRI]]
* Round/ovoid in shape
* Ki-67 index<ref name="pmid22525418">{{cite journal |vauthors=Rindi G, Falconi M, Klersy C, Albarello L, Boninsegna L, Buchler MW, Capella C, Caplin M, Couvelard A, Doglioni C, Delle Fave G, Fischer L, Fusai G, de Herder WW, Jann H, Komminoth P, de Krijger RR, La Rosa S, Luong TV, Pape U, Perren A, Ruszniewski P, Scarpa A, Schmitt A, Solcia E, Wiedenmann B |title=TNM staging of neoplasms of the endocrine pancreas: results from a large international cohort study |journal=J. Natl. Cancer Inst. |volume=104 |issue=10 |pages=764–77 |date=May 2012 |pmid=22525418 |doi=10.1093/jnci/djs208 |url=}}</ref>
* Variable in size between 2-5 cm
| style="background: #F5F5F5; padding: 5px;" |'''PET scan''' (11C-5-hydroxytryptophan, 11C-5-HTP)
* Detects [[metastasis]]
'''MRI'''
* Nodular mass
* Wall thickening
* [[Metastasis]]
'''Ki-67 index'''
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Solid or spongy nests of cells accentuated by neatly outlined luminal spaces <ref name="pmid28637502">{{cite journal |vauthors=Fang C, Wang W, Zhang Y, Feng X, Sun J, Zeng Y, Chen Y, Li Y, Chen M, Zhou Z, Chen J |title=Clinicopathologic characteristics and prognosis of gastroenteropancreatic neuroendocrine neoplasms: a multicenter study in South China |journal=Chin J Cancer |volume=36 |issue=1 |pages=51 |date=June 2017 |pmid=28637502 |pmc=5480192 |doi=10.1186/s40880-017-0218-3 |url=}}</ref>
* Solid/spongy nests of cells accentuated by neatly outlined luminal spaces  


* Peripheral nuclear palisading  
* Peripheral nuclear palisading  
* Granular eosinophilic cytoplasm.
* [[Granule cell|Granular]] [[eosinophilic]] [[cytoplasm]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |[[Biopsy]] and [[Histopathology|histopathological analysis]]
* [[Biopsy]] and [[Histopathology|histopathological analysis]]
|-
| style="background: #F5F5F5; padding: 5px;" |
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bowel frequency
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Blood in stool
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Abdominal pain
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Tenesmus
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other symptoms
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Anemia
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Colonoscopy
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |CT scan
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other diagnostic study
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Gold standard'''
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Juvenile polyposis syndrome|Juvenile Polyposis Coli]]<ref name="pmid7054044">{{cite journal |vauthors=Grotsky HW, Rickert RR, Smith WD, Newsome JF |title=Familial juvenile polyposis coli. A clinical and pathologic study of a large kindred |journal=Gastroenterology |volume=82 |issue=3 |pages=494–501 |date=March 1982 |pmid=7054044 |doi= |url=}}</ref>
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Juvenile polyposis syndrome|Juvenile Polyposis Coli]]<ref name="pmid7054044">{{cite journal |vauthors=Grotsky HW, Rickert RR, Smith WD, Newsome JF |title=Familial juvenile polyposis coli. A clinical and pathologic study of a large kindred |journal=Gastroenterology |volume=82 |issue=3 |pages=494–501 |date=March 1982 |pmid=7054044 |doi= |url=}}</ref><ref name="pmid22171123">{{cite journal |vauthors=Brosens LA, Langeveld D, van Hattem WA, Giardiello FM, Offerhaus GJ |title=Juvenile polyposis syndrome |journal=World J. Gastroenterol. |volume=17 |issue=44 |pages=4839–44 |date=November 2011 |pmid=22171123 |pmc=3235625 |doi=10.3748/wjg.v17.i44.4839 |url=}}</ref><ref name="pmid22965402">{{cite journal |vauthors=Latchford AR, Neale K, Phillips RK, Clark SK |title=Juvenile polyposis syndrome: a study of genotype, phenotype, and long-term outcome |journal=Dis. Colon Rectum |volume=55 |issue=10 |pages=1038–43 |date=October 2012 |pmid=22965402 |doi=10.1097/DCR.0b013e31826278b3 |url=}}</ref><ref name="pmid229654023">{{cite journal |vauthors=Latchford AR, Neale K, Phillips RK, Clark SK |title=Juvenile polyposis syndrome: a study of genotype, phenotype, and long-term outcome |journal=Dis. Colon Rectum |volume=55 |issue=10 |pages=1038–43 |date=October 2012 |pmid=22965402 |doi=10.1097/DCR.0b013e31826278b3 |url=}}</ref><ref name="pmid229654022">{{cite journal |vauthors=Latchford AR, Neale K, Phillips RK, Clark SK |title=Juvenile polyposis syndrome: a study of genotype, phenotype, and long-term outcome |journal=Dis. Colon Rectum |volume=55 |issue=10 |pages=1038–43 |date=October 2012 |pmid=22965402 |doi=10.1097/DCR.0b013e31826278b3 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |[[Diarrhea]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" |
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Prolapsing [[polyp]]<ref name="pmid22171123">{{cite journal |vauthors=Brosens LA, Langeveld D, van Hattem WA, Giardiello FM, Offerhaus GJ |title=Juvenile polyposis syndrome |journal=World J. Gastroenterol. |volume=17 |issue=44 |pages=4839–44 |date=November 2011 |pmid=22171123 |pmc=3235625 |doi=10.3748/wjg.v17.i44.4839 |url=}}</ref>
* Prolapsing [[polyp]]
* [[Intussusception]]
* [[Intussusception]]
* [[Macrocephalus]]
* [[Macrocephalus]]
* [[Hypotonia]]
* [[Hypotonia]]
| style="background: #F5F5F5; padding: 5px;" | +
* [[Intestinal obstruction|Bowel obstruction]]
| style="background: #F5F5F5; padding: 5px;" | -
* [[Heart]] or [[brain]] abnormalities
* [[Cleft lip and palate|Cleft palate]]
* [[Polydactyly]]
* Genitalia or urinary abnormalities
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* >5 juvenile [[Polyp|polyps]] in the [[colon]] and [[rectum]]<ref name="pmid22965402">{{cite journal |vauthors=Latchford AR, Neale K, Phillips RK, Clark SK |title=Juvenile polyposis syndrome: a study of genotype, phenotype, and long-term outcome |journal=Dis. Colon Rectum |volume=55 |issue=10 |pages=1038–43 |date=October 2012 |pmid=22965402 |doi=10.1097/DCR.0b013e31826278b3 |url=}}</ref>
* >5 juvenile [[Polyp|polyps]] in the [[colon]] and [[rectum]]
* Multiple [[Polyps|juvenile polyps]] in [[gastrointestinal tract]]
* Multiple [[Polyps|juvenile polyps]] in [[gastrointestinal tract]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Will show [[Polyps|multiple polyps]] in [[gastrointestinal tract]]
* [[Polyp|Multiple polyps]] in [[gastrointestinal tract|GI tract]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |'''Barium study'''
* [[PET scan]]
* Multiple polyps in [[Gastrointestinal tract|GI tract]]
 
'''Stool DNA test'''
* [[MRI]]
* ''[[SMAD4]]'' or ''[[BMPR1A]]''
| style="background: #F5F5F5; padding: 5px;" |[[Hamartomatous intestinal polyposis|Hamartomatous polyps]] on [[Histopathology|histopathological analysis]]
'''Diagnose if any of the following positive:'''
| style="background: #F5F5F5; padding: 5px;" |
* More than five juvenile [[Polyp|polyps]] of the colorectum
* Visualization of multiple [[polyps]] in [[gastrointestinal tract]] by [[endoscopy]]
* Multiple juvenile [[Polyp|polyps]] throughout the [[Gastrointestinal tract|GI tract]]
* Any number of juvenile [[Polyp|polyps]] and a family history of juvenile [[polyposis]]
* [[Heterozygous]] pathogenic variant in ''[[Mothers against decapentaplegic homolog 4|SMAD4]]'' or ''[[BMPR1A]]''
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Individuals who meet clinical criteria  should get genetic testing  germline mutation in the ''BMPR1A'' and ''SMAD4'' genes.<ref name="pmid229654022">{{cite journal |vauthors=Latchford AR, Neale K, Phillips RK, Clark SK |title=Juvenile polyposis syndrome: a study of genotype, phenotype, and long-term outcome |journal=Dis. Colon Rectum |volume=55 |issue=10 |pages=1038–43 |date=October 2012 |pmid=22965402 |doi=10.1097/DCR.0b013e31826278b3 |url=}}</ref>
* [[Cyst|Cystic]] and dilated [[Crypt (anatomy)|crypts]] or [[Gland|glands]] with inspissated [[mucin]] and [[Lumen (anatomy)|intraluminal]] [[Neutrophil|neutrophils]]
 
* [[Lamina propria]] [[Edema|edematous]] with associated [[Lymphocyte|lymphocytes]], [[Plasma cell|plasma cells]], [[Eosinophil granulocyte|eosinophils]], and [[Neutrophil|neutrophils]]
* Increased risk of colorectal and gastric cancer<ref name="pmid229654023">{{cite journal |vauthors=Latchford AR, Neale K, Phillips RK, Clark SK |title=Juvenile polyposis syndrome: a study of genotype, phenotype, and long-term outcome |journal=Dis. Colon Rectum |volume=55 |issue=10 |pages=1038–43 |date=October 2012 |pmid=22965402 |doi=10.1097/DCR.0b013e31826278b3 |url=}}</ref>
* [[Filiform papilla|Filiform]], multilobed forms with increased [[Glandular tissue|glandular]]-to-[[Stroma (animal tissue)|stroma]] ratio in nonclassic or [[Polyps|atypical polyps]]
* Areas of conventional [[dysplasia]]
| style="background: #F5F5F5; padding: 5px;" |Diagnostic criteria fulfilment
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Gastrointestinal stromal tumor|Gastrointestinal Stromal Tumors (GIST)]]<ref name="pmid24778074">{{cite journal |vauthors=Niazi AK, Kaley K, Saif MW |title=Gastrointestinal stromal tumor of colon: a case report and review of literature |journal=Anticancer Res. |volume=34 |issue=5 |pages=2547–50 |date=May 2014 |pmid=24778074 |doi= |url=}}</ref><ref name="pmid247780742">{{cite journal |vauthors=Niazi AK, Kaley K, Saif MW |title=Gastrointestinal stromal tumor of colon: a case report and review of literature |journal=Anticancer Res. |volume=34 |issue=5 |pages=2547–50 |date=May 2014 |pmid=24778074 |doi= |url=}}</ref>
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Gastrointestinal stromal tumor|Gastrointestinal Stromal Tumors (GIST)]]<ref name="pmid24778074">{{cite journal |vauthors=Niazi AK, Kaley K, Saif MW |title=Gastrointestinal stromal tumor of colon: a case report and review of literature |journal=Anticancer Res. |volume=34 |issue=5 |pages=2547–50 |date=May 2014 |pmid=24778074 |doi= |url=}}</ref><ref name="pmid247780742">{{cite journal |vauthors=Niazi AK, Kaley K, Saif MW |title=Gastrointestinal stromal tumor of colon: a case report and review of literature |journal=Anticancer Res. |volume=34 |issue=5 |pages=2547–50 |date=May 2014 |pmid=24778074 |doi= |url=}}</ref><ref name="pmid15223958">{{cite journal |vauthors=Medeiros F, Corless CL, Duensing A, Hornick JL, Oliveira AM, Heinrich MC, Fletcher JA, Fletcher CD |title=KIT-negative gastrointestinal stromal tumors: proof of concept and therapeutic implications |journal=Am. J. Surg. Pathol. |volume=28 |issue=7 |pages=889–94 |date=July 2004 |pmid=15223958 |doi= |url=}}</ref><ref name="pmid16222452">{{cite journal |vauthors=Kamiyama Y, Aihara R, Nakabayashi T, Mochiki E, Asao T, Kuwano H, Oriuchi N, Endo K |title=18F-fluorodeoxyglucose positron emission tomography: useful technique for predicting malignant potential of gastrointestinal stromal tumors |journal=World J Surg |volume=29 |issue=11 |pages=1429–35 |date=November 2005 |pmid=16222452 |doi=10.1007/s00268-005-0045-6 |url=}}</ref><ref name="pmid15613856">{{cite journal |vauthors=Miettinen M, Sobin LH, Lasota J |title=Gastrointestinal stromal tumors of the stomach: a clinicopathologic, immunohistochemical, and molecular genetic study of 1765 cases with long-term follow-up |journal=Am. J. Surg. Pathol. |volume=29 |issue=1 |pages=52–68 |date=January 2005 |pmid=15613856 |doi= |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |+/-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
| style="background: #F5F5F5; padding: 5px;" |+/-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/-
| style="background: #F5F5F5; padding: 5px;" |+/-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Mostly [[asymptomatic]]<ref name="pmid15613856">{{cite journal |vauthors=Miettinen M, Sobin LH, Lasota J |title=Gastrointestinal stromal tumors of the stomach: a clinicopathologic, immunohistochemical, and molecular genetic study of 1765 cases with long-term follow-up |journal=Am. J. Surg. Pathol. |volume=29 |issue=1 |pages=52–68 |date=January 2005 |pmid=15613856 |doi= |url=}}</ref>
* [[Asymptomatic]]
* Are discovered incidentally
* [[Satiety|Early satiety]]
* Non-specific symptoms
* [[Bloating]]
* Early satiety and bloating
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" |+/-
| style="background: #F5F5F5; padding: 5px;" |
* KIT protein
* [[CD117|CD 117 antigen]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Subepithelial round masses
* Subepithelial round masses
Line 315: Line 213:
* Normal overlying [[mucosa]] may be intact or [[Ulcerated lesion|ulcerated]]
* Normal overlying [[mucosa]] may be intact or [[Ulcerated lesion|ulcerated]]
* Bulging into [[Gastrointestinal tract|gastrointestinal]] [[lumen]]
* Bulging into [[Gastrointestinal tract|gastrointestinal]] [[lumen]]
| style="background: #F5F5F5; padding: 5px;" |[[Benign]]
* Small, < 10 cms
* [[Homogeneous]]
* Clear boundaries
* [[intraluminal]] or extraluminal growth
[[Malignant]] [[Gastrointestinal stromal tumor|GIST]] with [[metastasis]]:
* Size > 10 cm
* [[Calcification|Calcifications]]
* Irregular margins
* [[Heterogeneous]] and lobulated
* [[Lymphadenopathy]]
* [[Ulceration]]
* Extraluminal and [[mesenteric]] fat infiltration
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Study of choice
'''Endoscopic ultrasonography'''
* Evaluate extent and dimensions
 
* Evaluate metastatic disease
[[Benign]]:
* [[Mucosal]] [[ulceration]] or [[bleeding]]
* Smooth [[submucosal]] mass as [[hypoechoic mass]]
[[Malignant]] [[Gastrointestinal stromal tumor|GIST]]:
* [[Heterogeneous]] mass >4 cm in size
* Irregular borders
* [[Intraluminal|Intra]]/extraluminal growth
* Multiple [[cysts]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[MRI]]
*[[Spindle cells|Spindle cell]] type are [[eosinophilic]] cells arranged in the form of whorls or fascicles<ref name="pmid12075401">{{cite journal |vauthors=Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, Miettinen M, O'Leary TJ, Remotti H, Rubin BP, Shmookler B, Sobin LH, Weiss SW |title=Diagnosis of gastrointestinal stromal tumors: a consensus approach |journal=Int. J. Surg. Pathol. |volume=10 |issue=2 |pages=81–9 |date=April 2002 |pmid=12075401 |doi=10.1177/106689690201000201 |url=}}</ref><ref name="pmid120754012">{{cite journal |vauthors=Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, Miettinen M, O'Leary TJ, Remotti H, Rubin BP, Shmookler B, Sobin LH, Weiss SW |title=Diagnosis of gastrointestinal stromal tumors: a consensus approach |journal=Int. J. Surg. Pathol. |volume=10 |issue=2 |pages=81–9 |date=April 2002 |pmid=12075401 |doi=10.1177/106689690201000201 |url=}}</ref>
* [[Endoscopic ultrasound|Endoscopic]] [[ultrasonography]]
*[[Epithelioid]] [[GIST|GISTs]] are rounded cells with oval nuclei and vesicular [[chromatin]] and appears nested
* [[PET scan]]<ref name="pmid16222452">{{cite journal |vauthors=Kamiyama Y, Aihara R, Nakabayashi T, Mochiki E, Asao T, Kuwano H, Oriuchi N, Endo K |title=18F-fluorodeoxyglucose positron emission tomography: useful technique for predicting malignant potential of gastrointestinal stromal tumors |journal=World J Surg |volume=29 |issue=11 |pages=1429–35 |date=November 2005 |pmid=16222452 |doi=10.1007/s00268-005-0045-6 |url=}}</ref>
*On [[immunohistochemical staining]] they are positive for [[Molecular marker|molecular markers]] [[CD117]] antigen and KIT protein
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |[[Endoscopic ultrasound]]
**[[Spindle cells|Spindle cell]] type are [[eosinophilic]] cells arranged in the form of whorls or fascicles.<ref name="pmid12075401">{{cite journal |vauthors=Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, Miettinen M, O'Leary TJ, Remotti H, Rubin BP, Shmookler B, Sobin LH, Weiss SW |title=Diagnosis of gastrointestinal stromal tumors: a consensus approach |journal=Int. J. Surg. Pathol. |volume=10 |issue=2 |pages=81–9 |date=April 2002 |pmid=12075401 |doi=10.1177/106689690201000201 |url=}}</ref><ref name="pmid120754012">{{cite journal |vauthors=Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, Miettinen M, O'Leary TJ, Remotti H, Rubin BP, Shmookler B, Sobin LH, Weiss SW |title=Diagnosis of gastrointestinal stromal tumors: a consensus approach |journal=Int. J. Surg. Pathol. |volume=10 |issue=2 |pages=81–9 |date=April 2002 |pmid=12075401 |doi=10.1177/106689690201000201 |url=}}</ref>
[[biopsy]] and [[Histopathological|histopathological analysis]]
**[[Epithelioid]] [[GIST|GISTs]] are rounded cells with oval nuclei and vesicular chromatin and appears nested<ref name="pmid15223958">{{cite journal |vauthors=Medeiros F, Corless CL, Duensing A, Hornick JL, Oliveira AM, Heinrich MC, Fletcher JA, Fletcher CD |title=KIT-negative gastrointestinal stromal tumors: proof of concept and therapeutic implications |journal=Am. J. Surg. Pathol. |volume=28 |issue=7 |pages=889–94 |date=July 2004 |pmid=15223958 |doi= |url=}}</ref>
**On [[immunohistochemical staining]] they are positive for [[Molecular marker|molecular markers]] [[CD117]] antigen and KIT protein.
| style="background: #F5F5F5; padding: 5px;" |
* [[Biopsy]] and [[Histopathological|histopathological analysis]]
| style="background: #F5F5F5; padding: 5px;" |
* [[Cytological|Cytologic analysis]], and [[immunohistochemistry]] for KIT protein expression confirms the [[diagnosis]] of these [[Lesion|lesions]]
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hamartoma]]<ref name="pmid26672891">{{cite journal |vauthors=Cauchin E, Touchefeu Y, Matysiak-Budnik T |title=Hamartomatous Tumors in the Gastrointestinal Tract |journal=Gastrointest Tumors |volume=2 |issue=2 |pages=65–74 |date=September 2015 |pmid=26672891 |pmc=4668787 |doi=10.1159/000437175 |url=}}</ref>
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hamartoma]]<ref name="pmid26672891">{{cite journal |vauthors=Cauchin E, Touchefeu Y, Matysiak-Budnik T |title=Hamartomatous Tumors in the Gastrointestinal Tract |journal=Gastrointest Tumors |volume=2 |issue=2 |pages=65–74 |date=September 2015 |pmid=26672891 |pmc=4668787 |doi=10.1159/000437175 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" |[[Diarrhea|↑]]
| 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;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Diarrhea]]
* N/A
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
| style="background: #F5F5F5; padding: 5px;" |Depending on location
| style="background: #F5F5F5; padding: 5px;" |
* [[Tenesmus]]
| style="background: #F5F5F5; padding: 5px;" | -
| colspan="2" style="background: #F5F5F5; padding: 5px;" |
* S100 (mucosal Schwann cell hamartoma (MSCH))
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Large polypoid mass
* Large polypoid mass
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Isodense or hypodense solid [[Mass|masses]]
* Isodense/hypodense solid [[Mass|masses]]
* [[Heterogeneous]] mass
* [[Heterogeneous]] mass
* Presence of [[fat]] in a well circumscribed nodule
* Presence of [[fat]]
* [[Calcification]]
* [[Calcification]]
| style="background: #F5F5F5; padding: 5px;" |'''Biopsy'''
* Proliferation of bland [[spindle cells]] in the [[lamina propria]]
* Mucosal [[Schwann cell tumor|Schwann cell hamartoma]] (MSCH)
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Biopsy: Proliferation of bland spindle cells in the lamina propria (mucosal Schwann cell hamartoma (MSCH))
* Poorly circumscribed, short fascicles of uniform [[spindle cells]] replacing the [[Colon (anatomy)|colonic]] [[lamina propria]], separating and entrapping the [[Crypt (anatomy)|crypts]]
| style="background: #F5F5F5; padding: 5px;" |
* The [[Cell nucleus|nuclei]] are bland and mostly uniform, occasional larger [[Cell nucleus|nuclei]] are found. The [[Cytoplasm|cytoplasmic]] borders are indistinct
* poorly circumscribed, short fascicles of uniform spindle cells replacing the colonic lamina propria, separating and entrapping the crypts
* Involvement of [[Mucous membrane|mucosa]] but never the [[submucosa]]
* The nuclei are bland and mostly uniform, occasional larger nuclei are found. The cytoplasmic borders are indistinct
| style="background: #F5F5F5; padding: 5px;" |[[Biopsy]]
* Involvement of mucosa but never the submucosa
|-
| style="background: #F5F5F5; padding: 5px;" |
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
* Biopsy
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bowel frequency
| style="background: #F5F5F5; padding: 5px;" |
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Blood in stool
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Abdominal pain
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Tenesmus
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other symptoms
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Anemia
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Colonoscopy
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |CT scan
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other diagnostic study
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Gold standard'''
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[MALT lymphoma|Colorectal Lymphoma]]<ref name="pmid20011310">{{cite journal |vauthors=Quayle FJ, Lowney JK |title=Colorectal lymphoma |journal=Clin Colon Rectal Surg |volume=19 |issue=2 |pages=49–53 |date=May 2006 |pmid=20011310 |pmc=2780105 |doi=10.1055/s-2006-942344 |url=}}</ref><ref name="QuayleLowney2006">{{cite journal|last1=Quayle|first1=Frank|last2=Lowney|first2=Jennifer|title=Colorectal Lymphoma|journal=Clinics in Colon and Rectal Surgery|volume=19|issue=2|year=2006|pages=049–053|issn=1531-0043|doi=10.1055/s-2006-942344}}</ref>
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[MALT lymphoma|Colorectal Lymphoma]]<ref name="pmid20011310">{{cite journal |vauthors=Quayle FJ, Lowney JK |title=Colorectal lymphoma |journal=Clin Colon Rectal Surg |volume=19 |issue=2 |pages=49–53 |date=May 2006 |pmid=20011310 |pmc=2780105 |doi=10.1055/s-2006-942344 |url=}}</ref><ref name="QuayleLowney2006">{{cite journal|last1=Quayle|first1=Frank|last2=Lowney|first2=Jennifer|title=Colorectal Lymphoma|journal=Clinics in Colon and Rectal Surgery|volume=19|issue=2|year=2006|pages=049–053|issn=1531-0043|doi=10.1055/s-2006-942344}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" text-align: center;" | -
* Normal
| style="background: #F5F5F5; padding: 5px;" text-align: center;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |Depending on location
| style="background: #F5F5F5; padding: 5px;" text-align: center;" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Weight loss
* Weight loss
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" text-align: center;" | +
| colspan="2" style="background: #F5F5F5; padding: 5px;" |
* Non-Hodgkin’s lymphomas: CD-20
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Polypoid or ulcerated mass, intramural lesion, aphthous ulcer, stricture, extraluminal mass, or diffuse, multiple polypoid lesions
* Polypoid or ulcerated mass, intramural lesion, aphthous ulcer, stricture, extraluminal mass, or diffuse, multiple polypoid lesions
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* CT scan: polypoid mass, circumferential-cavitary lesions, focal mucosal nodularity, diffuse ulcerative or nodular lesions, regional lymph node involvement
* Polypoid mass
| style="background: #F5F5F5; padding: 5px;" |
* Circumferential-[[Cavity|cavitary lesions]]
* Biopsy:
* Focal mucosal nodularity
** [[Diffuse large B cell lymphoma|Diffuse large B-cell lymphoma]]
* Diffuse [[Ulcer|ulcerative]] or [[Nodule (medicine)|nodular]] lesions
** [[MALT lymphoma|Extranodal marginal zone lymphoma (MALT)]]
* [[Lymphadenopathy]]
** [[Mantle cell lymphoma]]
| style="background: #F5F5F5; padding: 5px;" |'''Double-contrast enema'''
** [[Burkitt's lymphoma|Burkitt’s lymphoma]]
* Subtle [[Mucous membrane|mucosal]] changes
** [[Follicular lymphoma]]
* Gross [[tumor]] morphology
* Double-contrast enema: Subtle mucosal changes, gross tumor morphology
'''Biopsy'''
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Diffuse large B cell lymphoma|Diffuse large B-cell lymphoma]]:  
* [[Diffuse large B cell lymphoma|Diffuse large B-cell lymphoma]]:  
Line 388: Line 308:
* [[Follicular lymphoma]]
* [[Follicular lymphoma]]
*  
*  
| style="background: #F5F5F5; padding: 5px;" |[[Biopsy]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Kaposi's sarcoma]]<ref name="pmid20827371">{{cite journal |vauthors=Arora M, Goldberg EM |title=Kaposi sarcoma involving the gastrointestinal tract |journal=Gastroenterol Hepatol (N Y) |volume=6 |issue=7 |pages=459–62 |date=July 2010 |pmid=20827371 |pmc=2933764 |doi= |url=}}</ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" |[[Diarrhea|↑]]
| 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;" |
* [[Nausea and vomiting]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |
* Localized [[Purpura|purpuric]] lesion
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Biopsy
* N/A
| style="background: #F5F5F5; padding: 5px;" |'''Serology'''
* [[Antibodies]] against [[Kaposi's sarcoma|Kaposi sarcoma]] [[Kaposi's sarcoma-associated herpesvirus|herpes virus  (HHV-8)]]
'''Biopsy'''
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Vascular]] proliferation
* [[Red blood cell|RBC]] and [[hemosiderin]] extravasation
* [[Lymphocyte|Lymphocytes]] and [[Monocyte|monocytes]]
* [[Premonitory sign]] [[Neovascularization|(neovascular]] lesion wrapped around a pre-existing space)
* Intracytoplasmic [[Periodic acid-Schiff stain|PAS +ve]] [[hyaline]] globules
| style="background: #F5F5F5; padding: 5px;" |[[Biopsy]]
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Kaposi's sarcoma]]<ref name="pmid20827371">{{cite journal |vauthors=Arora M, Goldberg EM |title=Kaposi sarcoma involving the gastrointestinal tract |journal=Gastroenterol Hepatol (N Y) |volume=6 |issue=7 |pages=459–62 |date=July 2010 |pmid=20827371 |pmc=2933764 |doi= |url=}}</ref>
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Arteriovenous malformation]]<ref name="pmid28139503">{{cite journal |vauthors=Lee HH, Kwon HM, Gil S, Kim YS, Cho M, Seo KJ, Chae HS, Cho YS |title=Endoscopic resection of asymptomatic, colonic, polypoid arteriovenous malformations: Two case reports and a literature review |journal=Saudi J Gastroenterol |volume=23 |issue=1 |pages=67–70 |date=2017 |pmid=28139503 |pmc=5329980 |doi=10.4103/1319-3767.199111 |url=}}</ref>
| 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;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Diarrhea]]
* N/A
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |Diffuse
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Melena]]
* Bright red, flat lesions
 
* Rarely, polypoid
* [[Hematochezia]]
* [[Abdominal pain]]
* [[Nausea and vomiting|N/V]]
| style="background: #F5F5F5; padding: 5px;" | +
| colspan="2" style="background: #F5F5F5; padding: 5px;" |
* [[CD34]]
* [[CD31]]
* [[D2-40]]
* [[HHV-8]]
* [[FHI-1]] antibody
* [[LANA-1]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Localized purpuric lesion
* N/A
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* N/A
* N/A
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Electrophoresis: [[antibodies]] against Kaposi sarcoma herpes virus  (HHV-8)
* Aberrant [[Blood vessel|vessels]] with thickened, hypertrophic walls in the [[Mucous membrane|mucosa]] and the [[submucosa]]
* Biopsy: [[Vascular]] proliferation, red blood cell and [[hemosiderin]] extravasation,[[Lymphocyte|lymphocytes]] and [[Monocyte|monocytes]], neovascular lesion wrapped around a pre-existing space, intracytoplasmic PAS +ve [[hyaline]] globules
* [[Artery|Arteries]] directly connected to [[Vein|veins]] without [[capillary beds]]
| style="background: #F5F5F5; padding: 5px;" |Accidental finding
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bowel frequency
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Blood in stool
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Abdominal pain
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Tenesmus
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other symptoms
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Anemia
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Colonoscopy
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |CT scan
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other diagnostic study
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Gold standard'''
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Diverticular disease|Diverticular diseases]]<ref name="pmid16187597">{{cite journal |vauthors=Shen SH, Chen JD, Tiu CM, Chou YH, Chiang JH, Chang CY, Lee CH |title=Differentiating colonic diverticulitis from colon cancer: the value of computed tomography in the emergency setting |journal=J Chin Med Assoc |volume=68 |issue=9 |pages=411–8 |date=September 2005 |pmid=16187597 |doi=10.1016/S1726-4901(09)70156-X |url=}}</ref><ref name="ShenChen2005">{{cite journal|last1=Shen|first1=Shu-Huei|last2=Chen|first2=Jen-Dar|last3=Tiu|first3=Chui-Mei|last4=Chou|first4=Yi-Hong|last5=Chiang|first5=Jen-Huei|last6=Chang|first6=Cheng-Yen|last7=Lee|first7=Chen-Hsen|title=Differentiating Colonic Diverticulitis from Colon Cancer: The Value of Computed Tomography in the Emergency Setting|journal=Journal of the Chinese Medical Association|volume=68|issue=9|year=2005|pages=411–418|issn=17264901|doi=10.1016/S1726-4901(09)70156-X}}</ref><ref name="SheimanLevine20082">{{cite journal|last1=Sheiman|first1=Laura|last2=Levine|first2=Marc S.|last3=Levin|first3=Alicia A.|last4=Hogan|first4=Jonathan|last5=Rubesin|first5=Stephen E.|last6=Furth|first6=Emma E.|last7=Laufer|first7=Igor|title=Chronic Diverticulitis: Clinical, Radiographic, and Pathologic Findings|journal=American Journal of Roentgenology|volume=191|issue=2|year=2008|pages=522–528|issn=0361-803X|doi=10.2214/AJR.07.3597}}</ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" |↑ or ↓
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
RLQ
| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
| style="background: #F5F5F5; padding: 5px;" |
* [[Fever]]
* [[Rigor|Chills]]
* [[Nausea and vomiting|N/V]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Vascular]] proliferation
* Not recommended
* Red blood cell and [[hemosiderin]] extravasation
* [[Lymphocyte|Lymphocytes]] and [[Monocyte|monocytes]]
* Premonitory sign (a neovascular lesion wrapped around a pre-existing space)
* Intracytoplasmic PAS +ve [[hyaline]] globules
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Biopsy
* Outpouchings of the [[Colon (anatomy)|colonic wall]] [[Diverticular|(diverticula)]]
* [[Diverticulitis|Inflamed diverticula]]
* [[Abscess|Abscess formation]]
* Intraperitoneal free air (microperforation)
| style="background: #F5F5F5; padding: 5px;" |'''Barium enema'''
* Circumferential narrowing
* Spiculated contour
* Tapered margins
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* N/A
| style="background: #F5F5F5; padding: 5px;" |[[Computed tomography|CT scan]]
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Ulcerative colitis]]<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref>
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hemorrhoids]]<ref name="JacobsSolomon2014">{{cite journal|last1=Jacobs|first1=Danny|last2=Solomon|first2=Caren G.|title=Hemorrhoids|journal=New England Journal of Medicine|volume=371|issue=10|year=2014|pages=944–951|issn=0028-4793|doi=10.1056/NEJMcp1204188}}</ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" |[[Constipation|↓]]
| 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;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Diarrhea]]
* Perianal Itching
| style="background: #F5F5F5; padding: 5px;" |<big>+</big>
* Pain with [[defecation]]  
| style="background: #F5F5F5; padding: 5px;" |LLQ<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref>
* Painful-hard lump in anus
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |[[Anoscopy]]
* Protruding mass from the [[anus]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" | +
* N/A
| colspan="2" style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |'''DRE'''
* [[Palpation|Palpable]] mass, tender if [[Thrombosis|thrombosed]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Continuous lesions<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref>
* N/A
* [[Erythema]] (or redness of the [[mucosa]]) and friability of the [[mucosa]]
| style="background: #F5F5F5; padding: 5px;" |Clinical
* Crypts, formation of residual mucosal tissue
|-
* [[Polyp (medicine)|Pseudopolyps]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Anal fissure]]<ref name="pmid27041801">{{cite journal |vauthors=Schlichtemeier S, Engel A |title=Anal fissure |journal=Aust Prescr |volume=39 |issue=1 |pages=14–7 |year=2016 |pmid=27041801 |pmc=4816871 |doi=10.18773/austprescr.2016.007 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | -
| 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;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Dyschezia|Painful defecation]]
* [[Itching]]
* [[Irritation]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/-
| style="background: #F5F5F5; padding: 5px;" |[[Anoscopy]]
* Anal wall laceration
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Mucosal and submucosal inflammation<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref>
* N/A
* Hemorrhage or inflammatory polymorphonuclear cells aggregate in the lamina propria
* Distorted crypts
* Crypt abscess
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Endoscopy and a mucosal biopsy<ref name="pmid16902215" />
* N/A
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* N/A
| style="background: #F5F5F5; padding: 5px;" |Clinical
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Crohn's disease]]<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref>
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bowel frequency
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Blood in stool
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Abdominal pain
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Tenesmus
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other symptoms
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Anemia
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Colonoscopy
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |CT scan
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other diagnostic study
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Gold standard'''
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Infectious colitis]]<ref name="pmid22080825">{{cite journal |vauthors=DuPont HL |title=Approach to the patient with infectious colitis |journal=Curr. Opin. Gastroenterol. |volume=28 |issue=1 |pages=39–46 |date=January 2012 |pmid=22080825 |doi=10.1097/MOG.0b013e32834d3208 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" |[[Diarrhea|↑]]
| 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;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Diarrhea]]
* [[Fever]], [[Rigor|chills]]
| style="background: #F5F5F5; padding: 5px;" | +
* [[Nausea and vomiting|N/V]]
| style="background: #F5F5F5; padding: 5px;" |LRQ<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref>
* [[Bloating]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Tenesmus
* Patchy or diffuse [[Erythematous|erythematous mucosa]]
*  
* [[Edema]], [[hemorrhage]], with or without [[ulcers]] of [[Mucous membrane|mucosa]]
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* N/A
| style="background: #F5F5F5; padding: 5px;" |'''Stool analysis'''
* [[Leukocytosis]]
'''Stool cultures'''
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* N/A
| style="background: #F5F5F5; padding: 5px;" |[[Stool culture]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Ulcerative colitis]]<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref>V
| style="background: #F5F5F5; padding: 5px; text-align: center;" |[[Diarrhea|↑]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
[[Left lower quadrant abdominal pain resident survival guide|LLQ]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Discontinuous lesions
* [[Weight loss|Weight loss]]
* Strictures
* [[Diarrhea]] with[[mucus]]
* Linear ulcerations<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref>
* Urgency
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Continuous lesions
* [[Erythema]] (or redness of the [[mucosa]]) and friability of the [[mucosa]]
* [[Crypt (anatomy)|Crypts]], formation of residual [[Mucous membrane|mucosal tissue]]
* [[Polyp (medicine)|Pseudopolyps]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Transmural pattern of inflammation<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref>
* N/A
* Mucosal damage
* Focal infiltration of leukocytes into the epithelium
* Granulomas
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Endoscopy and a mucosal biopsy<ref name="pmid16902215">{{cite journal |vauthors=Collins P, Rhodes J |title=Ulcerative colitis: diagnosis and management |journal=BMJ |volume=333 |issue=7563 |pages=340–3 |date=August 2006 |pmid=16902215 |pmc=1539087 |doi=10.1136/bmj.333.7563.340 |url=}}</ref>
* N/A
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Mucous membrane|Mucosal]] and [[Submucosa|submucosal]] [[inflammation]]
* [[Hemorrhages|Hemorrhage]] or [[Inflammation|inflammatory]] [[Neutrophil|polymorphonuclear cells]] aggregate in the [[lamina propria]]
* Distorted [[Crypt (anatomy)|crypts]]
* [[Crypt abscess]]
| style="background: #F5F5F5; padding: 5px;" |[[Biopsy|Endoscopic biopsy]]
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Irritable bowel syndrome]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Crohn's disease]]<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" |[[Diarrhea|↑]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
 
[[Right lower quadrant abdominal pain resident survival guide|RLQ]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |
* [[Nausea and vomiting|N/V]]
* [[Bowel obstruction]]
* [[Fever]]
*
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |
* Discontinuous lesions
* [[Strictures]]
* Linear [[Ulcer|ulcerations]]
| style="background: #F5F5F5; padding: 5px;" |
* N/A
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Constipation]]
* N/A
and/or
* [[diarrhea]]
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Transmural pattern of [[inflammation]]
* [[Mucous membrane|Mucosal]] damage
* Focal [[Infiltration (medical)|infiltration]] of [[White blood cells|leukocytes]] into the [[epithelium]]
* [[Granuloma|Granulomas]]
| style="background: #F5F5F5; padding: 5px;" |[[Biopsy|Endoscopic biopsy]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Irritable bowel syndrome]]<ref name="pmid28875974">{{cite journal |vauthors=Iwańczak B, Iwańczak F |title=[Functional gastrointestinal disorders in children and adolescents. The Rome IV criteria] |language=Polish |journal=Pol. Merkur. Lekarski |volume=43 |issue=254 |pages=75–82 |date=August 2017 |pmid=28875974 |doi= |url=}}</ref>
| 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;" |
| style="background: #F5F5F5; padding: 5px;" |
* Straining during [[defecation]]
* [[Weight loss]]
* Straining
* [[Urgency]]
* [[Urgency]]
* Sensation of incomplete evacuation
* [[Mucus]] passage
* [[Mucus]] passage
* [[Bloating]]
* [[Bloating]]
* Weight loss
| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| colspan="2" style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |Nor recommended
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Diagnosis of exclusion with fulfilment of [[Irritable bowel syndrome diagnostic criteria|Rome criteria]]<ref name="pmid28875974">{{cite journal |vauthors=Iwańczak B, Iwańczak F |title=[Functional gastrointestinal disorders in children and adolescents. The Rome IV criteria] |language=Polish |journal=Pol. Merkur. Lekarski |volume=43 |issue=254 |pages=75–82 |date=August 2017 |pmid=28875974 |doi= |url=}}</ref>
* Not recommended
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Clinical diagnosis ([[Irritable bowel syndrome Diagnostic Study of Choice|Rome criteria]])<ref name="pmid28875974" />
* N/A
| style="background: #F5F5F5; padding: 5px;" |'''Diagnosis of exclusion'''
* Fulfilment of [[Irritable bowel syndrome diagnostic criteria|Rome criteria]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* N/A
| style="background: #F5F5F5; padding: 5px;" |Clinical diagnosis  [[Irritable bowel syndrome Diagnostic Study of Choice|(Rome criteria)]]
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Bowel frequency
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Blood in stool
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Abdominal pain
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Tenesmus
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other symptoms
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Anemia
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Colonoscopy
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |CT scan
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other diagnostic study
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Gold standard'''
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Appendicitis]]<ref name="pmid14616200">{{cite journal |vauthors=Choi D, Park H, Lee YR, Kook SH, Kim SK, Kwag HJ, Chung EC |title=The most useful findings for diagnosing acute appendicitis on contrast-enhanced helical CT |journal=Acta Radiol |volume=44 |issue=6 |pages=574–82 |year=2003 |pmid=14616200 |doi= |url=}}</ref>
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Appendicitis]]<ref name="pmid14616200">{{cite journal |vauthors=Choi D, Park H, Lee YR, Kook SH, Kim SK, Kwag HJ, Chung EC |title=The most useful findings for diagnosing acute appendicitis on contrast-enhanced helical CT |journal=Acta Radiol |volume=44 |issue=6 |pages=574–82 |year=2003 |pmid=14616200 |doi= |url=}}</ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" |[[Diarrhea|↑]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
[[Right lower quadrant abdominal pain resident survival guide|RLQ]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Diarrhea]]
* Pain starting periumbilical before localizing to the [[Right lower quadrant abdominal pain resident survival guide|RLQ]]
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |RLQ
| style="background: #F5F5F5; padding: 5px;" |
* Pain starting periumbilical before localizing to the [[right iliac fossa]]
* [[Nausea and vomiting|N/V]]
* [[Nausea and vomiting|N/V]]
* [[Fever]], [[Rigor|chills]]
* [[Fever]]
* [[Rigor|Chills]]
* [[Anorexia|Loss of appetite]]
* [[Anorexia|Loss of appetite]]
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
| colspan="2" style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" | -
* N/A
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Appendiceal wall thickening (wall ≥ 3mm)
* [[Appendicitis CT|Appendiceal]] wall thickening (≥ 3mm)
* Periappendiceal fat stranding
* Periappendiceal fat stranding
* Thickening of the [[Fascia|lateral conal fascia]] and [[mesoappendix]]
* Thick [[Fascia|lateral conal fascia]] and [[mesoappendix]]
* Extraluminal fluid
* Extraluminal fluid
* [[Phlegmon]]
* [[Phlegmon]]
* [[Abscess]]
* [[Abscess]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Tc-99m labeled anti-CD15 antibodies
'''Ultrasound'''
* Ultrasound:
* Aperistaltic, noncompressible, dilated [[Appendicitis ultrasound|appendix]] (>6 mm)
** Aperistaltic, noncompressible, dilated appendix (>6 mm outer diameter)
* [[Appendicolith]]
** [[Appendicolith]]
* Echogenic prominent pericaecal fat
** Echogenic prominent pericaecal fat
* Periappendiceal fluid collection
** Periappeniceal fluid collection
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Computed tomography|CT scan]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* N/A
| style="background: #F5F5F5; padding: 5px;" |[[Computed tomography|CT scan]]
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Strangulated hernia]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Strangulated hernia]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" |↓
| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
[[Right lower quadrant abdominal pain resident survival guide|RLQ]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Constipation
* [[Nausea and vomiting|N/V]]
| style="background: #F5F5F5; padding: 5px;" | -
* Heaviness/dull discomfort in the groin, with straining, lifting, [[Cough|coughing]], or [[Physical exercise|exercising]]
| style="background: #F5F5F5; padding: 5px;" |[[Right lower quadrant abdominal pain resident survival guide|RLQ]]
* [[Weakness]], heaviness, burning, or aching in the groin
| style="background: #F5F5F5; padding: 5px;" |[[Nausea and vomiting|N/V]]
* [[Swelling]]
* [[Fever]]


Heaviness or dull discomfort in the groin, with straining, lifting, coughing, or exercising
| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
 
| style="background: #F5F5F5; padding: 5px;" |
Weakness, heaviness, burning, or aching in the groin
* N/A
 
Pain and [[swelling]]
 
[[Fever]]
 
| style="background: #F5F5F5; padding: 5px;" | -
| colspan="2" style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Defect in the abdominal wall muscles
* [[Abdominal wall defect|Defect in the abdominal wall]] [[Rectus abdominis muscle|muscles]]
* Appearance of bowel loops within the lesion
* [[Intestine|Bowel loops]] within the lesion
* Lateral crescent sign
* Lateral crescent sign
* The hernia neck will be superolateral to the course of the inferior [[epigastric]] vessels.
* The [[Hernia|hernia neck]] superolateral to the course of the inferior [[epigastric]] vessels
*
*
| style="background: #F5F5F5; padding: 5px;" |'''Ultrasound:'''
* Hypoechoic mass suggesting dilated and edematous [[Intestine|intestinal segment]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* N/A
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |[[Ultrasound]]
| style="background: #F5F5F5; padding: 5px;" |
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Endometriosis|Bowel endometriosis]]<ref name="pmid25400445">{{cite journal |vauthors=Wolthuis AM, Meuleman C, Tomassetti C, D'Hooghe T, de Buck van Overstraeten A, D'Hoore A |title=Bowel endometriosis: colorectal surgeon's perspective in a multidisciplinary surgical team |journal=World J. Gastroenterol. |volume=20 |issue=42 |pages=15616–23 |date=November 2014 |pmid=25400445 |pmc=4229526 |doi=10.3748/wjg.v20.i42.15616 |url=}}</ref>
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Endometriosis|Bowel endometriosis]]<ref name="pmid25400445">{{cite journal |vauthors=Wolthuis AM, Meuleman C, Tomassetti C, D'Hooghe T, de Buck van Overstraeten A, D'Hoore A |title=Bowel endometriosis: colorectal surgeon's perspective in a multidisciplinary surgical team |journal=World J. Gastroenterol. |volume=20 |issue=42 |pages=15616–23 |date=November 2014 |pmid=25400445 |pmc=4229526 |doi=10.3748/wjg.v20.i42.15616 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" |↑ or ↓
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
[[Pelvic pain|Pelvic]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Constipation]]
* [[Dyschezia]]
and/or
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
* [[Diarrhea]]
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
* Pelvic pain
| style="background: #F5F5F5; padding: 5px;" |
* Dyschezia
* Tenesmus
| style="background: #F5F5F5; padding: 5px;" | +
| colspan="2" style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* N/A
* N/A
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* N/A
* N/A
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |'''Transvaginal ultrasound'''
* Transvaginal ultrasonography: heterogeneous, hypoechoic, spiculated mass
* Heterogeneous, hypoechoic, spiculated mass
* Barium enema: Extrinsic mass compressing the bowel, fine crenulation of the mucosa, bowel strictures at the rectosigmoid junction
'''T1-weighted or fat-suppression T1-weighted MRIs'''
* T1-weighted or fat-suppression T1-weighted MRIs: Contrast enhanced mass or hyperintense foci, hemorrhagic foci or hyperintense cavities  
* Contrast enhanced mass  
* Hyperintense [[hemorrhagic]]
* Hyperintense [[Cavity|cavities]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* N/A
* N/A
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |[[Gynecologic ultrasonography|Transvaginal ultrasound]]
* Transvaginal ultrasonography
|-
| style="background: #F5F5F5; padding: 5px;" |
| colspan="12" |'''<small>ABBREVIATIONS''':'''N/A''': Not available , '''N/V''': Nausea/vomiting, '''M/C''': Most common, '''DRE''': Digital rectal exam, '''RLQ''': Right lower quadrant, '''LLQ''': Left lower quadrant </small><small><nowiki/></small><small><nowiki/></small>
|}
|}
</small>
</div>


==References==
==References==

Latest revision as of 20:51, 13 February 2019

To view the differential diagnosis of familial adenomatous polyposis (FAP), click here
To view the differential diagnosis of hereditary nonpolyposis colorectal cancer (HNPCC), click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]: Associate Editor(s)-in-Chief: Trusha Tank, M.D.[2], Qurrat-ul-ain Abid, M.D.[3]

Overview

Colorectal cancer must be differentiated from other diseases that cause unexplained weight loss, unexplained loss of appetite, nausea, vomiting, diarrhea, anemia, jaundice, and fatigue, such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), hemorrhoids, anal fissures, and diverticular disease. There are less common conditions that may be confused as colorectal cancer such as infectious colitis and gastrointestinal lymphoma.

Colorectal Cancer Differential Diagnosis

Other conditions that can be mistaken for colorectal cancer include the following:

ABBREVIATIONS:N/A: Not available , N/V: Nausea/vomiting, M/C: Most common, DRE: Digital rectal exam, RLQ: Right lower quadrant, LLQ: Left lower quadrant
Diseases Clinical manifestations Para-clinical findings Gold standard
Symptoms
Lab Findings Imaging Histopathology
Bowel frequency Blood in stool Abdominal pain Tenesmus Other symptoms Anemia Colonoscopy CT scan Other diagnostic study
Colorectal carcinoma (Adenocarcinoma)[7] ↑ or ↓ + +/- + + PET scans

Barium enema

Biopsy, genetic testing, and histopathological analysis
Peutz-Jeghers syndrome
[8][9][10][11][12]
↑ or ↓ + + - + Barium enema

MRI

Genetic testing for STK11 and colonoscopy
Carcinoids
[13][14][15][16][17]
+/- + - +
  • Well-defined single/multiple lesions
  • Round/ovoid in shape
  • Variable in size between 2-5 cm
PET scan (11C-5-hydroxytryptophan, 11C-5-HTP)

MRI

Ki-67 index

  • Solid/spongy nests of cells accentuated by neatly outlined luminal spaces
Biopsy and histopathological analysis
Diseases Bowel frequency Blood in stool Abdominal pain Tenesmus Other symptoms Anemia Colonoscopy CT scan Other diagnostic study Histopathology Gold standard
Juvenile Polyposis Coli[18][19][20][21][22] + + - + Barium study

Stool DNA test

Diagnose if any of the following positive:

Diagnostic criteria fulfilment
Gastrointestinal Stromal Tumors (GIST)[23][24][25][26][27] - +/- - - +/- Benign

Malignant GIST with metastasis:

Endoscopic ultrasonography

Benign:

Malignant GIST:

Endoscopic ultrasound

biopsy and histopathological analysis

Hamartoma[30] + + +
  • N/A
-
  • Large polypoid mass
Biopsy Biopsy
Diseases Bowel frequency Blood in stool Abdominal pain Tenesmus Other symptoms Anemia Colonoscopy CT scan Other diagnostic study Histopathology Gold standard
Colorectal Lymphoma[31][32] - +/- + -
  • Weight loss
+
  • Polypoid or ulcerated mass, intramural lesion, aphthous ulcer, stricture, extraluminal mass, or diffuse, multiple polypoid lesions
Double-contrast enema

Biopsy

Biopsy
Kaposi's sarcoma[33] + + - +
  • N/A
Serology

Biopsy

Biopsy
Arteriovenous malformation[34] - + - -
  • N/A
+
  • Bright red, flat lesions
  • Rarely, polypoid
  • N/A
  • N/A
Accidental finding
Diseases Bowel frequency Blood in stool Abdominal pain Tenesmus Other symptoms Anemia Colonoscopy CT scan Other diagnostic study Histopathology Gold standard
Diverticular diseases[35][36][37] ↑ or ↓ +/- +

RLQ

- -
  • Not recommended
Barium enema
  • Circumferential narrowing
  • Spiculated contour
  • Tapered margins
  • N/A
CT scan
Hemorrhoids[38] + + -
  • Perianal Itching
  • Pain with defecation
  • Painful-hard lump in anus
+ Anoscopy
  • Protruding mass from the anus
  • N/A
DRE
  • N/A
Clinical
Anal fissure[39] - + + - +/- Anoscopy
  • Anal wall laceration
  • N/A
  • N/A
  • N/A
Clinical
Diseases Bowel frequency Blood in stool Abdominal pain Tenesmus Other symptoms Anemia Colonoscopy CT scan Other diagnostic study Histopathology Gold standard
Infectious colitis[40] + + - -
  • N/A
Stool analysis

Stool cultures

  • N/A
Stool culture
Ulcerative colitis[41]V + +

LLQ

+ +
  • N/A
  • N/A
Endoscopic biopsy
Crohn's disease[41] + +

RLQ

+ +
  • N/A
  • N/A
Endoscopic biopsy
Irritable bowel syndrome[42] ↑ ↓ + + + -
  • Not recommended
  • N/A
Diagnosis of exclusion
  • N/A
Clinical diagnosis (Rome criteria)
Diseases Bowel frequency Blood in stool Abdominal pain Tenesmus Other symptoms Anemia Colonoscopy CT scan Other diagnostic study Histopathology Gold standard
Appendicitis[43] - +

RLQ

- -
  • N/A

Ultrasound

  • Aperistaltic, noncompressible, dilated appendix (>6 mm)
  • Appendicolith
  • Echogenic prominent pericaecal fat
  • Periappendiceal fluid collection
  • N/A
CT scan
Strangulated hernia - +

RLQ

- -
  • N/A
Ultrasound:
  • N/A
Ultrasound
Bowel endometriosis[44] ↑ or ↓ + +

Pelvic

+ +
  • N/A
  • N/A
Transvaginal ultrasound
  • Heterogeneous, hypoechoic, spiculated mass

T1-weighted or fat-suppression T1-weighted MRIs

  • N/A
Transvaginal ultrasound
ABBREVIATIONS:N/A: Not available , N/V: Nausea/vomiting, M/C: Most common, DRE: Digital rectal exam, RLQ: Right lower quadrant, LLQ: Left lower quadrant

References

  1. Laurell H, Hansson LE, Gunnarsson U (2007). "Acute diverticulitis--clinical presentation and differential diagnostics". Colorectal Dis. 9 (6): 496–501, discussion 501-2. doi:10.1111/j.1463-1318.2006.01162.x. PMID 17573742.
  2. Hardin, M. Acute Appendicitis: Review and Update. Am Fam Physician".1999, Nov 1;60(7):2027-2034
  3. Hanauer SB (1996). "Inflammatory bowel disease". N Engl J Med. 334 (13): 841–8. doi:10.1056/NEJM199603283341307. PMID 8596552.
  4. Cystitis-acute. MedlinePlus.https://www.nlm.nih.gov/medlineplus/ency/article/000526.htm Accessed on February 9, 2016
  5. Prostatitis - bacterial. NLM Medline Plus 2016. https://www.nlm.nih.gov/medlineplus/ency/article/000519.htm. Accessed on March 2, 2016
  6. Ford GW, Decker CF (2016). "Pelvic inflammatory disease". Dis Mon. 62 (8): 301–5. doi:10.1016/j.disamonth.2016.03.015. PMID 27107781.
  7. Secco GB, Fardelli R, Campora E, Lapertosa G, Gentile R, Zoli S, Prior C (1994). "Primary mucinous adenocarcinomas and signet-ring cell carcinomas of colon and rectum". Oncology. 51 (1): 30–4. doi:10.1159/000227306. PMID 8265100.
  8. Zhong ME, Niu BZ, Ji WY, Wu B (June 2016). "Laparoscopic restorative proctocolectomy with ileal pouch-anal anastomosis for Peutz-Jeghers syndrome with synchronous rectal cancer". World J. Gastroenterol. 22 (22): 5293–6. doi:10.3748/wjg.v22.i22.5293. PMID 27298573.
  9. Kopacova, Marcela; Tacheci, Ilja; Rejchrt, Stanislav; Bures, Jan (2009). "Peutz-Jeghers syndrome: Diagnostic and therapeuticapproach". World Journal of Gastroenterology. 15 (43): 5397. doi:10.3748/wjg.15.5397. ISSN 1007-9327.
  10. Giardiello, F; Trimbath, J (2006). "Peutz-Jeghers Syndrome and Management Recommendations". Clinical Gastroenterology and Hepatology. 4 (4): 408–415. doi:10.1016/j.cgh.2005.11.005. ISSN 1542-3565.
  11. Beggs, A. D.; Latchford, A. R.; Vasen, H. F. A.; Moslein, G.; Alonso, A.; Aretz, S.; Bertario, L.; Blanco, I.; Bulow, S.; Burn, J.; Capella, G.; Colas, C.; Friedl, W.; Moller, P.; Hes, F. J.; Jarvinen, H.; Mecklin, J.-P.; Nagengast, F. M.; Parc, Y.; Phillips, R. K. S.; Hyer, W.; Ponz de Leon, M.; Renkonen-Sinisalo, L.; Sampson, J. R.; Stormorken, A.; Tejpar, S.; Thomas, H. J. W.; Wijnen, J. T.; Clark, S. K.; Hodgson, S. V. (2010). "Peutz-Jeghers syndrome: a systematic review and recommendations for management". Gut. 59 (7): 975–986. doi:10.1136/gut.2009.198499. ISSN 0017-5749.
  12. Kopacova, Marcela; Tacheci, Ilja; Rejchrt, Stanislav; Bures, Jan (2009). "Peutz-Jeghers syndrome: Diagnostic and therapeuticapproach". World Journal of Gastroenterology. 15 (43): 5397. doi:10.3748/wjg.15.5397. ISSN 1007-9327.
  13. Chung TP, Hunt SR (May 2006). "Carcinoid and neuroendocrine tumors of the colon and rectum". Clin Colon Rectal Surg. 19 (2): 45–8. doi:10.1055/s-2006-942343. PMC 2780103. PMID 20011309.
  14. Diagnostics: Biochemical Markers, Imaging, and Approach. National cancer institute. http://www.cancer.gov/types/gi-carcinoid-tumors/hp/gi-carcinoid-treatment-pdq
  15. Rindi G, Falconi M, Klersy C, Albarello L, Boninsegna L, Buchler MW, Capella C, Caplin M, Couvelard A, Doglioni C, Delle Fave G, Fischer L, Fusai G, de Herder WW, Jann H, Komminoth P, de Krijger RR, La Rosa S, Luong TV, Pape U, Perren A, Ruszniewski P, Scarpa A, Schmitt A, Solcia E, Wiedenmann B (May 2012). "TNM staging of neoplasms of the endocrine pancreas: results from a large international cohort study". J. Natl. Cancer Inst. 104 (10): 764–77. doi:10.1093/jnci/djs208. PMID 22525418.
  16. Fang C, Wang W, Zhang Y, Feng X, Sun J, Zeng Y, Chen Y, Li Y, Chen M, Zhou Z, Chen J (June 2017). "Clinicopathologic characteristics and prognosis of gastroenteropancreatic neuroendocrine neoplasms: a multicenter study in South China". Chin J Cancer. 36 (1): 51. doi:10.1186/s40880-017-0218-3. PMC 5480192. PMID 28637502.
  17. Signs and symptoms of carcinoid syndrome. National Cancer Institute. http://www.cancer.gov/types/gi-carcinoid-tumors/patient/gi-carcinoid-treatment-pdq
  18. Grotsky HW, Rickert RR, Smith WD, Newsome JF (March 1982). "Familial juvenile polyposis coli. A clinical and pathologic study of a large kindred". Gastroenterology. 82 (3): 494–501. PMID 7054044.
  19. Brosens LA, Langeveld D, van Hattem WA, Giardiello FM, Offerhaus GJ (November 2011). "Juvenile polyposis syndrome". World J. Gastroenterol. 17 (44): 4839–44. doi:10.3748/wjg.v17.i44.4839. PMC 3235625. PMID 22171123.
  20. Latchford AR, Neale K, Phillips RK, Clark SK (October 2012). "Juvenile polyposis syndrome: a study of genotype, phenotype, and long-term outcome". Dis. Colon Rectum. 55 (10): 1038–43. doi:10.1097/DCR.0b013e31826278b3. PMID 22965402.
  21. Latchford AR, Neale K, Phillips RK, Clark SK (October 2012). "Juvenile polyposis syndrome: a study of genotype, phenotype, and long-term outcome". Dis. Colon Rectum. 55 (10): 1038–43. doi:10.1097/DCR.0b013e31826278b3. PMID 22965402.
  22. Latchford AR, Neale K, Phillips RK, Clark SK (October 2012). "Juvenile polyposis syndrome: a study of genotype, phenotype, and long-term outcome". Dis. Colon Rectum. 55 (10): 1038–43. doi:10.1097/DCR.0b013e31826278b3. PMID 22965402.
  23. Niazi AK, Kaley K, Saif MW (May 2014). "Gastrointestinal stromal tumor of colon: a case report and review of literature". Anticancer Res. 34 (5): 2547–50. PMID 24778074.
  24. Niazi AK, Kaley K, Saif MW (May 2014). "Gastrointestinal stromal tumor of colon: a case report and review of literature". Anticancer Res. 34 (5): 2547–50. PMID 24778074.
  25. Medeiros F, Corless CL, Duensing A, Hornick JL, Oliveira AM, Heinrich MC, Fletcher JA, Fletcher CD (July 2004). "KIT-negative gastrointestinal stromal tumors: proof of concept and therapeutic implications". Am. J. Surg. Pathol. 28 (7): 889–94. PMID 15223958.
  26. Kamiyama Y, Aihara R, Nakabayashi T, Mochiki E, Asao T, Kuwano H, Oriuchi N, Endo K (November 2005). "18F-fluorodeoxyglucose positron emission tomography: useful technique for predicting malignant potential of gastrointestinal stromal tumors". World J Surg. 29 (11): 1429–35. doi:10.1007/s00268-005-0045-6. PMID 16222452.
  27. Miettinen M, Sobin LH, Lasota J (January 2005). "Gastrointestinal stromal tumors of the stomach: a clinicopathologic, immunohistochemical, and molecular genetic study of 1765 cases with long-term follow-up". Am. J. Surg. Pathol. 29 (1): 52–68. PMID 15613856.
  28. Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, Miettinen M, O'Leary TJ, Remotti H, Rubin BP, Shmookler B, Sobin LH, Weiss SW (April 2002). "Diagnosis of gastrointestinal stromal tumors: a consensus approach". Int. J. Surg. Pathol. 10 (2): 81–9. doi:10.1177/106689690201000201. PMID 12075401.
  29. Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, Miettinen M, O'Leary TJ, Remotti H, Rubin BP, Shmookler B, Sobin LH, Weiss SW (April 2002). "Diagnosis of gastrointestinal stromal tumors: a consensus approach". Int. J. Surg. Pathol. 10 (2): 81–9. doi:10.1177/106689690201000201. PMID 12075401.
  30. Cauchin E, Touchefeu Y, Matysiak-Budnik T (September 2015). "Hamartomatous Tumors in the Gastrointestinal Tract". Gastrointest Tumors. 2 (2): 65–74. doi:10.1159/000437175. PMC 4668787. PMID 26672891.
  31. Quayle FJ, Lowney JK (May 2006). "Colorectal lymphoma". Clin Colon Rectal Surg. 19 (2): 49–53. doi:10.1055/s-2006-942344. PMC 2780105. PMID 20011310.
  32. Quayle, Frank; Lowney, Jennifer (2006). "Colorectal Lymphoma". Clinics in Colon and Rectal Surgery. 19 (2): 049–053. doi:10.1055/s-2006-942344. ISSN 1531-0043.
  33. Arora M, Goldberg EM (July 2010). "Kaposi sarcoma involving the gastrointestinal tract". Gastroenterol Hepatol (N Y). 6 (7): 459–62. PMC 2933764. PMID 20827371.
  34. Lee HH, Kwon HM, Gil S, Kim YS, Cho M, Seo KJ, Chae HS, Cho YS (2017). "Endoscopic resection of asymptomatic, colonic, polypoid arteriovenous malformations: Two case reports and a literature review". Saudi J Gastroenterol. 23 (1): 67–70. doi:10.4103/1319-3767.199111. PMC 5329980. PMID 28139503.
  35. Shen SH, Chen JD, Tiu CM, Chou YH, Chiang JH, Chang CY, Lee CH (September 2005). "Differentiating colonic diverticulitis from colon cancer: the value of computed tomography in the emergency setting". J Chin Med Assoc. 68 (9): 411–8. doi:10.1016/S1726-4901(09)70156-X. PMID 16187597.
  36. Shen, Shu-Huei; Chen, Jen-Dar; Tiu, Chui-Mei; Chou, Yi-Hong; Chiang, Jen-Huei; Chang, Cheng-Yen; Lee, Chen-Hsen (2005). "Differentiating Colonic Diverticulitis from Colon Cancer: The Value of Computed Tomography in the Emergency Setting". Journal of the Chinese Medical Association. 68 (9): 411–418. doi:10.1016/S1726-4901(09)70156-X. ISSN 1726-4901.
  37. Sheiman, Laura; Levine, Marc S.; Levin, Alicia A.; Hogan, Jonathan; Rubesin, Stephen E.; Furth, Emma E.; Laufer, Igor (2008). "Chronic Diverticulitis: Clinical, Radiographic, and Pathologic Findings". American Journal of Roentgenology. 191 (2): 522–528. doi:10.2214/AJR.07.3597. ISSN 0361-803X.
  38. Jacobs, Danny; Solomon, Caren G. (2014). "Hemorrhoids". New England Journal of Medicine. 371 (10): 944–951. doi:10.1056/NEJMcp1204188. ISSN 0028-4793.
  39. Schlichtemeier S, Engel A (2016). "Anal fissure". Aust Prescr. 39 (1): 14–7. doi:10.18773/austprescr.2016.007. PMC 4816871. PMID 27041801.
  40. DuPont HL (January 2012). "Approach to the patient with infectious colitis". Curr. Opin. Gastroenterol. 28 (1): 39–46. doi:10.1097/MOG.0b013e32834d3208. PMID 22080825.
  41. 41.0 41.1 Fakhoury M, Negrulj R, Mooranian A, Al-Salami H (2014). "Inflammatory bowel disease: clinical aspects and treatments". J Inflamm Res. 7: 113–20. doi:10.2147/JIR.S65979. PMC 4106026. PMID 25075198.
  42. Iwańczak B, Iwańczak F (August 2017). "[Functional gastrointestinal disorders in children and adolescents. The Rome IV criteria]". Pol. Merkur. Lekarski (in Polish). 43 (254): 75–82. PMID 28875974.
  43. Choi D, Park H, Lee YR, Kook SH, Kim SK, Kwag HJ, Chung EC (2003). "The most useful findings for diagnosing acute appendicitis on contrast-enhanced helical CT". Acta Radiol. 44 (6): 574–82. PMID 14616200.
  44. Wolthuis AM, Meuleman C, Tomassetti C, D'Hooghe T, de Buck van Overstraeten A, D'Hoore A (November 2014). "Bowel endometriosis: colorectal surgeon's perspective in a multidisciplinary surgical team". World J. Gastroenterol. 20 (42): 15616–23. doi:10.3748/wjg.v20.i42.15616. PMC 4229526. PMID 25400445.


Template:WikiDoc Sources