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* ESR mildly or moderately increased  
* ESR mildly or moderately increased  
* C-reactive protein elevated
* C-reactive protein elevated
==References==
{{reflist|2}}

Revision as of 18:13, 13 August 2015

Differential Diagnosis

The following conditions must be considered in the differential diagnosis of Hodgkin's lymphoma: DDx [1][2][3][4][5][6][7]
  • Sarcoidosis DDx
  • Lymphocytic lymphoma DDx
  • Miliary tuberculosis DDx
  • Infectious mononucleosis DDx
  • Thoracic aortic aneurysm DDx
  • Substernal goiter DDx
  • Thymoma DDx
  • Actinomycosis DDx
  • Chronic lymphocytic leukemia DDx
  • Superior vena cava syndrome DDx
  • Unicentric Castleman disease DDx
  • Adult Still disease DDx
  • Small cell lung carcinoma DDx
  • Malignant histiocytosis DDx


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Mahshid Mir, M.D. [2]

Differential Diagnosis
DDx Alphabetic Order
A B
C D
E F
G H
I J
K L
M N
O P
Q R
S T
U V
W X
Y Z


Template:WikiDoc Sources

Clinical manifestations
  • mental nerve neuropathy
  • alcohol intolerance
  • dermatitis, exfoliative
  • epitrochlear lymph node enlargement
  • inguinal lymph node enlargement
  • hepatomegaly
  • liver mass
  • superior vena cava obstruction
  • inferior vena cava obstruction
  • femoral lymph node enlargement
  • popliteal lymph node enlargement
  • Pemberton sign positive
  • fever, Pel-Ebstein
  • ascites, chylous
  • axillary lymph node enlargement
  • erythema multiforme
  • erythema nodosum
  • hepatosplenomegaly
  • mesenteric lymph node enlargement
  • paraplegia
  • pruritus
  • spinal cord compression
  • spleen enlargement
  • urinary tract obstruction
  • generalized diffuse lymph node enlargement
  • airway compression or obstruction
  • cryptococcosis
  • bone pain
  • cervical lymph node enlargement
  • fever, recurrent
  • recurrent infection
  • lymph node, fixed
  • neck mass
  • night sweats
  • anergy
  • supraclavicular lymph node enlargement
  • sweating increase
  • fever unknown origin
  • fever, remittent
  • painless lymphadenopathy
  • regional lymph node enlargement
Laboratory abnormalities
  • nucleated red cells
  • hypogammaglobulinemia
  • pancytopenia
  • lymphocytes decreased
  • granulomas on biopsy
Radiographic features
  • retroperitoneal lymph node enlargement
  • abdominal ultrasound, biliary tract dilatation
  • bone lesion
  • chest xray mediastinal mass, adenopathy, or widening
  • chest xray mediastinal mass middle
  • mediastinal lymph node enlargement
  • Anterior mediastinal mass on chest radiograph
  • gallium scan, increased uptake, abdomen
  • ivory vertebra
  • gallium scan increased uptake, mediastinum



Editor-In-Chief: C. Michael Gibson, M.S., M.D. [3] Mahshid Mir, M.D. [4]

Differential Diagnosis
DDx Alphabetic Order
A B
C D
E F
G H
I J
K L
M N
O P
Q R
S T
U V
W X
Y Z


Template:WikiDoc Sources

Clinical manifestations
Laboratory abnormalities
Radiographic features


Evidence of "SARCOIDOSIS" (COMMON)

The following clinical manifestations (if present) would support this disease:

  • corneal deposit
  • corneal opacity
  • parotid gland swelling
  • polyneuropathy
  • cranial nerve paralysis
  • airway compression or obstruction
  • retinal granuloma
  • erythema nodosum
  • uveitis
  • ankle pain
  • facial paralysis
  • salivary gland swelling
  • splenomegaly, massive
  • cryptococcosis
  • generalized rash, papules (elevated, <0.5cm)
  • iridocyclitis
  • iritis
  • cough, dry
  • night sweats
  • spleen enlargement
  • uveitis, bilateral
  • generalized diffuse lymph node enlargement
  • polyarthritis

The following lab data (if present) would be useful in establishing the presence of the disease:

  • heart conduction abnormality, electrocardiographic
  • atrioventricular block
  • hypercalcemia
  • retroperitoneal lymph node enlargement
  • pleural effusion, lymphocytes increased
  • CXR lung cyst
  • lymphocytes decreased
  • chest xray interstitial infiltrate ( incl. reticulonodular )
  • hypercalciuria
  • alkaline phosphatase, mild-moderate elevation
  • gallium scan increased uptake, mediastinum
  • gallium scan increased uptake, lungs
  • PFT's: restrictive defect
  • PFT's: diffusion capacity decreased
  • mediastinal lymph node enlargement
  • bone marrow granulomas
  • serum angiotensin-converting enzyme elevated
  • vitamin D, 1,25-dihydroxy, increased
  • chest xray mediastinal mass, adenopathy, or widening
  • granulomas on biopsy
  • chest xray hilar lymph node enlargement

Evidence of "LYMPHOCYTIC LYMPHOMA" (COMMON)

The following clinical manifestations (if present) would support this disease:

  • mental nerve neuropathy
  • dermatitis, exfoliative
  • extremity paralysis, lower
  • gout
  • esophageal candidiasis
  • abdominal mass
  • biliary tract obstruction
  • breast mass
  • epitrochlear lymph node enlargement
  • erythema multiforme
  • erythema nodosum
  • esophageal obstruction
  • facial edema
  • gastric obstruction
  • thyroid nodule
  • hepatosplenomegaly
  • intestinal obstruction
  • intussusception
  • liver mass
  • mesenteric lymph node enlargement
  • mucous membrane bleeding
  • night sweats
  • paraplegia
  • pruritus
  • anergy
  • spinal cord compression
  • stool clay color
  • stool color yellow
  • superior vena cava obstruction
  • supraclavicular lymph node enlargement
  • testicular mass
  • urinary tract obstruction
  • inferior vena cava obstruction
  • generalized diffuse lymph node enlargement
  • splenomegaly, massive
  • femoral lymph node enlargement
  • popliteal lymph node enlargement
  • airway compression or obstruction
  • cryptococcosis
  • recurrent infection
  • lymph node, fixed
  • neck mass
  • spleen enlargement
  • fever unknown origin
  • regional lymph node enlargement
  • painless lymphadenopathy
  • cancer
  • lymphoma
  • non-Hodgkin lymphoma

The following lab data (if present) would be useful in establishing the presence of the disease:

  • IVP bladder mass or abnormal shape
  • hypercalcemia, extreme (>14 mg/dl)
  • bone destruction
  • kidney mass
  • mediastinal lymph node enlargement
  • prolonged bleeding time
  • ESR markedly increased
  • retroperitoneal lymph node enlargement
  • hypogammaglobulinemia
  • bone lesion
  • pancytopenia
  • lymphocytes decreased
  • chest xray mediastinal mass, adenopathy, or widening
  • chest xray mediastinal mass anterior
  • pleural effusion, exudate
  • bone marrow plasma cells increased
  • cryoglobulinemia
  • abdominal ultrasound, biliary tract dilatation
  • pleural effusion, lymphocytes increased
  • pleural effusion, chylous
  • malignant ascites
  • gallium scan increased uptake, mediastinum
  • gallium scan, increased uptake, abdomen
  • vitamin D, 1,25-dihydroxy, increased


The following clinical manifestations (if present) would support this disease:

  • prison inmate
  • retinal granuloma
  • erythema nodosum
  • Haiti
  • immunosuppressive therapy
  • weight loss, severe
  • corticosteroid use
  • chest pain, pleuritic
  • dyspnea, progressive
  • fever unknown origin
  • retinitis
  • tuberculosis exposure

The following lab data (if present) would be useful in establishing the presence of the disease:

  • pancytopenia
  • PPD positive
  • nucleated red cells
  • gallium scan, increased uptake, abdomen
  • abdominal CT: multiple hypodense liver lesions
  • bone marrow granulomas
  • AFB smear positive
  • chest xray multiple pulmonary nodules, non-calcified
  • granulomas on biopsy

Evidence of "INFECTIOUS MONONUCLEOSIS" (COMMON) The following clinical manifestations (if present) would support this disease:

  • optic neuritis
  • epitrochlear lymph node enlargement
  • periorbital edema
  • pharyngeal petechia
  • spleen enlargement
  • spleen palpable
  • tonsillitis
  • abdominal tenderness, left upper quadrant
  • axillary lymph node enlargement
  • inguinal lymph node enlargement
  • mesenteric lymph node enlargement
  • pharyngeal exudate
  • pharyngeal erythema
  • spleen tenderness
  • tonsillar exudate
  • generalized diffuse lymph node enlargement
  • cervical lymph node enlargement
  • pharyngeal swelling
  • sore throat

The following lab data (if present) would be useful in establishing the presence of the disease:

  • SGPT (ALT), marked elevation
  • SGPT (ALT), elevated
  • lymphocytes increased
  • atypical lymphocytes increased
  • heterophile antibody positive
  • monocytes, increased
  • Epstein-Barr virus titre positive



Evidence of "THORACIC AORTIC ANEURYSM" (RARE)

The following clinical manifestations (if present) would support this disease:

  • cocaine use
  • Turner syndrome
  • Pemberton sign positive
  • marfan syndrome
  • aortic valve regurgitation
  • superior vena cava obstruction
  • aortic dilation, ascending

The following lab data (if present) would be useful in establishing the presence of the disease:

  • chest xray mediastinal mass middle
  • chest xray mediastinal mass posterior
  • mediastinal widening
  • chest xray aorta prominent or enlarged
  • chest xray mediastinal mass anterior
  • chest xray mediastinal mass, adenopathy, or widening


Evidence of "SUBSTERNAL GOITER" (RARE)

The following clinical manifestations (if present) would support this disease:

  • upper extremity edema
  • chest mass
  • neck mass
  • thyroid enlargement
  • tracheal compression
  • Pemberton sign positive

The following lab data (if present) would be useful in establishing the presence of the disease:

  • TSH elevated
  • chest xray mediastinal mass, adenopathy, or widening
  • chest xray mediastinal mass anterior

Evidence of "THYMOMA" (RARE)

The following clinical manifestations (if present) would support this disease:

  • bulbar palsy
  • facial candida infection
  • facial cyanosis
  • jugular venous distention
  • mouth candida infection
  • superior vena cava obstruction
  • diplopia
  • Pemberton sign positive

The following lab data (if present) would be useful in establishing the presence of the disease:

  • pancytopenia
  • antistriational antibodies
  • chest xray mediastinal mass, adenopathy, or widening
  • chest xray mediastinal mass anterior



Evidence of "ACTINOMYCOSIS" (RARE) The following clinical manifestations (if present) would support this disease:

  • tongue mass
  • trismus
  • pericardial constriction
  • pharyngeal swelling
  • pharyngeal tenderness
  • abdominal fistula
  • bronchial fistula
  • empyema
  • lung abscess
  • abdominal mass, right lower quadrant
  • chest wall suppuration
  • gingival fistula
  • chest wall fistula
  • gingival swelling
  • gingival tenderness
  • jaw induration
  • mandibular swelling

The following lab data (if present) would be useful in establishing the presence of the disease:

  • echocardiogram: intracardiac mass
  • hepatic cyst(s)
  • mediastinal lymph node enlargement
  • chest xray mediastinal mass, adenopathy, or widening
  • Gram stain: branching Gram-positive bacilli
  • sulfur granule


Evidence of "CHRONIC LYMPHOCYTIC LEUKEMIA" (RARE)

The following clinical manifestations (if present) would support this disease:

  • skin infiltration
  • sternal tenderness
  • lymph node firmness

The following lab data (if present) would be useful in establishing the presence of the disease:

  • hemolysis
  • mediastinal lymph node enlargement
  • prolonged bleeding time
  • chest xray mediastinal mass, adenopathy, or widening
  • monoclonal gammopathy
  • cryoglobulinemia
  • leukocytes, marked increase
  • flow cytometry: clonal B-lymphocytes
  • lymphocytes increased

The following findings (if present) would make this disease less likely:

  • left shift
  • metamyelocytes increased

Evidence of "SUPERIOR VENA CAVA SYNDROME" (RARE - Urgent action required) The following clinical manifestations (if present) would support this disease:

  • stridor
  • facial erythema
  • forehead vein distention
  • lymphoma
  • tracheal displacement
  • chest vein distention
  • facial cyanosis
  • collateral circulation increase
  • conjunctival edema
  • conjunctival vein distention
  • upper extremity edema
  • upper extremity erythema
  • head edema
  • jugular venous distention with inspiration
  • lung tumor
  • extremity cyanosis
  • upper extremity vein distention
  • facial edema
  • neck edema
  • jugular venous distention
  • lung cancer
  • upper extremity cyanosis
  • facial vein distention
  • superior vena cava obstruction

The following lab data (if present) would be useful in establishing the presence of the disease:

  • mediastinal lymph node enlargement
  • chest xray pulmonary nodule (< 4 cm), non-calcified
  • chest xray mediastinal mass, adenopathy, or widening

The following findings (if present) would exclude this disease:

  • hepatojugular reflux

Evidence of "UNICENTRIC CASTLEMAN DISEASE" (RARE)

  • The following lab data (if present) would be useful in establishing the presence of the disease:
  • mediastinal lymph node enlargement
  • chest xray mediastinal mass, adenopathy, or widening

Evidence of "ADULT STILL DISEASE" (RARE)

The following clinical manifestations (if present) would support this disease:

  • ankylosis
  • hepatosplenomegaly
  • weight loss, severe
  • fever, recurrent
  • night sweats
  • wrist pain
  • generalized diffuse lymph node enlargement
  • fever unknown origin
  • fever, remittent
  • fever, high grade
  • polyarticular
  • rash, evanescent

The following lab data (if present) would be useful in establishing the presence of the disease:

  • leukocytes, marked increase
  • ESR markedly increased
  • serum ferritin greatly increased

The following findings (if present) would make this disease less likely:

  • monoarticular

The following findings (if present) would exclude this disease:

  • asymptomatic

Evidence of "SMALL CELL LUNG CARCINOMA" (COMMON)

The following clinical manifestations (if present) would support this disease:

  • acanthosis nigricans
  • axillary lymph node enlargement
  • axillary lymph node pain
  • dysphagia
  • esophageal obstruction
  • heart tamponade
  • pericardial effusion
  • rib tenderness, lower
  • tracheal displacement
  • hoarseness
  • digital clubbing
  • airway compression or obstruction
  • Pemberton sign positive
  • palms, velvet
  • Horner syndrome
  • superior vena cava obstruction
  • bone pain
  • spinal cord compression
  • supraclavicular lymph node enlargement
  • intracranial metastatic tumor
  • acute symmetrical peripheral neuropathy
  • hemoptysis
  • right supraclavicular lymph node enlargement
  • tobacco smoking

The following lab data (if present) would be useful in establishing the presence of the disease:

  • bone destruction
  • chest xray unilateral diaphragm elevation
  • chest xray pulmonary nodule (< 4 cm), non-calcified
  • chest xray mediastinal mass, adenopathy, or widening
  • pleural effusion
  • pleural effusion, bloody
  • chest xray pulmonary mass (>= 4 cm), non-calcified
  • hyponatremia
  • bone marrow tumor cells
  • serum calcitonin, increased
  • chest xray hilar lymph node enlargement

The following findings (if present) would make this disease less likely:

  • chest xray normal
  • chest CT (contrast enhanced) normal

Evidence of "MALIGNANT HISTIOCYTOSIS" (RARE)

The following clinical manifestations (if present) would support this disease:

  • tendon xanthoma
  • xanthoma
  • tuberous xanthoma
  • planar xanthoma
  • palmar planar xanthoma
  • hepatosplenomegaly
  • spleen enlargement
  • panniculitis
  • generalized diffuse lymph node enlargement

The following lab data (if present) would be useful in establishing the presence of the disease:

  • ESR markedly increased
  • serum ferritin greatly increased
  • ESR mildly or moderately increased
  • C-reactive protein elevated

References

  1. ↑ Ferri, Fred (2011). Ferri's differential diagnosis: a practical guide to the differential diagnosis of symptoms, signs, and clinical disorders. Philadelphia, PA: Elsevier/Mosby. ISBN 978-0323076999.
  2. ↑ Siegenthaler, Walter (2007). Differential diagnosis in internal medicine: from symptom to diagnosis. Stuttgart New York: Thieme. ISBN 978-1588905512.
  3. ↑ Mesko, Dusan (2002). Differential diagnosis by laboratory medicine: a quick reference for physicians. Berlin New York: Springer-Verlag. ISBN 978-3540430575.
  4. ↑ Reeder and Felson's gamuts in radiology: comprehensive lists of roentgen differential diagnosis. Place of publication not identified: Springer. 2014. ISBN 978-1475781229.
  5. ↑ Burgener, Francis (2008). Differential diagnosis in conventional radiology. Stuttgart New York: Thieme. ISBN 978-1588902757.
  6. ↑ Gattuso, Paolo (2015). Differential diagnosis in surgical pathology. Philadelphia, PA: Saunders/Elsevier. ISBN 978-1455770137.
  7. ↑ "DXplain".
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