Sandbox:Mazia: Difference between revisions

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{{CMG}}; {{AE}} {{Mazia}}
{{CMG}}; {{AE}} {{Mazia}}
==Overview==
Gastrointestinal tract is the most common extranodal site involved by lymphoma with the majority being non-Hodgkin type. Although lymphoma can involve any part of the gastrointestinal tract, the most frequent sites in order of its occurrence are the stomach followed by small intestine and ileocecal region. Gastrointestinal tract lymphoma is usually secondary to the widespread nodal diseases and primary gastrointestinal tract lymphoma is relatively rare. Gastrointestinal lymphomas are usually not clinically specific and indistinguishable from other benign and malignant conditions. Diffuse large B-cell lymphoma is the most common pathological type of gastrointestinal lymphoma in essentially all sites of the gastrointestinal tract, although recently the frequency of other forms has also increased in certain regions of the world. Although some radiological features such as bulky lymph nodes and maintenance of fat plane are more suggestive of lymphoma, they are not specific, thus mandating histopathological analysis for its definitive diagnosis. There has been a tremendous leap in the diagnosis, staging and management of gastrointestinal lymphoma in the last two decades attributed to a better insight into its etiology and molecular aspect as well as the knowledge about its critical signaling pathways.
Diagnosis of multinodular goiter is made by measurement of  serum thyroid-stimulating hormone (TSH)  , serum Free T4 test , total thyroxine (T4) and  free triiodothyronine (T3).
 
==Laboratory Findings==
*Diagnosis of multinodular goiter is made by measurement of  serum thyroid-stimulating hormone (TSH)  , serum Free T4 test , total thyroxine (T4) and  free triiodothyronine (T3).<ref name="pmid26462967">{{cite journal |vauthors=Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F, Randolph GW, Sawka AM, Schlumberger M, Schuff KG, Sherman SI, Sosa JA, Steward DL, Tuttle RM, Wartofsky L |title=2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer |journal=Thyroid |volume=26 |issue=1 |pages=1–133 |year=2016 |pmid=26462967 |pmc=4739132 |doi=10.1089/thy.2015.0020 |url=}}</ref>
*Additional tests include:
**Serum thyroglobulin and thyroid autoantibodies to detect autoimmunity that may co-exist with goiter and lung function testing.
**Urinary iodine excretion can be measured in case of suspected iodine excess.
*Laboratory findings consistent with the diagnosis of multinodular goiter include:<ref name="pmid12588812">{{cite journal |vauthors=Hegedüs L, Bonnema SJ, Bennedbaek FN |title=Management of simple nodular goiter: current status and future perspectives |journal=Endocr. Rev. |volume=24 |issue=1 |pages=102–32 |year=2003 |pmid=12588812 |doi=10.1210/er.2002-0016 |url=}}</ref>
**TSH is usually normal or decreased.
**Free T4, and free T3 is usually Normal or elevated.
**An isolated increase in T4 is observed in:
***Hyperthyroidism induced by iodine
***Hyperthyroidism due to agents that reduce peripheral conversion of T4 to triiodothyronine (T3) like:<ref name="pmid26462967">{{cite journal |vauthors=Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F, Randolph GW, Sawka AM, Schlumberger M, Schuff KG, Sherman SI, Sosa JA, Steward DL, Tuttle RM, Wartofsky L |title=2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer |journal=Thyroid |volume=26 |issue=1 |pages=1–133 |year=2016 |pmid=26462967 |pmc=4739132 |doi=10.1089/thy.2015.0020 |url=}}</ref>
****Propranolol
****Corticosteroids
****Radiocontrast agents
****Amiodarone
**Serum thyroglobulin is usually elevated.
**Thyroid autoantibodies (TPO and Tg) usually negative.
**Some patients with multinodular goiter may have impaired inspiratory capacity lung function testing.
 
==References==
{{Reflist|2}}
 
{{WH}}
{{WS}}

Revision as of 15:39, 2 January 2018


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mazia Fatima, MBBS [2] Gastrointestinal tract is the most common extranodal site involved by lymphoma with the majority being non-Hodgkin type. Although lymphoma can involve any part of the gastrointestinal tract, the most frequent sites in order of its occurrence are the stomach followed by small intestine and ileocecal region. Gastrointestinal tract lymphoma is usually secondary to the widespread nodal diseases and primary gastrointestinal tract lymphoma is relatively rare. Gastrointestinal lymphomas are usually not clinically specific and indistinguishable from other benign and malignant conditions. Diffuse large B-cell lymphoma is the most common pathological type of gastrointestinal lymphoma in essentially all sites of the gastrointestinal tract, although recently the frequency of other forms has also increased in certain regions of the world. Although some radiological features such as bulky lymph nodes and maintenance of fat plane are more suggestive of lymphoma, they are not specific, thus mandating histopathological analysis for its definitive diagnosis. There has been a tremendous leap in the diagnosis, staging and management of gastrointestinal lymphoma in the last two decades attributed to a better insight into its etiology and molecular aspect as well as the knowledge about its critical signaling pathways.

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