Colorectal cancer differential diagnosis: Difference between revisions

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

Colorectal cancer must be differentiated from other diseases that cause lower abdominal pain and fever like appendicitis, diverticulitis, inflammatory bowel disease, cystitis, and endometritis.^[1]^[2]^[3]^[4]^[5]^[6]

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

	Symptoms					Lab Findings	Imaging			Histopathology
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					Para-clinical findings
	Bowel frequency	Blood in stool	Abdominal pain	Tenesmus	Other symptoms	Anemia	Colonoscopy	CT scan	Other diagnostic study	Histopathology
Colorectal carcinoma (Adenocarcinoma)^[7]	↑ or ↓	+	+/-	+	Weight loss Fatigue Low caliber of stools Mucus in stools	+	Polyps (villous, tubular, tubulo-villous) Ulcerating polyps Cancerous lesions	Luminal narrowing Bowel obstruction Thickening of the bowel wall Lymphadenopathy Metastases	PET scans Metastasis Barium enema Cancer or precancerous polyp	Different grades of differentiation of glandular structures Sheets or cords of malignant cells Cellular atypia and pleomorphism High mitotic rate Necrotic debris in glandular lumina Desmoplastic reaction (sign of invasion)	Biopsy, genetic testing, and histopathological analysis
Peutz-Jeghers syndrome ^[8]^[9]^[10]^[11]^[12]	↑ or ↓	+	+	-	Weight loss Fatigue Mucocutaneous hyperpigmentation Rectal prolapse	+	Multiple polyps Mucocutaneous pigmentation	Multiple polyps Intussusception Bowel obstruction	Barium enema Multiple polyps MRI Multiple hamartomatous polyps	Hamartomatous mucosal polyps with core of smooth muscle associated with mucosa Smaller polyps lack the prominent arborizing smooth muscle	Genetic testing for STK11 and colonoscopy
Carcinoids ^[13]^[14]^[15]^[16]^[17]	↑	+/-	+	-	Weight loss Weakness Flushing Wheezing Shortness of breath Palpitations Leg edema	+	Infiltrating, ulcerating or fungating lesions in the wall of colon	Well-defined single/multiple lesions Round/ovoid in shape Variable in size between 2-5 cm	PET scan (11C-5-hydroxytryptophan, 11C-5-HTP) Detects metastasis MRI Nodular mass Wall thickening Metastasis Ki-67 index	Solid/spongy nests of cells accentuated by neatly outlined luminal spaces Peripheral nuclear palisading Granular eosinophilic cytoplasm	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]	↑	+	+	-	Prolapsing polyp Intussusception Macrocephalus Hypotonia Bowel obstruction Heart or brain abnormalities Cleft palate Polydactyly Genitalia or urinary abnormalities	+	>5 juvenile polyps in the colon and rectum Multiple juvenile polyps in gastrointestinal tract	Multiple polyps in GI tract	Barium study Multiple polyps in GI tract Stool DNA test SMAD4 or BMPR1A Diagnose if any of the following positive: More than five juvenile polyps of the colorectum Multiple juvenile polyps throughout the GI tract Any number of juvenile polyps and a family history of juvenile polyposis Heterozygous pathogenic variant in SMAD4 or BMPR1A	Cystic and dilated crypts or glands with inspissated mucin and intraluminal neutrophils Lamina propria edematous with associated lymphocytes, plasma cells, eosinophils, and neutrophils Filiform, multilobed forms with increased glandular-to-stroma ratio in nonclassic or atypical polyps Areas of conventional dysplasia	Diagnostic criteria fulfilment
Gastrointestinal Stromal Tumors (GIST)^[23]^[24]^[25]^[26]^[27]	-	+/-	-	-	Asymptomatic Early satiety Bloating	+/-	Subepithelial round masses Smooth margins Normal overlying mucosa may be intact or ulcerated Bulging into gastrointestinal lumen	Benign Small, < 10 cms Homogeneous Clear boundaries intraluminal or extraluminal growth Malignant GIST with metastasis: Size > 10 cm Calcifications Irregular margins Heterogeneous and lobulated Lymphadenopathy Ulceration Extraluminal and mesenteric fat infiltration	Endoscopic ultrasonography Benign: Mucosal ulceration or bleeding Smooth submucosal mass as hypoechoic mass Malignant GIST: Heterogeneous mass >4 cm in size Irregular borders Intra/extraluminal growth Multiple cysts	Spindle cell type are eosinophilic cells arranged in the form of whorls or fascicles^[28]^[29] Epithelioid GISTs are rounded cells with oval nuclei and vesicular chromatin and appears nested On immunohistochemical staining they are positive for molecular markers CD117 antigen and KIT protein	Endoscopic ultrasound biopsy and histopathological analysis
Hamartoma^[30]	↑	+	+	+	N/A	-	Large polypoid mass	Isodense/hypodense solid masses Heterogeneous mass Presence of fat Calcification	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 colonic lamina propria, separating and entrapping the crypts The nuclei are bland and mostly uniform, occasional larger nuclei are found. The cytoplasmic borders are indistinct Involvement of mucosa but never the submucosa	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	Polypoid mass Circumferential-cavitary lesions Focal mucosal nodularity Diffuse ulcerative or nodular lesions Lymphadenopathy	Double-contrast enema Subtle mucosal changes Gross tumor morphology Biopsy	Diffuse large B-cell lymphoma: Extranodal marginal zone lymphoma (MALT) Mantle cell lymphoma Burkitt’s lymphoma Follicular lymphoma	Biopsy
Kaposi's sarcoma^[33]	↑	+	+	-	Nausea and vomiting	+	Localized purpuric lesion	N/A	Serology Antibodies against Kaposi sarcoma herpes virus (HHV-8) Biopsy	Vascular proliferation RBC and hemosiderin extravasation Lymphocytes and monocytes Premonitory sign (neovascular lesion wrapped around a pre-existing space) Intracytoplasmic PAS +ve hyaline globules	Biopsy
Arteriovenous malformation^[34]	-	+	-	-	N/A	+	Bright red, flat lesions Rarely, polypoid	N/A	N/A	Aberrant vessels with thickened, hypertrophic walls in the mucosa and the submucosa Arteries directly connected to veins without capillary beds	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	-	Fever Chills N/V	-	Not recommended	Outpouchings of the colonic wall (diverticula) Inflamed diverticula Abscess formation Intraperitoneal free air (microperforation)	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 Palpable mass, tender if thrombosed	N/A	Clinical
Anal fissure^[39]	-	+	+	-	Painful defecation Itching Irritation	+/-	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]	↑	+	+	-	Fever, chills N/V Bloating	-	Patchy or diffuse erythematous mucosa Edema, hemorrhage, with or without ulcers of mucosa	N/A	Stool analysis Leukocytosis Stool cultures	N/A	Stool culture
Ulcerative colitis^[41]V	↑	+	+ LLQ	+	Weight loss Diarrhea withmucus Urgency	+	Continuous lesions Erythema (or redness of the mucosa) and friability of the mucosa Crypts, formation of residual mucosal tissue Pseudopolyps	N/A	N/A	Mucosal and submucosal inflammation Hemorrhage or inflammatory polymorphonuclear cells aggregate in the lamina propria Distorted crypts Crypt abscess	Endoscopic biopsy
Crohn's disease^[41]	↑	+	+ RLQ	+	N/V Bowel obstruction Fever	+	Discontinuous lesions Strictures Linear ulcerations	N/A	N/A	Transmural pattern of inflammation Mucosal damage Focal infiltration of leukocytes into the epithelium Granulomas	Endoscopic biopsy
Irritable bowel syndrome^[42]	↑ ↓	+	+	+	Weight loss Straining Urgency Mucus passage Bloating	-	Not recommended	N/A	Diagnosis of exclusion Fulfilment of Rome criteria	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	-	Pain starting periumbilical before localizing to the RLQ N/V Fever Chills Loss of appetite	-	N/A	Appendiceal wall thickening (≥ 3mm) Periappendiceal fat stranding Thick lateral conal fascia and mesoappendix Extraluminal fluid Phlegmon Abscess	Ultrasound Aperistaltic, noncompressible, dilated appendix (>6 mm) Appendicolith Echogenic prominent pericaecal fat Periappendiceal fluid collection	N/A	CT scan
Strangulated hernia	↓	-	+ RLQ	-	N/V Heaviness/dull discomfort in the groin, with straining, lifting, coughing, or exercising Weakness, heaviness, burning, or aching in the groin Swelling Fever	-	N/A	Defect in the abdominal wall muscles Bowel loops within the lesion Lateral crescent sign The hernia neck superolateral to the course of the inferior epigastric vessels	Ultrasound: Hypoechoic mass suggesting dilated and edematous intestinal segment	N/A	Ultrasound
Bowel endometriosis^[44]	↑ or ↓	+	+ Pelvic	+	Dyschezia	+	N/A	N/A	Transvaginal ultrasound Heterogeneous, hypoechoic, spiculated mass T1-weighted or fat-suppression T1-weighted MRIs Contrast enhanced mass Hyperintense hemorrhagic Hyperintense cavities	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

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↑ Hardin, M. Acute Appendicitis: Review and Update. Am Fam Physician".1999, Nov 1;60(7):2027-2034
↑ Hanauer SB (1996). "Inflammatory bowel disease". N Engl J Med. 334 (13): 841–8. doi:10.1056/NEJM199603283341307. PMID 8596552.
↑ Cystitis-acute. MedlinePlus.https://www.nlm.nih.gov/medlineplus/ency/article/000526.htm Accessed on February 9, 2016
↑ Prostatitis - bacterial. NLM Medline Plus 2016. https://www.nlm.nih.gov/medlineplus/ency/article/000519.htm. Accessed on March 2, 2016
↑ Ford GW, Decker CF (2016). "Pelvic inflammatory disease". Dis Mon. 62 (8): 301–5. doi:10.1016/j.disamonth.2016.03.015. PMID 27107781.
↑ 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.
↑ 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.
↑ 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.
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↑ 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.
↑ 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.
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↑ Signs and symptoms of carcinoid syndrome. National Cancer Institute. http://www.cancer.gov/types/gi-carcinoid-tumors/patient/gi-carcinoid-treatment-pdq
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↑ 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.
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↑ ^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.
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↑ 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

[pmid17573742-1] 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

[pmid8596552-3] Hanauer SB (1996). "Inflammatory bowel disease". N Engl J Med. 334 (13): 841–8. doi:10.1056/NEJM199603283341307. PMID 8596552.

[hhh-4] Cystitis-acute. MedlinePlus.https://www.nlm.nih.gov/medlineplus/ency/article/000526.htm Accessed on February 9, 2016

[nlm-5] Prostatitis - bacterial. NLM Medline Plus 2016. https://www.nlm.nih.gov/medlineplus/ency/article/000519.htm. Accessed on March 2, 2016

[pmid27107781-6] Ford GW, Decker CF (2016). "Pelvic inflammatory disease". Dis Mon. 62 (8): 301–5. doi:10.1016/j.disamonth.2016.03.015. PMID 27107781.

[pmid8265100-7] 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.

[pmid27298573-8] 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.

[KopacovaTacheci20092-9] 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.

[GiardielloTrimbath2006-10] 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.

[BeggsLatchford2010-11] 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.

[KopacovaTacheci20093-12] 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.

[pmid20011309-13] 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.

[diagnostics-14] Diagnostics: Biochemical Markers, Imaging, and Approach. National cancer institute. http://www.cancer.gov/types/gi-carcinoid-tumors/hp/gi-carcinoid-treatment-pdq

[pmid22525418-15] 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.

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@@ Line 1: / Line 1: @@
 __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 hereditary nonpolyposis colorectal cancer (HNPCC), click [[Hereditary nonpolyposis colorectal cancer differential diagnosis|'''here''']]<br><br>
@@ Line 13: / Line 13: @@
 '''Other conditions that can be mistaken for colorectal cancer include the following:'''
 *Benign colon polyps
-*[[Ischemic colitis]]
 *[[Infectious colitis]]
 *[[Arteriovenous malformation]] ([[AVM]])
@@ Line 19: / Line 18: @@
 *[[Small intestine]] carcinomas
 *Gastrointestinal lymphoma
-*[[Ileus]]
 *[[Pregnancy]]
 *[[Appendicitis]]
@@ Line 28: / Line 26: @@
 *[[Cholecystitis]]
-{| class="wikitable"
+<small>
+<div style="width: 80%;">
+{|
+| 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;"
 ! 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="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="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'''
 |-
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
@@ Line 41: / Line 43: @@
 ! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
 |-
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Constipation/<br>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
 ! 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
@@ Line 50: / Line 53: @@
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other diagnostic study
 |-
-! colspan="11" style="background: #7d7d7d; color: #FFFFFF; text-align: center;" |Malignancy
+| 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; text-align: center;" |↑ or ↓
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[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; text-align: center;" | +
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/-
-* [[Constipation]]
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
-and/or
-* [[Diarrhea]]
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" |
-* Diffuse abdominal pain +/-
 | style="background: #F5F5F5; padding: 5px;" |
-*[[Tenesmus]]
+*[[Weight loss]]
-*Diminished caliber of stools
+*[[Fatigue]]
+*Low caliber of stools
 *[[Mucus]] in stools
-| style="background: #F5F5F5; padding: 5px;" | +
+| 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]]
+*[[Cancerous]] [[lesions]]
 | style="background: #F5F5F5; padding: 5px;" |
-*Luminal narrowing and [[bowel obstruction]]
+*Luminal narrowing
-*Circumferential thickening of the bowel wall
+*[[Bowel obstruction]]
-*[[Enlarged lymph nodes]]
+*Thickening of the bowel wall
-*Pulmonary [[metastases]]
+*[[Lymphadenopathy]]
-*Peritoneal metastases
+*[[Metastases]]
-*[[Metastases|Hepatic metastases]]
+| style="background: #F5F5F5; padding: 5px;" |'''PET scans'''
-| style="background: #F5F5F5; padding: 5px;" |
+*[[Metastasis]]
-*[[PET scan|PET scans]]: Detailed images and metastasis
+'''Barium enema'''
-*[[Barium enema]]: Cancer or a precancerous polyp
+*[[Cancer]] or [[Premalignant condition|precancerous]] [[polyp]]
-*[[Genetic testing]]: [[hereditary nonpolyposis colorectal cancer]] (HNPCC) or [[familial adenomatous polyposis]] (FAP)
-| style="background: #F5F5F5; padding: 5px;" |
-* Different grades of differentiation of glandular structures
-** Sheets or cords of malignant cells,
-**Cellular atypia, pleomorphism
-**High mitotic rate
-* Necrotic debris in glandular lumina
-* Desmoplastic reaction (sign of invasion)
-| style="background: #F5F5F5; padding: 5px;" |
-* [[Biopsy]] and [[histopathological]] analysis
-|-
-| 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;" |
-* Normal
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" |
-* No pain
-| style="background: #F5F5F5; padding: 5px;" |
-* N/A
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" |
-* Bright red, flat lesions
-* Rarely, polypoid
-| style="background: #F5F5F5; padding: 5px;" |
-* N/A
-| style="background: #F5F5F5; padding: 5px;" |
-* N/A
-| 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;" |
-* Accidental fining
-|-
-| 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;" |
-* [[Constipation]]
-and/or
-* [[Diarrhea]]
-| style="background: #F5F5F5; padding: 5px;" | +/-
-| style="background: #F5F5F5; padding: 5px;" |
-* Pain in RLQ
-| style="background: #F5F5F5; padding: 5px;" |
-* [[Fever]], [[Rigor|chills]]
-* [[Nausea and vomiting|Nausea/vomiting(N/V)]]
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" |
-* Not recommended
-| style="background: #F5F5F5; padding: 5px;" |
-* Outpouchings of the colonic wall (Diverticula)
-* Inflamed diverticula
-* Abscess formation
-* Intraperitoneal free air (microperforation)
-| style="background: #F5F5F5; padding: 5px;" |
-* Barium enema: Circumferential narrowing, spiculated contour and tapered margins
-| style="background: #F5F5F5; padding: 5px;" |
-* N/A
-| style="background: #F5F5F5; padding: 5px;" |
-* CT scan
-|-
-| 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;" |
-* Localized  pain
-| style="background: #F5F5F5; padding: 5px;" |
-* Perianal Itching
-* Pain with [[defecation]]
-* Painful, hard lump in anus
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" |
-* [[Anoscopy]]: Protruding mass from the [[anus]]
-| style="background: #F5F5F5; padding: 5px;" |
-* N/A
-| style="background: #F5F5F5; padding: 5px;" |
-* [[Digital rectal examination|DRE]]: Palpable mass, tender if [[Thrombosis|thrombosed]]
-| style="background: #F5F5F5; padding: 5px;" |
-* N/A
-| style="background: #F5F5F5; padding: 5px;" |
-* Clinical
-|-
-| 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;" |
-* Normal
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" |
-* Localized pain
-| style="background: #F5F5F5; padding: 5px;" |
-* Painful [[defecation]]
-* [[Itching]]
-* [[Irritation]]
-| style="background: #F5F5F5; padding: 5px;" | +/-
-| style="background: #F5F5F5; padding: 5px;" |
-* [[Anoscopy]]: Anal wall laceration
-| style="background: #F5F5F5; padding: 5px;" |
-* N/A
-| style="background: #F5F5F5; padding: 5px;" |
-* N/A
-| style="background: #F5F5F5; padding: 5px;" |
-* N/A
-| style="background: #F5F5F5; padding: 5px;" |
-* Clinical
-|-
-| 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;" |
-* Diffuse abdominal
-| style="background: #F5F5F5; padding: 5px;" |
-* [[Fever]], [[Rigor|chills]]
-* [[Nausea and vomiting|N/V]]
-* [[Bloating]]
-| 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;" |
-* N/A
-| style="background: #F5F5F5; padding: 5px;" |
-* [[Stool culture|Stool cultures]] in adequate [[culture media]]
-* Stool analysis: [[Leukocytosis]]
-| style="background: #F5F5F5; padding: 5px;" |
-* N/A
 | style="background: #F5F5F5; padding: 5px;" |
-* Stool culture
+* 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;" |
-* [[Constipation]]
+* [[Weight loss]]
-and/or
-* [[Diarrhea]]
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" |
-* Abdominal pain
-| style="background: #F5F5F5; padding: 5px;" |
-* [[Mucocutaneous]]   [[hyperpigmentation]] (mouth, hands, and feet)
 * [[Fatigue]]
-* [[Weight loss]]
+* [[Hyperpigmentation|Mucocutaneous   hyperpigmentation]]
 * [[Rectal prolapse]]
-| style="background: #F5F5F5; padding: 5px;" | +
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
 | style="background: #F5F5F5; padding: 5px;" |
 * [[Hamartomatous intestinal polyposis|Multiple polyps]]
-* [[mucocutaneous]] [[pigmentation]]
+* [[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;" |
-* [[Barium enema]]: Multiple [[Polyp|polyps]].
+* [[Hamartoma|Hamartomatous]] [[Polyps|mucosal polyps]] with core of [[smooth muscle]] associated with [[Mucous membrane|mucosa]]
-* [[MRI]]: Multiple [[Hamartoma|hamartomatous]] polyps
+* Smaller [[Polyp|polyps]] lack the prominent arborizing [[smooth muscle]]
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |[[Genetic testing]] for [[STK11]] and [[colonoscopy]]
-** [[Hamartoma|Hamartomatous]] [[Polyps|mucosal polyps]] with central core of branching smooth muscle associated with mucosa
-** Smaller [[Polyp|polyps]] may lack the prominent arborizing smooth muscle
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Genetic testing]] for [[STK11]]
-*[[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;" |
-* [[Diarrhea]]
+*[[Weight gain|Weight loss]]
-| style="background: #F5F5F5; padding: 5px;" | +/-
+*[[Weakness]]
-| style="background: #F5F5F5; padding: 5px;" |
-* Abdominal pain
-| style="background: #F5F5F5; padding: 5px;" |
 *[[Flushing (physiology)|Flushing]]
 *[[Wheezing]]
 *[[Shortness of breath]]
 *[[Palpitations]]
-*[[Weight gain]]
-*[[Hirsutism]]
-*[[Weakness]]
 *[[Leg edema]]
-| style="background: #F5F5F5; padding: 5px;" | +
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
-| style="background: #F5F5F5; padding: 5px;" |
-* Infiltrating, ulcerating or fungating lesions in the wall of colon
 | 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;" |
-* [[PET scan]] 11C-5-hydroxytryptophan (11C-5-HTP): Deetects metastasis
+* Well-defined single/multiple lesions
-* [[MRI]]:
+* Round/ovoid in shape
-** Nodular mass originating from the bowel wall or regional uniform bowel wall thickening with moderate intense enhancement on post gadolinium T1-weighted fat-suppressed images
+* Variable in size between 2-5 cm
-** Mesenteric metastases presents as nodular masses with [[mesenteric]] stranding
+| style="background: #F5F5F5; padding: 5px;" |'''PET scan''' (11C-5-hydroxytryptophan, 11C-5-HTP)
-** [[Liver]] metastases may show hypointense precontrast T1- and hyperintense T2-weighted images
+* Detects [[metastasis]]
-** [[Liver]] metastases are commonly hypervascular
+'''MRI'''
-* Ki-67 index
+* Nodular mass
+* Wall thickening
+* [[Metastasis]]
+'''Ki-67 index'''
 | style="background: #F5F5F5; padding: 5px;" |
-* Solid or spongy nests of cells accentuated by neatly outlined luminal spaces
+* Solid/spongy nests of cells accentuated by neatly outlined luminal spaces
 * 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: #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><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;" |
+| style="background: #F5F5F5; padding: 5px; text-align: center;" |↑
-* [[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;" | -
-* Diffuse abdominal pain
 | style="background: #F5F5F5; padding: 5px;" |
 * Prolapsing [[polyp]]
@@ Line 288: / Line 172: @@
 * [[Hypotonia]]
 * [[Intestinal obstruction|Bowel obstruction]]
-* Heart or brain abnormalities
+* [[Heart]] or [[brain]] abnormalities
-* Cleft palate
+* [[Cleft lip and palate|Cleft palate]]
-* Polydactyly
+* [[Polydactyly]]
-* Abnormalities of the genitalia or urinary tract.
+* Genitalia or urinary abnormalities
-| style="background: #F5F5F5; padding: 5px;" | +
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
 | style="background: #F5F5F5; padding: 5px;" |
 * >5 juvenile [[Polyp|polyps]] in the [[colon]] and [[rectum]]
 * Multiple [[Polyps|juvenile polyps]] in [[gastrointestinal tract]]
 | style="background: #F5F5F5; padding: 5px;" |
-* M[[Polyps|ultiple polyps]] in [[gastrointestinal tract]]
+* [[Polyp|Multiple polyps]] in [[gastrointestinal tract|GI tract]]
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |'''Barium study'''
-* Barium study: Multiple polyps in GI tract
+* Multiple polyps in [[Gastrointestinal tract|GI tract]]
-* Stool DNA test: ''SMAD4'' or ''BMPR1A''
+'''Stool DNA test'''
-* Diagnose if any of the following positive:
+* ''[[SMAD4]]'' or ''[[BMPR1A]]''
-** More than five juvenile polyps of the colorectum
+'''Diagnose if any of the following positive:'''
-** Multiple juvenile polyps throughout the GI tract
+* More than five juvenile [[Polyp|polyps]] of the colorectum
-** Any number of juvenile polyps and a family history of juvenile polyposis
+* Multiple juvenile [[Polyp|polyps]] throughout the [[Gastrointestinal tract|GI tract]]
-** Heterozygous pathogenic variant in ''SMAD4'' or ''BMPR1A''
+* Any number of juvenile [[Polyp|polyps]] and a family history of juvenile [[polyposis]]
-| style="background: #F5F5F5; padding: 5px;" |
+* [[Heterozygous]] pathogenic variant in ''[[Mothers against decapentaplegic homolog 4|SMAD4]]'' or ''[[BMPR1A]]''
-* Numerous cystic and dilated crypts or glands with inspissated mucin and intraluminal neutrophils
-* Lamina propria edematous with associated lymphocytes, plasma cells, eosinophils and neutrophils
-* Filiform, multilobated forms with increased glandular-to-stroma ratio in nonclassic or atypical polyps
-* Areas of conventional dysplasia
 | style="background: #F5F5F5; padding: 5px;" |
-* If any of the following positive:
+* [[Cyst|Cystic]] and dilated [[Crypt (anatomy)|crypts]] or [[Gland|glands]] with inspissated [[mucin]] and [[Lumen (anatomy)|intraluminal]] [[Neutrophil|neutrophils]]
-** More than five juvenile polyps of the colorectum
+* [[Lamina propria]] [[Edema|edematous]] with associated [[Lymphocyte|lymphocytes]], [[Plasma cell|plasma cells]], [[Eosinophil granulocyte|eosinophils]], and [[Neutrophil|neutrophils]]
-** Multiple juvenile polyps throughout the GI tract
+* [[Filiform papilla|Filiform]], multilobed forms with increased [[Glandular tissue|glandular]]-to-[[Stroma (animal tissue)|stroma]] ratio in nonclassic or [[Polyps|atypical polyps]]
-** Any number of juvenile polyps and a family history of juvenile polyposis
+* Areas of conventional [[dysplasia]]
-** Heterozygous pathogenic variant in ''SMAD4'' or ''BMPR1A''
+| 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><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; 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;" |
-* Normal
+* [[Asymptomatic]]
-| style="background: #F5F5F5; padding: 5px;" | +/-
+* [[Satiety|Early satiety]]
-| style="background: #F5F5F5; padding: 5px;" |
+* [[Bloating]]
-* No pain
-| style="background: #F5F5F5; padding: 5px;" |
-* Mostly [[asymptomatic]]
-* Are discovered incidentally
-* Non-specific symptoms
-* Early satiety and bloating
 | style="background: #F5F5F5; padding: 5px;" | +/-
 | style="background: #F5F5F5; padding: 5px;" |
@@ Line 335: / Line 213: @@
 * Normal overlying [[mucosa]] may be intact or [[Ulcerated lesion|ulcerated]]
 * 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;" |
-* Small GIST (< 5 cms) are [[homogeneous]] with clear boundaries and have an [[intraluminal]] pattern of growth.
+'''Endoscopic ultrasonography'''
-* Intermediate GIST (size of 5-10 cms) are [[heterogeneous]] with irregular borders and [[Intraluminal|intra]] or extra-luminal pattern of [[growth]].
-* Large GISTs (>10 cms) are [[heterogeneous]] with irregular borders and have local or distant spread
+[[Benign]]:
-* Malignant GIST with metastasis:
+* [[Mucosal]] [[ulceration]] or [[bleeding]]
-** Size greater than 10 cm
+* Smooth [[submucosal]] mass as [[hypoechoic mass]]
-** [[Calcification|Calcifications]]
+[[Malignant]] [[Gastrointestinal stromal tumor|GIST]]:
-** Irregular margins
+* [[Heterogeneous]] mass >4 cm in size
-** [[Heterogeneous]] and lobulated
+* Irregular borders
-** [[Lymphadenopathy]]
+* [[Intraluminal|Intra]]/extraluminal growth
-** [[Ulceration]]
+* Multiple [[cysts]]
-** Extraluminal and [[mesenteric]] fat infiltration
 | style="background: #F5F5F5; padding: 5px;" |
-* [[MRI]]: [[Hemorrhage]], [[necrosis]], surrounding structures and [[metastasis]].
+*[[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
-** [[Mucosal]] [[ulceration]] or [[bleeding]]
+*On [[immunohistochemical staining]] they are positive for [[Molecular marker|molecular markers]] [[CD117]] antigen and KIT protein
-** Smooth [[submucosal]] mass as hypoechoic mass
+| style="background: #F5F5F5; padding: 5px;" |[[Endoscopic ultrasound]]
-** [[Malignant]] GIST lesions present with:
+[[biopsy]] and [[Histopathological|histopathological analysis]]
-*** [[Heterogeneous]] mass >4 cm in size
-*** Irregular borders
-*** [[Intraluminal|Intra]] and extraluminal growth
-*** Multiple [[cysts]] within the main [[lesion]]
-| style="background: #F5F5F5; padding: 5px;" |
-*[[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>
-*[[Epithelioid]] [[GIST|GISTs]] are rounded cells with oval nuclei and vesicular chromatin and appears nested
-*On [[immunohistochemical staining]] they are positive for [[Molecular marker|molecular markers]] [[CD117]] antigen and KIT protein.
-| style="background: #F5F5F5; padding: 5px;" |
-* Endoscopic ultrasound with[[Biopsy]] and [[Histopathological|histopathological analysis]]
 |-
 | 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;" |
-* [[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;" | -
 | style="background: #F5F5F5; padding: 5px;" |
 * Large polypoid mass
 | style="background: #F5F5F5; padding: 5px;" |
-* Isodense or hypodense solid [[Mass|masses]]
+* Isodense/hypodense solid [[Mass|masses]]
 * [[Heterogeneous]] mass
-* Presence of [[fat]] in a well circumscribed nodule
+* Presence of [[fat]]
 * [[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;" |
-* 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: #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: #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;" |
+| style="background: #F5F5F5; padding: 5px;" text-align: center;" | -
-* Depending on location
 | style="background: #F5F5F5; padding: 5px;" |
 * Weight loss
-| style="background: #F5F5F5; padding: 5px;" | +
+| style="background: #F5F5F5; padding: 5px;" text-align: center;" | +
 | style="background: #F5F5F5; padding: 5px;" |
 * Polypoid or ulcerated mass, intramural lesion, aphthous ulcer, stricture, extraluminal mass, or diffuse, multiple polypoid lesions
 | 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;" |
 * [[Diffuse large B cell lymphoma|Diffuse large B-cell lymphoma]]:
@@ Line 417: / Line 308: @@
 * [[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;" |
+* 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;" |
-* Biopsy
+* [[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;" |
+* N/A
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
+| style="background: #F5F5F5; padding: 5px;" |
+* Bright red, flat lesions
+* Rarely, polypoid
+| style="background: #F5F5F5; padding: 5px;" |
+* N/A
 | style="background: #F5F5F5; padding: 5px;" |
-* [[Diarrhea]]
+* N/A
-| style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" |
-* Diffuse abdominal pain
+* Aberrant [[Blood vessel|vessels]] with thickened, hypertrophic walls in the [[Mucous membrane|mucosa]] and the [[submucosa]]
+* [[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;" |
-* [[Melena]]
+* [[Fever]]
+* [[Rigor|Chills]]
-* [[Hematochezia]]
-* [[Abdominal pain]]
 * [[Nausea and vomiting|N/V]]
-| style="background: #F5F5F5; padding: 5px;" | +
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
+| style="background: #F5F5F5; padding: 5px;" |
+* Not recommended
+| style="background: #F5F5F5; padding: 5px;" |
+* 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;" |
+* N/A
+| style="background: #F5F5F5; padding: 5px;" |[[Computed tomography|CT scan]]
+|-
+| 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;" |
-* Localized purpuric lesion
+* Perianal Itching
+* Pain with [[defecation]]
+* 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;" |
 * N/A
+| style="background: #F5F5F5; padding: 5px;" |'''DRE'''
+* [[Palpation|Palpable]] mass, tender if [[Thrombosis|thrombosed]]
 | style="background: #F5F5F5; padding: 5px;" |
-* Electrophoresis: [[antibodies]] against Kaposi sarcoma herpes virus  (HHV-8)
+* N/A
-* 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
+| style="background: #F5F5F5; padding: 5px;" |Clinical
+|-
+| 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; 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;" |
-* [[Vascular]] proliferation
+* [[Dyschezia|Painful defecation]]
-* Red blood cell and [[hemosiderin]] extravasation
+* [[Itching]]
-* [[Lymphocyte|Lymphocytes]] and [[Monocyte|monocytes]]
+* [[Irritation]]
-* Premonitory sign (a neovascular lesion wrapped around a pre-existing space)
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/-
-* Intracytoplasmic PAS +ve [[hyaline]] globules
+| style="background: #F5F5F5; padding: 5px;" |[[Anoscopy]]
+* Anal wall laceration
+| style="background: #F5F5F5; padding: 5px;" |
+* N/A
+| style="background: #F5F5F5; padding: 5px;" |
+* N/A
 | style="background: #F5F5F5; padding: 5px;" |
-* Biopsy
+* N/A
+| style="background: #F5F5F5; padding: 5px;" |Clinical
 |-
-| 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: #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;" |
+* [[Fever]], [[Rigor|chills]]
+* [[Nausea and vomiting|N/V]]
+* [[Bloating]]
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
+| style="background: #F5F5F5; padding: 5px;" |
+* Patchy or diffuse [[Erythematous|erythematous mucosa]]
+* [[Edema]], [[hemorrhage]], with or without [[ulcers]] of [[Mucous membrane|mucosa]]
 | style="background: #F5F5F5; padding: 5px;" |
-* [[Diarrhea]]
+* N/A
-| style="background: #F5F5F5; padding: 5px;" |<big>+</big>
+| style="background: #F5F5F5; padding: 5px;" |'''Stool analysis'''
+* [[Leukocytosis]]
+'''Stool cultures'''
 | style="background: #F5F5F5; padding: 5px;" |
-* Lain in LQ<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
+| 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;" |
-* [[Diarrhea]] mixed with blood and [[mucus]]
+* [[Weight loss|Weight loss]]
-* W[[Weight loss|eight loss]]
+* [[Diarrhea]] with[[mucus]]
 * Urgency
-* [[Tenesmus]]
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
-| 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>
+* Continuous lesions
 * [[Erythema]] (or redness of the [[mucosa]]) and friability of the [[mucosa]]
-* Crypts, formation of residual mucosal tissue
+* [[Crypt (anatomy)|Crypts]], formation of residual [[Mucous membrane|mucosal tissue]]
 * [[Polyp (medicine)|Pseudopolyps]]
 | style="background: #F5F5F5; padding: 5px;" |
@@ Line 471: / Line 489: @@
 * N/A
 | 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>
+* [[Mucous membrane|Mucosal]] and [[Submucosa|submucosal]] [[inflammation]]
-* Hemorrhage or inflammatory polymorphonuclear cells aggregate in the lamina propria
+* [[Hemorrhages|Hemorrhage]] or [[Inflammation|inflammatory]] [[Neutrophil|polymorphonuclear cells]] aggregate in the [[lamina propria]]
-* Distorted crypts
+* Distorted [[Crypt (anatomy)|crypts]]
-* Crypt abscess
+* [[Crypt abscess]]
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |[[Biopsy|Endoscopic biopsy]]
-* 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>
 |-
 | 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;" |
-* [[Diarrhea]]
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" |
-* Lain in RQ
-| style="background: #F5F5F5; padding: 5px;" |
-* [[Tenesmus]]
 * [[Nausea and vomiting|N/V]]
 * [[Bowel obstruction]]
 * [[Fever]]
 *
-| style="background: #F5F5F5; padding: 5px;" | +
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
 | style="background: #F5F5F5; padding: 5px;" |
 * Discontinuous lesions
-* Strictures
+* [[Strictures]]
-* Linear ulcerations
+* Linear [[Ulcer|ulcerations]]
 | style="background: #F5F5F5; padding: 5px;" |
 * N/A
@@ Line 500: / Line 517: @@
 * N/A
 | style="background: #F5F5F5; padding: 5px;" |
-* Transmural pattern of inflammation
+* Transmural pattern of [[inflammation]]
-* Mucosal damage
+* [[Mucous membrane|Mucosal]] damage
-* Focal infiltration of leukocytes into the epithelium
+* Focal [[Infiltration (medical)|infiltration]] of [[White blood cells|leukocytes]] into the [[epithelium]]
-* Granulomas
+* [[Granuloma|Granulomas]]
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |[[Biopsy|Endoscopic biopsy]]
-* Endoscopy and a mucosal 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;" |
-* [[Constipation]]
+* [[Weight loss]]
-and/or
+* Straining
-* [[diarrhea]]
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" |
-* Diffuse abdominal pain
-| style="background: #F5F5F5; padding: 5px;" |
-* Straining during [[defecation]]
 * [[Urgency]]
-* Sensation of incomplete evacuation
 * [[Mucus]] passage
 * [[Bloating]]
-* Weight loss
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
-| style="background: #F5F5F5; padding: 5px;" | -
 | style="background: #F5F5F5; padding: 5px;" |
 * Not recommended
 | style="background: #F5F5F5; padding: 5px;" |
 * N/A
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |'''Diagnosis of exclusion'''
-* Diagnosis of exclusion with fulfilment of [[Irritable bowel syndrome diagnostic criteria|Rome criteria]]
+* Fulfilment of [[Irritable bowel syndrome diagnostic criteria|Rome criteria]]
 | style="background: #F5F5F5; padding: 5px;" |
 * N/A
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |Clinical diagnosis  [[Irritable bowel syndrome Diagnostic Study of Choice|(Rome criteria)]]
-* 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: #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;" |
-* [[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;" |
-* Pain in RLQ
-| style="background: #F5F5F5; padding: 5px;" |
-* Pain starting periumbilical before localizing to the [[right iliac fossa]]
 * [[Nausea and vomiting|N/V]]
-* [[Fever]], [[Rigor|chills]]
+* [[Fever]]
+* [[Rigor|Chills]]
 * [[Anorexia|Loss of appetite]]
-| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
 | style="background: #F5F5F5; padding: 5px;" |
 * N/A
 | style="background: #F5F5F5; padding: 5px;" |
-* Appendiceal wall thickening (wall ≥ 3mm)
+* [[Appendicitis CT|Appendiceal]] wall thickening (≥ 3mm)
 * Periappendiceal fat stranding
-* Thickening of the [[Fascia|lateral conal fascia]] and [[mesoappendix]]
+* Thick [[Fascia|lateral conal fascia]] and [[mesoappendix]]
 * Extraluminal fluid
 * [[Phlegmon]]
 * [[Abscess]]
 | 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;" |
 * N/A
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |[[Computed tomography|CT scan]]
-* [[Computed tomography|CT scan]]
 |-
 | 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;" |
-* 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;" |
+* [[Weakness]], heaviness, burning, or aching in the groin
-* Pain in [[Right lower quadrant abdominal pain resident survival guide|RLQ]]
+* [[Swelling]]
-| style="background: #F5F5F5; padding: 5px;" |[[Nausea and vomiting|N/V]]
+* [[Fever]]
-Heaviness or dull discomfort in the groin, with straining, lifting, coughing, or exercising
-Weakness, heaviness, burning, or aching in the groin
-Pain and [[swelling]]
-[[Fever]]
-| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
 | style="background: #F5F5F5; padding: 5px;" |
 * N/A
 | 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
-* 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;" |
 * N/A
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |[[Ultrasound]]
-* N/A
-| style="background: #F5F5F5; padding: 5px;" |
-* Ultrasound: Hypoechoic mass suggesting dilated and edematous intestinal segment
 |-
 | 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;" |
-* [[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;" | +
 | style="background: #F5F5F5; padding: 5px;" |
 * N/A
 | style="background: #F5F5F5; padding: 5px;" |
 * 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;" |
 * N/A
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |[[Gynecologic ultrasonography|Transvaginal ultrasound]]
-* Transvaginal ultrasonography
+|-
+| 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==

Colorectal cancer differential diagnosis: Difference between revisions

Latest revision as of 20:51, 13 February 2019

Overview

Colorectal Cancer Differential Diagnosis

References

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