Leiomyosarcoma differential diagnosis
|
Leiomyosarcoma Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Leiomyosarcoma differential diagnosis On the Web |
|
American Roentgen Ray Society Images of Leiomyosarcoma differential diagnosis |
|
Risk calculators and risk factors for Leiomyosarcoma differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Rekha, M.D.
Overview
Leiomyosarcoma must be differentiated from Peptic ulcer, Stomach cancer, Uterine cancer.
Differentiating Leiomyosarcoma from other Diseases
The table below summarizes the findings that differentiate Leiomyosarcoma from other conditions that may cause similar signs and symptoms.[1][2][3]
| Diseases | Clinical manifestations | Para-clinical findings | Gold standard | Additional findings | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Symptoms | Physical examination | ||||||||||||||
| Lab Findings | Imaging | Histology | |||||||||||||
| Symptom 1 | Symptom 2 | Symptom 3 | Physical exam 1 | Physical exam 2 | Physical exam 3 | Lab 1 | Lab 2 | Lab 3 | Imaging 1 | Imaging 2 | Imaging 3 | ||||
| Peptic Ulcer Disease | Episodic Epigastric pain | Melena | Hematemesis | Epigastric tenderness | Abdominal guarding and rigidity if perforated | Normal Bowel Sounds | CBC Suggestive of Anemia | Serum Gastrin Level or Secretin stimulation test to rule out Zollinger Ellison syndrome | Urea breath test or Stool antigen done for Helicobacter pylori | Chest xray suggestive of pneumoperitoneum if perforated | CT scan suggestive of pneumoperitoneumif perforated peptic ulcer | Barium radiography,although infrequently used,suggestive of an ulcer niche is generally round or oval and may be surrounded by a smooth mound of edema | On histological cross section peptic ulcer appear as a mucosal defect which penetrates the muscularis mucosae and muscularis propria, produced by acid-pepsin aggression. Ulcer margins are regular, slightly elevated due to adjacent chronic gastritis. During the active phase, the base of the ulcer shows 4 zones : inflammatory exudate, fibrinoid necrosis, granulation tissue and fibrous tissue. The fibrous base of the ulcer may contain vessels with thickened wall or with thrombosis. | Upper GI Endoscopy | - |
| Gastric Adenocarcinoma | Abdominal pain | Dysphagia | Hematemesis or Melena | Abdominal mass/Distension | Pallor | Left supraclavicular lyphadenopathy | CBC suggestive of anemia | LFT suggestive of Jaundice is seen in the pre terminal stages of metastatic disease | Ascitic fluid analysis in case of peritoneal carcinomatosis | Barium studies can identify both malignant gastric ulcers and infiltrating lesions and some early gastric cancers but false negative can be as high as 50% | - | - | Histological varieties of intestinal type cancer can be tubular, papillary and mucinous.Rarely, adenosquamous histology is observed. Some intestinal-type tumors do not form tubules and their cells form solid aggregates as the multiple cell adhesions lead to sheets of cohesive cell aggregates without polarity or gland formation. | Esophagogastrduodenoscopy | Systematic manifestation of gastric cancer are Acanthosis Nigrans and Leasr-trelat but are not specific of gastric cancer |
| Endometrial Cancer | Abnormal Vaginal bleeding or post coital bleeding | Pelvic pain | Dysparunia | Vaginal Bleeding | Enlarged uterus | Lymphadenopathy | CBC and Clotting studies to r/o anemia and coagulopathy | Urine or serum Beta HCG to r/o pregnancy | LFT/ CA-125 can also be done | Thickened endometrial line on ultrasound. | Thickened endometrial line on CT | Thickened endometrial line on MRI | In well-differentiated forms, endometrioid adenocarcinoma produces small, round back-to-back glands without intervening stroma with varying degrees of glandular complexity are demonstrated by luminal infolding, budding, papillae (with or without psammoma bodies), and cribriforming. In grade 1 lesions, nuclei of the lining epithelial cells are uniform and oval to cylindrical, with minimal atypia and small discrete nucleoli. The cellular axes are perpendicular to the basement membrane, and stratification may or may not be present. Typically, high-grade tumors (with significant solid components) display an increased amount of nuclear atypia, as demonstrated by pleomorphism, irregular chromatin clumping, and prominent nucleoli | Biopsy under hysteroscopic guidance | - |
| Symptom 1 | Symptom 2 | Symptom 3 | Physical exam 1 | Physical exam 2 | Physical exam 3 | Lab 1 | Lab 2 | Lab 3 | Imaging 1 | Imaging 2 | Imaging 3 | Histopathology | Gold standard | Additional findings | |
| Differential Diagnosis 4 | |||||||||||||||
| Differential Diagnosis 5 | |||||||||||||||
| Differential Diagnosis 6 | |||||||||||||||
References
- ↑ Cotton PB, Shorvon PJ (1984) Analysis of endoscopy and radiography in the diagnosis, follow-up and treatment of peptic ulcer disease. Clin Gastroenterol 13 (2):383-403. PMID: 6378443
- ↑ Wanebo HJ, Kennedy BJ, Chmiel J, Steele G, Winchester D, Osteen R (1993) Cancer of the stomach. A patient care study by the American College of Surgeons. Ann Surg 218 (5):583-92. PMID: 8239772
- ↑ Kimura T, Kamiura S, Yamamoto T, Seino-Noda H, Ohira H, Saji F (2004) Abnormal uterine bleeding and prognosis of endometrial cancer. Int J Gynaecol Obstet 85 (2):145-50. DOI:10.1016/j.ijgo.2003.12.001 PMID: 15099776