Prostate cancer differential diagnosis: Difference between revisions

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__NOTOC__
__NOTOC__
{{Prostate cancer}}
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Prostate_cancer]]
{{CMG}}
{{CMG}} {{AE}} {{sali}} {{HK}} {{ADS}}  
==Overview==
==Overview==
Prostate cancer must be differentiated from [[benign prostatic hypertrophy]], [[renal cancer]], [[renal stones]], [[bladder cancer]], and [[cystitis]].
Prostate cancer must be differentiated from [[benign prostatic hypertrophy]], [[renal cancer]], [[renal stones]], [[bladder cancer]], and [[cystitis]].


==Differential diagnosis==
==Differential diagnosis==
Prostate cancer must be differentiated from:
Prostate cancer must be differentiated from:<ref name="pmid18486720">{{cite journal |vauthors=Worcester EM, Coe FL |title=Nephrolithiasis |journal=Prim. Care |volume=35 |issue=2 |pages=369–91, vii |date=June 2008 |pmid=18486720 |pmc=2518455 |doi=10.1016/j.pop.2008.01.005 |url=}}</ref><ref name="pmid21789078">{{cite journal |vauthors=Semins MJ, Matlaga BR |title=Medical evaluation and management of urolithiasis |journal=Ther Adv Urol |volume=2 |issue=1 |pages=3–9 |date=February 2010 |pmid=21789078 |pmc=3126068 |doi=10.1177/1756287210369121 |url=}}</ref><ref name="pmid28764263">{{cite journal |vauthors=Venkatesh L, Hanumegowda RK |title=Acute Pyelonephritis - Correlation of Clinical Parameter with Radiological Imaging Abnormalities |journal=J Clin Diagn Res |volume=11 |issue=6 |pages=TC15–TC18 |date=June 2017 |pmid=28764263 |pmc=5535453 |doi=10.7860/JCDR/2017/27247.10033 |url=}}</ref><ref name="pmid17375337">{{cite journal |vauthors=Garin EH, Olavarria F, Araya C, Broussain M, Barrera C, Young L |title=Diagnostic significance of clinical and laboratory findings to localize site of urinary infection |journal=Pediatr. Nephrol. |volume=22 |issue=7 |pages=1002–6 |date=July 2007 |pmid=17375337 |doi=10.1007/s00467-007-0465-7 |url=}}</ref><ref name="pmid19399273">{{cite journal |vauthors=Lee DG, Jeon SH, Lee CH, Lee SJ, Kim JI, Chang SG |title=Acute pyelonephritis: clinical characteristics and the role of the surgical treatment |journal=J. Korean Med. Sci. |volume=24 |issue=2 |pages=296–301 |date=April 2009 |pmid=19399273 |pmc=2672131 |doi=10.3346/jkms.2009.24.2.296 |url=}}</ref><ref name="pmid22969301">{{cite journal |vauthors=Saeed K |title=Renal infarction |journal=Int J Nephrol Renovasc Dis |volume=5 |issue= |pages=119–23 |date=2012 |pmid=22969301 |pmc=3437809 |doi=10.2147/IJNRD.S33768 |url=}}</ref><ref name="pmid24812524">{{cite journal |vauthors=Mahamid M, Francis A, Abid A, Awawde M, Abu-Elhija O |title=Embolic renal infarction mimicking renal colic |journal=Int J Nephrol Renovasc Dis |volume=7 |issue= |pages=157–9 |date=2014 |pmid=24812524 |pmc=4011809 |doi=10.2147/IJNRD.S59745 |url=}}</ref><ref name="pmid12389340">{{cite journal |vauthors=Korzets Z, Plotkin E, Bernheim J, Zissin R |title=The clinical spectrum of acute renal infarction |journal=Isr. Med. Assoc. J. |volume=4 |issue=10 |pages=781–4 |date=October 2002 |pmid=12389340 |doi= |url=}}</ref><ref name="pmid12512867">{{cite journal |vauthors=Brix AE |title=Renal papillary necrosis |journal=Toxicol Pathol |volume=30 |issue=6 |pages=672–4 |date=2002 |pmid=12512867 |doi=10.1080/01926230290166760 |url=}}</ref><ref name="pmid7038374">{{cite journal |vauthors=Eknoyan G, Qunibi WY, Grissom RT, Tuma SN, Ayus JC |title=Renal papillary necrosis: an update |journal=Medicine (Baltimore) |volume=61 |issue=2 |pages=55–73 |date=March 1982 |pmid=7038374 |doi= |url=}}</ref><ref name="pmid18806169">{{cite journal |vauthors=Ng CS, Wood CG, Silverman PM, Tannir NM, Tamboli P, Sandler CM |title=Renal cell carcinoma: diagnosis, staging, and surveillance |journal=AJR Am J Roentgenol |volume=191 |issue=4 |pages=1220–32 |date=October 2008 |pmid=18806169 |doi=10.2214/AJR.07.3568 |url=}}</ref><ref name="pmid15536955">{{cite journal |vauthors=Ares Valdés Y, Amador Sandoval B, Morales JC, Alonso Domínguez F, Carballo Velásquez L, Fragas Valdés R, Shou Rodríguez A |title=[The role of CT scan in the diagnosis of renal cell carcinoma] |language=Spanish; Castilian |journal=Arch. Esp. Urol. |volume=57 |issue=7 |pages=737–42 |date=September 2004 |pmid=15536955 |doi= |url=}}</ref><ref name="pmid20479778">{{cite journal |vauthors=Leveridge MJ, Bostrom PJ, Koulouris G, Finelli A, Lawrentschuk N |title=Imaging renal cell carcinoma with ultrasonography, CT and MRI |journal=Nat Rev Urol |volume=7 |issue=6 |pages=311–25 |date=June 2010 |pmid=20479778 |doi=10.1038/nrurol.2010.63 |url=}}</ref><ref name="pmid25393274">{{cite journal |vauthors=Bratt O, Lilja H |title=Serum markers in prostate cancer detection |journal=Curr Opin Urol |volume=25 |issue=1 |pages=59–64 |date=January 2015 |pmid=25393274 |pmc=4315142 |doi=10.1097/MOU.0000000000000128 |url=}}</ref><ref name="urlProstate Cancer (Prostate Carcinoma): Symptoms - National Library of Medicine - PubMed Health">{{cite web |url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024422/ |title=Prostate Cancer (Prostate Carcinoma): Symptoms - National Library of Medicine - PubMed Health |format= |work= |accessdate=}}</ref>
* [[Benign prostatic hypertrophy]] (BPH)
* [[Renal cancer]]
* [[Renal stones]]
* [[Bladder cancer]]
* [[Cystitis]]
* [[Glomerulonephritis]]
* [[Prostatitis]]
* [[Pyelonephritis]]


==Benign prostatic hypertrophy==
*[[Benign prostatic hypertrophy]] (BPH)
*The main difference between [[BPH]] and [[prostate cancer]] is that even though the [[prostate gland]] is enlarged in both, in [[BPH]] it is a [[benign]] or noncancerous condition<ref name="pmid22792684">{{cite journal |vauthors=Chang RT, Kirby R, Challacombe BJ |title=Is there a link between BPH and prostate cancer? |journal=Practitioner |volume=256 |issue=1750 |pages=13–6, 2 |date=April 2012 |pmid=22792684 |doi= |url=}}</ref>
*[[Renal cancer]]
*[[BPH]] is very common especially as a man ages and his [[prostate]] begins to grow. When this happens, it puts pressure on the [[urethra]] resulting in the following symptoms:
*[[Renal stones]]
*An urgent need to [[urinate]]
*[[Bladder cancer]]
*Having the need to urinate many times during the day and night
*[[Cystitis]]
*Hesitancy or troubling starting a urine flow
*[[Glomerulonephritis]]
*Weak or dribbling urine stream
*[[Prostatitis]]
*[[Digital rectal exam]] and elevated blood test called [[prostate]] specific antigen or [[PSA]], can confirm if it might be [[BPH]].
*[[Pyelonephritis]]
*[[BPH]] does not cause [[prostate cancer]] and unlike [[prostate cancer]], it cannot spread to other areas of the body.


==Renal Cancer==


*[[Renal cell carcinoma]] doesn’t usually cause any symptoms<ref name="pmid16336324">{{cite journal |vauthors=Barocas DA, Rabbani F, Scherr DS, Vaughan ED |title=A population-based study of renal cell carcinoma and prostate cancer in the same patients |journal=BJU Int. |volume=97 |issue=1 |pages=33–6 |date=January 2006 |pmid=16336324 |doi=10.1111/j.1464-410X.2005.05880.x |url=}}</ref>
{|
*As the [[disease]] gets more serious, you might have warning signs like:
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
**[[Lump]] on your side, belly, or lower back
! colspan="2" rowspan="5" |Diseases
**[[Blood]] in your pee
| colspan="9" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Clinical manifestations'''
**Low [[back pain]] on one side
! colspan="2" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Para-clinical findings
**Losing weight for no clear reason
! rowspan="5" |'''Gold standard'''
**Not feeling hungry
|-
**[[Fever]]
| colspan="6" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Symptoms'''
**Feeling tired
! colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical examina
**Not enough [[red blood cells]] ([[anemia]])
|-
**Night sweats
! rowspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
**High levels of [[calcium]] in your blood
! rowspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diagnosi
**High blood pressure
|-
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Low back pain
! colspan="1" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fever
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Nausea/
Vomiting
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Urinary symptoms
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hypertension
! colspan="1" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Pitting edema
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Dysuria
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Frequency
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Oliguria
|-
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Disease
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Low back pain
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fever
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Nausea/
Vomiting
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Dysuria
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Frequency
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Oliguria
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hypertension
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Pitting edema
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diagnosis method
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard
|-
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Nephrolithiasis]]<ref name="pmid12649987">{{cite journal |vauthors=Hochreiter W, Knoll T, Hess B |title=[Pathophysiology, diagnosis and conservative therapy of non-calcium kidney calculi] |language=German |journal=Ther Umsch |volume=60 |issue=2 |pages=89–97 |date=February 2003 |pmid=12649987 |doi=10.1024/0040-5930.60.2.89 |url=}}</ref><ref name="pmid23392537">{{cite journal |vauthors=Trinchieri A |title=Diet and renal stone formation |journal=Minerva Med. |volume=104 |issue=1 |pages=41–54 |date=February 2013 |pmid=23392537 |doi= |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |±
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |±
| style="background: #F5F5F5; padding: 5px;" |±
| style="background: #F5F5F5; padding: 5px;" |±
| style="background: #F5F5F5; padding: 5px;" |–
| style="background: #F5F5F5; padding: 5px;" |–
| style="background: #F5F5F5; padding: 5px;" |
*Radiating pain to groin
| style="background: #F5F5F5; padding: 5px;" |
*[[Hypercalciuria]]
*[[Hyperoxaluria]]
*[[Hypocitraturia]]
*[[Hyperuricemia]]
*[[Hyperuricosuria]]
| style="background: #F5F5F5; padding: 5px;" |
*Ultrasound: [[Hydronephrosis]] +/-
*[[Computed tomography|Abdominal CT scan]] without contrast
| style="background: #F5F5F5; padding: 5px;" |Abdominal [[Computed tomography|CT scan]] without contrast
|-
| rowspan="3" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Malignancy]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Renal cell carcinoma|Renal cell carcinoma (RCC)]]<ref name="pmid16339096">{{cite journal| author=Cohen HT, McGovern FJ| title=Renal-cell carcinoma. | journal=N Engl J Med | year= 2005 | volume= 353 | issue= 23 | pages= 2477-90 | pmid=16339096 | doi=10.1056/NEJMra043172 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16339096  }}</ref><ref name="pmid20479778">{{cite journal |vauthors=Leveridge MJ, Bostrom PJ, Koulouris G, Finelli A, Lawrentschuk N |title=Imaging renal cell carcinoma with ultrasonography, CT and MRI |journal=Nat Rev Urol |volume=7 |issue=6 |pages=311–25 |date=June 2010 |pmid=20479778 |doi=10.1038/nrurol.2010.63 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |±
| style="background: #F5F5F5; padding: 5px;" |±
| style="background: #F5F5F5; padding: 5px;" |
*[[Flanks|Flank]] mass
| style="background: #F5F5F5; padding: 5px;" |
*[[Anemia]]
*[[Hematuria]]
| style="background: #F5F5F5; padding: 5px;" |
*Both [[CT]] and [[MRI]] may be used to detect [[neoplastic]] masses that may define renal cell carcinoma or metastasis of the primary cancer. [[CT]] scan and use of intravenous (IV) contrast is generally used for work-up and follow-up of patients with [[Renal cell carcinoma|renal cell carcinom]]<nowiki/>a.
*The histological pattern of renal cell [[carcinoma]] depends whether it is [[Papillary|papillary,]] [[chromophobe]] or [[collecting duct]] renal cell carcinoma.
| style="background: #F5F5F5; padding: 5px;" |–
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Bladder cancer]]<ref name="pmid21360040">{{cite journal| author=Pons F, Orsola A, Morote J, Bellmunt J| title=Variant forms of bladder cancer: basic considerations on treatment approaches. | journal=Curr Oncol Rep | year= 2011 | volume= 13 | issue= 3 | pages= 216-21 | pmid=21360040 | doi=10.1007/s11912-011-0161-4 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21360040  }}</ref><ref name="pmid10918764">{{cite journal |vauthors=Metts MC, Metts JC, Milito SJ, Thomas CR |title=Bladder cancer: a review of diagnosis and management |journal=J Natl Med Assoc |volume=92 |issue=6 |pages=285–94 |date=June 2000 |pmid=10918764 |pmc=2640522 |doi= |url=}}</ref><ref name="pmid182316182">{{cite journal |vauthors=Rom M, Kuehhas FE, Djavan B |title=New findings in bladder and prostate cancer: highlights of the 22nd annual congress of the European association of urology, march 21-24, 2007, berlin, Germany |journal=Rev Urol |volume=9 |issue=4 |pages=214–9 |date=2007 |pmid=18231618 |pmc=2199502 |doi= |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |±
| style="background: #F5F5F5; padding: 5px;" |±
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |Suprapubic pain
| style="background: #F5F5F5; padding: 5px;" |
*[[Anemia]]
*[[Hematuria]]
| style="background: #F5F5F5; padding: 5px;" |[[Ultrasound]], [[Computed tomography|CT scan]], Biopsy
| style="background: #F5F5F5; padding: 5px;" |Biopsy
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Prostate cancer]]<ref name="pmid23451265">{{cite journal |vauthors=Chung SD, Liu SP, Lin HC |title=Association between prostate cancer and urinary calculi: a population-based study |journal=PLoS ONE |volume=8 |issue=2 |pages=e57743 |date=2013 |pmid=23451265 |pmc=3581486 |doi=10.1371/journal.pone.0057743 |url=}}</ref><ref name="pmid18231618">{{cite journal |vauthors=Rom M, Kuehhas FE, Djavan B |title=New findings in bladder and prostate cancer: highlights of the 22nd annual congress of the European association of urology, march 21-24, 2007, berlin, Germany |journal=Rev Urol |volume=9 |issue=4 |pages=214–9 |date=2007 |pmid=18231618 |pmc=2199502 |doi= |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |±
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |±
| style="background: #F5F5F5; padding: 5px;" |±
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
*[[Anemia]]
*[[Hematuria]]
| style="background: #F5F5F5; padding: 5px;" |[[Ultrasound]], [[Computed tomography|CT scan]], Biopsy
| style="background: #F5F5F5; padding: 5px;" |Biopsy
|-
| rowspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Urinary system|Lower urinary tract diseases]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Benign prostatic hyperplasia]]
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
*[[Nocturia]]
*Other voiding symptoms
**Slow urinary stream
**Splitting or spraying of the [[Urinary system|urinary]] stream
**Intermittent urinary stream
**Hesitancy
**Straining to void
**Terminal dribbling
| style="background: #F5F5F5; padding: 5px;" |
*Urinalysis to rule out [[Urinary tract infection|UTI]]
*Elevated [[Blood urea nitrogen|BUN]]/[[Creatinine|Cr]]
*High [[Prostate specific antigen|PSA]] values
| style="background: #F5F5F5; padding: 5px;" |
*Urine cytology to screen for bladder cancer
*Biopsy to rule out cancer
| style="background: #F5F5F5; padding: 5px;" |Biopsy
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Urolithiasis]]<ref name="pmid126499872">{{cite journal |vauthors=Hochreiter W, Knoll T, Hess B |title=[Pathophysiology, diagnosis and conservative therapy of non-calcium kidney calculi] |language=German |journal=Ther Umsch |volume=60 |issue=2 |pages=89–97 |date=February 2003 |pmid=12649987 |doi=10.1024/0040-5930.60.2.89 |url=}}</ref><ref name="pmid24818849">{{cite journal |vauthors=Flannigan R, Choy WH, Chew B, Lange D |title=Renal struvite stones--pathogenesis, microbiology, and management strategies |journal=Nat Rev Urol |volume=11 |issue=6 |pages=333–41 |date=June 2014 |pmid=24818849 |doi=10.1038/nrurol.2014.99 |url=}}</ref><ref name="pmid25685869">{{cite journal |vauthors=Pereira DJ, Schoolwerth AC, Pais VM |title=Cystinuria: current concepts and future directions |journal=Clin. Nephrol. |volume=83 |issue=3 |pages=138–46 |date=March 2015 |pmid=25685869 |doi= |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
*[[Flanks|Flank]]
*[[Groin]] pain
| style="background: #F5F5F5; padding: 5px;" |
*[[Urine|Urine analysis]]


==Renal Stones==
*High [[Creatinine|Cr]]
*[[Kidney stone]] usually remains symptomless until it moves into the ureter<ref name="pmid23451265">{{cite journal |vauthors=Chung SD, Liu SP, Lin HC |title=Association between prostate cancer and urinary calculi: a population-based study |journal=PLoS ONE |volume=8 |issue=2 |pages=e57743 |date=2013 |pmid=23451265 |pmc=3581486 |doi=10.1371/journal.pone.0057743 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |Abdominppelvic [[Computed tomography|CT scan]] without contrast
*When symptoms of kidney stones become apparent, they commonly include:
| style="background: #F5F5F5; padding: 5px;" |Abdominppelvic [[Computed tomography|CT scan]] without contrast
**Severe pain in the [[groin]] and/or side
|-
**[[Blood]] in urine
| rowspan="3" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Infectious disease|Infectious diseases]]
**[[Vomiting]] and nausea
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pyelonephritis]]<ref name="pmid256858692">{{cite journal |vauthors=Pereira DJ, Schoolwerth AC, Pais VM |title=Cystinuria: current concepts and future directions |journal=Clin. Nephrol. |volume=83 |issue=3 |pages=138–46 |date=March 2015 |pmid=25685869 |doi= |url=}}</ref><ref name="pmid18092884">{{cite journal| author=Rosen DA, Hooton TM, Stamm WE, Humphrey PA, Hultgren SJ| title=Detection of intracellular bacterial communities in human urinary tract infection. | journal=PLoS Med | year= 2007 | volume= 4 | issue= 12 | pages= e329 | pmid=18092884 | doi=10.1371/journal.pmed.0040329 | pmc=2140087 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18092884  }}</ref>
**[[White blood cells]] or [[pus]] in the urine
| style="background: #F5F5F5; padding: 5px;" | +
**Reduced amount of [[urine]] excreted
| style="background: #F5F5F5; padding: 5px;" | +
**Burning sensation during urination
| style="background: #F5F5F5; padding: 5px;" | +
**Persistent urge to urinate
| style="background: #F5F5F5; padding: 5px;" | +
**[[Fever]] and chills if there is an [[infection]]
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
*[[Delirium]]
*[[Headache]]
| style="background: #F5F5F5; padding: 5px;" |
*Positive  [[leukocyte esterase]] test and [[nitrite test]].
*Blood/urine cultures
| style="background: #F5F5F5; padding: 5px;" |[[Computed tomography|CT]] and [[ultrasound]]:


==Bladder Cancer==
*Enlarged [[Kidney|kidneys]]
*Bladder cancer is often painless<ref name="pmid18231618">{{cite journal |vauthors=Rom M, Kuehhas FE, Djavan B |title=New findings in bladder and prostate cancer: highlights of the 22nd annual congress of the European association of urology, march 21-24, 2007, berlin, Germany |journal=Rev Urol |volume=9 |issue=4 |pages=214–9 |date=2007 |pmid=18231618 |pmc=2199502 |doi= |url=}}</ref>  
*Round swollen [[Kidney|kidneys]]
*The most significant sign of a malignancy is urinary bleeding, either overt (known as gross hematuria) or detected with blood or imaging tests (microscopic hematuria). 
*Hypodense appearance
*The bleeding may be consistent or intermittent.
*[[Abscess|Abscesses]] may not be present
*While blood in urine may be distressing, it is neither diagnostic of cancer nor predictive of the severity of a malignancy.
| style="background: #F5F5F5; padding: 5px;" | -
*The signs and symptoms of bladder cancer can vary based on the size and location of the tumor as well as the stage of the disease.
|-
*In addition to bleeding, other symptoms may include:
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Cystitis]]<ref name="pmid16298166">{{cite journal| author=Franco AV| title=Recurrent urinary tract infections. | journal=Best Pract Res Clin Obstet Gynaecol | year= 2005 | volume= 19 | issue= 6 | pages= 861-73 | pmid=16298166 | doi=10.1016/j.bpobgyn.2005.08.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16298166  }}</ref><ref name="pmid162981662">{{cite journal| author=Franco AV| title=Recurrent urinary tract infections. | journal=Best Pract Res Clin Obstet Gynaecol | year= 2005 | volume= 19 | issue= 6 | pages= 861-73 | pmid=16298166 | doi=10.1016/j.bpobgyn.2005.08.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16298166  }}</ref>
**A persistent urge to urinate (urinary urgency)
| style="background: #F5F5F5; padding: 5px;" | -
**Frequent urination (urinary frequency)
| style="background: #F5F5F5; padding: 5px;" | -
**Back or abdominal pain
| style="background: #F5F5F5; padding: 5px;" | -
**Loss of appetite
| style="background: #F5F5F5; padding: 5px;" | +
**Unexplained weight loss
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
*[[Dyspareunia]]
*Supra pubic tenderness
| style="background: #F5F5F5; padding: 5px;" |
*[[Pyuria]]: > 5-10 [[White blood cells|WBC]]/hpf or 27 [[WBC]]/microliter
*Positive  [[leukocyte esterase]] test and [[nitrite test]].
*Positive urine/blood cultures
| style="background: #F5F5F5; padding: 5px;" |[[Ultrasound|Ultrasound:]]
*Presence of gas in the bladder wall.


==Cystitis==
*Also, help to detect the presence of a [[tumor]] or a [[Stone massage|stone]].
| style="background: #F5F5F5; padding: 5px;" |Urine culture
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Prostatitis]]<ref>{{Cite journal
| author = [[John N. Krieger]], [[Ulrich Dobrindt]], [[Donald E. Riley]] & [[Eric Oswald]]
| title = Acute Escherichia coli prostatitis in previously health young men: bacterial virulence factors, antimicrobial resistance, and clinical outcomes
| journal = [[Urology]]
| volume = 77
| issue = 6
| pages = 1420–1425
| year = 2011
| month = June
| doi = 10.1016/j.urology.2010.12.059
| pmid = 21459419
}}</ref><ref name="pmid20704171">{{cite journal| author=Sharp VJ, Takacs EB, Powell CR| title=Prostatitis: diagnosis and treatment. | journal=Am Fam Physician | year= 2010 | volume= 82 | issue= 4 | pages= 397-406 | pmid=20704171 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20704171  }}</ref>
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
*Body aches
| style="background: #F5F5F5; padding: 5px;" |
*Increased [[leukocytes]] (>10 per high power field) on [[Complete blood count|CBC]]
*Bacteria seen on [[urine culture]]
*Elevated [[C-reactive protein]]
*Transiently elevated [[PSA]] ([[prostate specific antigen]]) levels
| style="background: #F5F5F5; padding: 5px;" |[[Ultrasound|Ultrasound:]]
*Focal hypoechoic region located in the peripheral part of the [[prostate]]


*Cystitis refers to an inflammation of the bladder, in most cases caused when upward moving bowel bacteria invades the bladder and begins to grow<ref name="pmid28046120">{{cite journal |vauthors=Fan CY, Huang WY, Lin KT, Lin CS, Chao HL, Yang JF, Lin CL, Kao CH |title=Lower Urinary Tract Infection and Subsequent Risk of Prostate Cancer: A Nationwide Population-Based Cohort Study |journal=PLoS ONE |volume=12 |issue=1 |pages=e0168254 |date=2017 |pmid=28046120 |pmc=5207623 |doi=10.1371/journal.pone.0168254 |url=}}</ref>
[[Computed tomography|CT scan:]]
*The following are common signs and symptoms of cystitis:
**Traces of blood in the urine
**Dark, cloudy, or strong-smelling urine
**Pain just above the pubic bone, in the lower back, or in the abdomen
**Burning sensation when urinating
**Urinating frequently or feeling the need to urinate frequently
**Elderly individuals may feel weak and feverish but have none of the other symptoms.They may also present with altered mental status.
**There is a frequent need to urinate, but only small amounts of urine are passed each time.


==Glomerulonephritis==
*Edema of the [[prostate gland]] with diffuse enlargement,.
| style="background: #F5F5F5; padding: 5px;" | -
|}


*Glomerulonephritis is a disorder of glomeruli (clusters of microscopic blood vessels in the kidneys with small pores through which blood is filtered)<ref name="pmid29394927">{{cite journal |vauthors=Heaf JG, Hansen A, Laier GH |title=Quantification of cancer risk in glomerulonephritis |journal=BMC Nephrol |volume=19 |issue=1 |pages=27 |date=February 2018 |pmid=29394927 |pmc=5797419 |doi=10.1186/s12882-018-0828-2 |url=}}</ref>
==References==
*It is characterized by body tissue swelling (edema), high blood pressure, and the presence of red blood cells in the urine.
{{Reflist|2}}
*Glomerulonephritis can be caused by various disorders, such as infections, an inherited genetic disorder, or autoimmune disorders.
*Diagnosis is based on tests of blood and urine and sometimes imaging tests, a biopsy of the kidneys, or both.
*People often need to restrict salt and protein intake and take diuretics or antibiotics until kidney function improves.
*Acute glomerulonephritis may appear suddenly, following a throat or skin infection.
*Symptoms include:
**puffiness of the face on waking up
**urine that is brown or contains traces of blood
**decreased urination
**fluid in the lungs leading to coughing and shortness of breath
**high blood pressure


*Chronic glomerulonephritis develops over a long time, often without obvious symptoms. However, complete kidney failure can result.
[[Category:Medicine]]
[[Category:Nephrology]]
[[Category:Urology]]
[[Category:Up-To-Date]]
[[Category:Emergency medicine]]


==Prostatitis==
*Prostatitis is a painful condition in which the prostate is inflamed, swollen, and tender. It can be caused by a bacterial infection or just simply be inflamed.<ref name="pmid26620738">{{cite journal |vauthors=Rybicki BA, Kryvenko ON, Wang Y, Jankowski M, Trudeau S, Chitale DA, Gupta NS, Rundle A, Tang D |title=Racial differences in the relationship between clinical prostatitis, presence of inflammation in benign prostate and subsequent risk of prostate cancer |journal=Prostate Cancer Prostatic Dis. |volume=19 |issue=2 |pages=145–50 |date=June 2016 |pmid=26620738 |pmc=4865439 |doi=10.1038/pcan.2015.54 |url=}}</ref>
*Symptoms includes:
**Pain in the perineum (the area between the rectum and the testicles)
**Pain on defecation
**Aches and pains in the joints or muscles and the lower back
**Blood in the urine
**Pain or burning during urination
**Painful ejaculation
==Pyelonephritis==
*Pyelonephritis denotes infection of the renal parenchyma. <ref name="pmid29696626">{{cite journal |vauthors=Doat S, Marous M, Rebillard X, Trétarre B, Lamy PJ, Soares P, Delbos O, Thuret R, Segui B, Cénée S, Menegaux F |title=Prostatitis, other genitourinary infections and prostate cancer risk: Influence of non-steroidal anti-inflammatory drugs? Results from the EPICAP study |journal=Int. J. Cancer |volume= |issue= |pages= |date=April 2018 |pmid=29696626 |doi=10.1002/ijc.31565 |url=}}</ref>
*Symptoms of pyelonephritis include:
**local pain (costovertebral tenderness, back or flank pain)
**systemic signs of infection (chills, fever, nausea, vomiting)
**Suprapubic discomfort or hematuria may also be reported.
*These symptoms may or may not be associated with symptoms of cystitis (dysuria, frequency, urgency, new incontinence).


==References==
==References==

Latest revision as of 19:28, 27 January 2021

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Syed Musadiq Ali M.B.B.S.[2] Syed Hassan A. Kazmi BSc, MD [3] Amandeep Singh M.D.[4]

Overview

Prostate cancer must be differentiated from benign prostatic hypertrophy, renal cancer, renal stones, bladder cancer, and cystitis.

Differential diagnosis

Prostate cancer must be differentiated from:[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15]


Diseases Clinical manifestations Para-clinical findings Gold standard
Symptoms Physical examina
Lab Findings Diagnosi
Low back pain Fever Nausea/

Vomiting

Urinary symptoms Hypertension Pitting edema Other
Dysuria Frequency Oliguria
Disease Low back pain Fever Nausea/

Vomiting

Dysuria Frequency Oliguria Hypertension Pitting edema Other Lab Findings Diagnosis method Gold standard
Nephrolithiasis[16][17] + ± + ± ± ± – –
  • Radiating pain to groin
 Abdominal CT scan without contrast
Malignancy Renal cell carcinoma (RCC)[18][13] - - - - - - ± ± –
Bladder cancer[19][20][21] - - - - ± ± - - Suprapubic pain Ultrasound, CT scan, Biopsy Biopsy
Prostate cancer[22][23] ± - - - ± ± - - - Ultrasound, CT scan, Biopsy Biopsy
Lower urinary tract diseases Benign prostatic hyperplasia +/- - - + + - - -
  • Nocturia
  • Other voiding symptoms
    • Slow urinary stream
    • Splitting or spraying of the urinary stream
    • Intermittent urinary stream
    • Hesitancy
    • Straining to void
    • Terminal dribbling
  • Urinalysis to rule out UTI
  • Elevated BUN/Cr
  • High PSA values
  • Urine cytology to screen for bladder cancer
  • Biopsy to rule out cancer
 Biopsy
Urolithiasis[24][25][26] + +/- + + + + - - Abdominppelvic CT scan without contrast Abdominppelvic CT scan without contrast
Infectious diseases Pyelonephritis[27][28] + + + + + + - - CT and ultrasound: -
Cystitis[29][30] - - - + + + - - Ultrasound:
  • Presence of gas in the bladder wall.
  • Also, help to detect the presence of a tumor or a stone.
 Urine culture
Prostatitis[31][32] - + - + + + - -
  • Body aches
 Ultrasound:
  • Focal hypoechoic region located in the peripheral part of the prostate

CT scan:

-

References

  1. ↑ Worcester EM, Coe FL (June 2008). "Nephrolithiasis". Prim. Care. 35 (2): 369–91, vii. doi:10.1016/j.pop.2008.01.005. PMC 2518455. PMID 18486720.
  2. ↑ Semins MJ, Matlaga BR (February 2010). "Medical evaluation and management of urolithiasis". Ther Adv Urol. 2 (1): 3–9. doi:10.1177/1756287210369121. PMC 3126068. PMID 21789078.
  3. ↑ Venkatesh L, Hanumegowda RK (June 2017). "Acute Pyelonephritis - Correlation of Clinical Parameter with Radiological Imaging Abnormalities". J Clin Diagn Res. 11 (6): TC15–TC18. doi:10.7860/JCDR/2017/27247.10033. PMC 5535453. PMID 28764263.
  4. ↑ Garin EH, Olavarria F, Araya C, Broussain M, Barrera C, Young L (July 2007). "Diagnostic significance of clinical and laboratory findings to localize site of urinary infection". Pediatr. Nephrol. 22 (7): 1002–6. doi:10.1007/s00467-007-0465-7. PMID 17375337.
  5. ↑ Lee DG, Jeon SH, Lee CH, Lee SJ, Kim JI, Chang SG (April 2009). "Acute pyelonephritis: clinical characteristics and the role of the surgical treatment". J. Korean Med. Sci. 24 (2): 296–301. doi:10.3346/jkms.2009.24.2.296. PMC 2672131. PMID 19399273.
  6. ↑ Saeed K (2012). "Renal infarction". Int J Nephrol Renovasc Dis. 5: 119–23. doi:10.2147/IJNRD.S33768. PMC 3437809. PMID 22969301.
  7. ↑ Mahamid M, Francis A, Abid A, Awawde M, Abu-Elhija O (2014). "Embolic renal infarction mimicking renal colic". Int J Nephrol Renovasc Dis. 7: 157–9. doi:10.2147/IJNRD.S59745. PMC 4011809. PMID 24812524.
  8. ↑ Korzets Z, Plotkin E, Bernheim J, Zissin R (October 2002). "The clinical spectrum of acute renal infarction". Isr. Med. Assoc. J. 4 (10): 781–4. PMID 12389340.
  9. ↑ Brix AE (2002). "Renal papillary necrosis". Toxicol Pathol. 30 (6): 672–4. doi:10.1080/01926230290166760. PMID 12512867.
  10. ↑ Eknoyan G, Qunibi WY, Grissom RT, Tuma SN, Ayus JC (March 1982). "Renal papillary necrosis: an update". Medicine (Baltimore). 61 (2): 55–73. PMID 7038374.
  11. ↑ Ng CS, Wood CG, Silverman PM, Tannir NM, Tamboli P, Sandler CM (October 2008). "Renal cell carcinoma: diagnosis, staging, and surveillance". AJR Am J Roentgenol. 191 (4): 1220–32. doi:10.2214/AJR.07.3568. PMID 18806169.
  12. ↑ Ares Valdés Y, Amador Sandoval B, Morales JC, Alonso Domínguez F, Carballo Velásquez L, Fragas Valdés R, Shou Rodríguez A (September 2004). "[The role of CT scan in the diagnosis of renal cell carcinoma]". Arch. Esp. Urol. (in Spanish; Castilian). 57 (7): 737–42. PMID 15536955.
  13. ↑ 13.0 13.1 Leveridge MJ, Bostrom PJ, Koulouris G, Finelli A, Lawrentschuk N (June 2010). "Imaging renal cell carcinoma with ultrasonography, CT and MRI". Nat Rev Urol. 7 (6): 311–25. doi:10.1038/nrurol.2010.63. PMID 20479778.
  14. ↑ Bratt O, Lilja H (January 2015). "Serum markers in prostate cancer detection". Curr Opin Urol. 25 (1): 59–64. doi:10.1097/MOU.0000000000000128. PMC 4315142. PMID 25393274.
  15. ↑ "Prostate Cancer (Prostate Carcinoma): Symptoms - National Library of Medicine - PubMed Health".
  16. ↑ Hochreiter W, Knoll T, Hess B (February 2003). "[Pathophysiology, diagnosis and conservative therapy of non-calcium kidney calculi]". Ther Umsch (in German). 60 (2): 89–97. doi:10.1024/0040-5930.60.2.89. PMID 12649987.
  17. ↑ Trinchieri A (February 2013). "Diet and renal stone formation". Minerva Med. 104 (1): 41–54. PMID 23392537.
  18. ↑ Cohen HT, McGovern FJ (2005). "Renal-cell carcinoma". N Engl J Med. 353 (23): 2477–90. doi:10.1056/NEJMra043172. PMID 16339096.
  19. ↑ Pons F, Orsola A, Morote J, Bellmunt J (2011). "Variant forms of bladder cancer: basic considerations on treatment approaches". Curr Oncol Rep. 13 (3): 216–21. doi:10.1007/s11912-011-0161-4. PMID 21360040.
  20. ↑ Metts MC, Metts JC, Milito SJ, Thomas CR (June 2000). "Bladder cancer: a review of diagnosis and management". J Natl Med Assoc. 92 (6): 285–94. PMC 2640522. PMID 10918764.
  21. ↑ Rom M, Kuehhas FE, Djavan B (2007). "New findings in bladder and prostate cancer: highlights of the 22nd annual congress of the European association of urology, march 21-24, 2007, berlin, Germany". Rev Urol. 9 (4): 214–9. PMC 2199502. PMID 18231618.
  22. ↑ Chung SD, Liu SP, Lin HC (2013). "Association between prostate cancer and urinary calculi: a population-based study". PLoS ONE. 8 (2): e57743. doi:10.1371/journal.pone.0057743. PMC 3581486. PMID 23451265.
  23. ↑ Rom M, Kuehhas FE, Djavan B (2007). "New findings in bladder and prostate cancer: highlights of the 22nd annual congress of the European association of urology, march 21-24, 2007, berlin, Germany". Rev Urol. 9 (4): 214–9. PMC 2199502. PMID 18231618.
  24. ↑ Hochreiter W, Knoll T, Hess B (February 2003). "[Pathophysiology, diagnosis and conservative therapy of non-calcium kidney calculi]". Ther Umsch (in German). 60 (2): 89–97. doi:10.1024/0040-5930.60.2.89. PMID 12649987.
  25. ↑ Flannigan R, Choy WH, Chew B, Lange D (June 2014). "Renal struvite stones--pathogenesis, microbiology, and management strategies". Nat Rev Urol. 11 (6): 333–41. doi:10.1038/nrurol.2014.99. PMID 24818849.
  26. ↑ Pereira DJ, Schoolwerth AC, Pais VM (March 2015). "Cystinuria: current concepts and future directions". Clin. Nephrol. 83 (3): 138–46. PMID 25685869.
  27. ↑ Pereira DJ, Schoolwerth AC, Pais VM (March 2015). "Cystinuria: current concepts and future directions". Clin. Nephrol. 83 (3): 138–46. PMID 25685869.
  28. ↑ Rosen DA, Hooton TM, Stamm WE, Humphrey PA, Hultgren SJ (2007). "Detection of intracellular bacterial communities in human urinary tract infection". PLoS Med. 4 (12): e329. doi:10.1371/journal.pmed.0040329. PMC 2140087. PMID 18092884.
  29. ↑ Franco AV (2005). "Recurrent urinary tract infections". Best Pract Res Clin Obstet Gynaecol. 19 (6): 861–73. doi:10.1016/j.bpobgyn.2005.08.003. PMID 16298166.
  30. ↑ Franco AV (2005). "Recurrent urinary tract infections". Best Pract Res Clin Obstet Gynaecol. 19 (6): 861–73. doi:10.1016/j.bpobgyn.2005.08.003. PMID 16298166.
  31. ↑ John N. Krieger, Ulrich Dobrindt, Donald E. Riley & Eric Oswald (2011). "Acute Escherichia coli prostatitis in previously health young men: bacterial virulence factors, antimicrobial resistance, and clinical outcomes". Urology. 77 (6): 1420–1425. doi:10.1016/j.urology.2010.12.059. PMID 21459419. Unknown parameter |month= ignored (help)
  32. ↑ Sharp VJ, Takacs EB, Powell CR (2010). "Prostatitis: diagnosis and treatment". Am Fam Physician. 82 (4): 397–406. PMID 20704171.


References

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