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Gerald Chi- (talk | contribs) (Created page with " ==Differential Diagnosis== {{ddx0|Hodgkin's lymphoma}} {{ddx1|Sarcoidosis}} {{ddx1|Lymphocytic lymphoma}} {{ddx1|Miliary tuberculosis}} {{ddx1|Infectious mononucleosis}} {{dd...") |
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---- | ---- | ||
{{ddx|Hodgkin's lymphoma}} | |||
=====Clinical manifestations===== | |||
* mental nerve neuropathy | |||
* alcohol intolerance | |||
* dermatitis, exfoliative | |||
* epitrochlear lymph node enlargement | |||
* inguinal lymph node enlargement | |||
* hepatomegaly | |||
* liver mass | |||
* superior vena cava obstruction | |||
* inferior vena cava obstruction | |||
* femoral lymph node enlargement | |||
* popliteal lymph node enlargement | |||
* Pemberton sign positive | |||
* fever, Pel-Ebstein | |||
* ascites, chylous | |||
* axillary lymph node enlargement | |||
* erythema multiforme | |||
* erythema nodosum | |||
* hepatosplenomegaly | |||
* mesenteric lymph node enlargement | |||
* paraplegia | |||
* pruritus | |||
* spinal cord compression | |||
* spleen enlargement | |||
* urinary tract obstruction | |||
* generalized diffuse lymph node enlargement | |||
* airway compression or obstruction | |||
* cryptococcosis | |||
* bone pain | |||
* cervical lymph node enlargement | |||
* fever, recurrent | |||
* recurrent infection | |||
* lymph node, fixed | |||
* neck mass | |||
* night sweats | |||
* anergy | |||
* supraclavicular lymph node enlargement | |||
* sweating increase | |||
* fever unknown origin | |||
* fever, remittent | |||
* painless lymphadenopathy | |||
* regional lymph node enlargement | |||
=====Laboratory abnormalities===== | |||
* nucleated red cells | |||
* hypogammaglobulinemia | |||
* pancytopenia | |||
* lymphocytes decreased | |||
* granulomas on biopsy | |||
=====Radiographic features===== | |||
* retroperitoneal lymph node enlargement | |||
* abdominal ultrasound, biliary tract dilatation | |||
* bone lesion | |||
* chest xray mediastinal mass, adenopathy, or widening | |||
* chest xray mediastinal mass middle | |||
* mediastinal lymph node enlargement | |||
* Anterior mediastinal mass on chest radiograph | |||
* gallium scan, increased uptake, abdomen | |||
* ivory vertebra | |||
* gallium scan increased uptake, mediastinum | |||
---- | |||
{{ddx|Sarcoidosis}} | |||
=====Clinical manifestations===== | |||
=====Laboratory abnormalities===== | |||
=====Radiographic features===== | |||
---- | ---- | ||
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The following clinical manifestations (if present) would support this disease: | The following clinical manifestations (if present) would support this disease: | ||
corneal deposit | * corneal deposit | ||
corneal opacity | * corneal opacity | ||
parotid gland swelling | * parotid gland swelling | ||
polyneuropathy | * polyneuropathy | ||
cranial nerve paralysis | * cranial nerve paralysis | ||
airway compression or obstruction | * airway compression or obstruction | ||
retinal granuloma | * retinal granuloma | ||
erythema nodosum | * erythema nodosum | ||
uveitis | * uveitis | ||
ankle pain | * ankle pain | ||
facial paralysis | * facial paralysis | ||
salivary gland swelling | * salivary gland swelling | ||
splenomegaly, massive | * splenomegaly, massive | ||
cryptococcosis | * cryptococcosis | ||
generalized rash, papules (elevated, <0.5cm) | * generalized rash, papules (elevated, <0.5cm) | ||
iridocyclitis | * iridocyclitis | ||
iritis | * iritis | ||
cough, dry | * cough, dry | ||
night sweats | * night sweats | ||
spleen enlargement | * spleen enlargement | ||
uveitis, bilateral | * uveitis, bilateral | ||
generalized diffuse lymph node enlargement | * generalized diffuse lymph node enlargement | ||
polyarthritis | * polyarthritis | ||
The following lab data (if present) would be useful in establishing the presence of the disease: | The following lab data (if present) would be useful in establishing the presence of the disease: | ||
heart conduction abnormality, electrocardiographic | * heart conduction abnormality, electrocardiographic | ||
atrioventricular block | * atrioventricular block | ||
hypercalcemia | * hypercalcemia | ||
retroperitoneal lymph node enlargement | * retroperitoneal lymph node enlargement | ||
pleural effusion, lymphocytes increased | * pleural effusion, lymphocytes increased | ||
CXR lung cyst | * CXR lung cyst | ||
lymphocytes decreased | * lymphocytes decreased | ||
chest xray interstitial infiltrate ( incl. reticulonodular ) | * chest xray interstitial infiltrate ( incl. reticulonodular ) | ||
hypercalciuria | * hypercalciuria | ||
alkaline phosphatase, mild-moderate elevation | * alkaline phosphatase, mild-moderate elevation | ||
gallium scan increased uptake, mediastinum | * gallium scan increased uptake, mediastinum | ||
gallium scan increased uptake, lungs | * gallium scan increased uptake, lungs | ||
PFT's: restrictive defect | * PFT's: restrictive defect | ||
PFT's: diffusion capacity decreased | * PFT's: diffusion capacity decreased | ||
mediastinal lymph node enlargement | * mediastinal lymph node enlargement | ||
bone marrow granulomas | * bone marrow granulomas | ||
serum angiotensin-converting enzyme elevated | * serum angiotensin-converting enzyme elevated | ||
vitamin D, 1,25-dihydroxy, increased | * vitamin D, 1,25-dihydroxy, increased | ||
chest xray mediastinal mass, adenopathy, or widening | * chest xray mediastinal mass, adenopathy, or widening | ||
granulomas on biopsy | * granulomas on biopsy | ||
chest xray hilar lymph node enlargement | * chest xray hilar lymph node enlargement | ||
---- | ---- | ||
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The following clinical manifestations (if present) would support this disease: | The following clinical manifestations (if present) would support this disease: | ||
mental nerve neuropathy | * mental nerve neuropathy | ||
dermatitis, exfoliative | * dermatitis, exfoliative | ||
extremity paralysis, lower | * extremity paralysis, lower | ||
gout | * gout | ||
esophageal candidiasis | * esophageal candidiasis | ||
abdominal mass | * abdominal mass | ||
biliary tract obstruction | * biliary tract obstruction | ||
breast mass | * breast mass | ||
epitrochlear lymph node enlargement | * epitrochlear lymph node enlargement | ||
erythema multiforme | * erythema multiforme | ||
erythema nodosum | * erythema nodosum | ||
esophageal obstruction | * esophageal obstruction | ||
facial edema | * facial edema | ||
gastric obstruction | * gastric obstruction | ||
thyroid nodule | * thyroid nodule | ||
hepatosplenomegaly | * hepatosplenomegaly | ||
intestinal obstruction | * intestinal obstruction | ||
intussusception | * intussusception | ||
liver mass | * liver mass | ||
mesenteric lymph node enlargement | * mesenteric lymph node enlargement | ||
mucous membrane bleeding | * mucous membrane bleeding | ||
night sweats | * night sweats | ||
paraplegia | * paraplegia | ||
pruritus | * pruritus | ||
anergy | * anergy | ||
spinal cord compression | * spinal cord compression | ||
stool clay color | * stool clay color | ||
stool color yellow | * stool color yellow | ||
superior vena cava obstruction | * superior vena cava obstruction | ||
supraclavicular lymph node enlargement | * supraclavicular lymph node enlargement | ||
testicular mass | * testicular mass | ||
urinary tract obstruction | * urinary tract obstruction | ||
inferior vena cava obstruction | * inferior vena cava obstruction | ||
generalized diffuse lymph node enlargement | * generalized diffuse lymph node enlargement | ||
splenomegaly, massive | * splenomegaly, massive | ||
femoral lymph node enlargement | * femoral lymph node enlargement | ||
popliteal lymph node enlargement | * popliteal lymph node enlargement | ||
airway compression or obstruction | * airway compression or obstruction | ||
cryptococcosis | * cryptococcosis | ||
recurrent infection | * recurrent infection | ||
lymph node, fixed | * lymph node, fixed | ||
neck mass | * neck mass | ||
spleen enlargement | * spleen enlargement | ||
fever unknown origin | * fever unknown origin | ||
regional lymph node enlargement | * regional lymph node enlargement | ||
painless lymphadenopathy | * painless lymphadenopathy | ||
cancer | * cancer | ||
lymphoma | * lymphoma | ||
non-Hodgkin lymphoma | * non-Hodgkin lymphoma | ||
The following lab data (if present) would be useful in establishing the presence of the disease: | The following lab data (if present) would be useful in establishing the presence of the disease: | ||
IVP bladder mass or abnormal shape | * IVP bladder mass or abnormal shape | ||
hypercalcemia, extreme (>14 mg/dl) | * hypercalcemia, extreme (>14 mg/dl) | ||
bone destruction | * bone destruction | ||
kidney mass | * kidney mass | ||
mediastinal lymph node enlargement | * mediastinal lymph node enlargement | ||
prolonged bleeding time | * prolonged bleeding time | ||
ESR markedly increased | * ESR markedly increased | ||
retroperitoneal lymph node enlargement | * retroperitoneal lymph node enlargement | ||
hypogammaglobulinemia | * hypogammaglobulinemia | ||
bone lesion | * bone lesion | ||
pancytopenia | * pancytopenia | ||
lymphocytes decreased | * lymphocytes decreased | ||
chest xray mediastinal mass, adenopathy, or widening | * chest xray mediastinal mass, adenopathy, or widening | ||
chest xray mediastinal mass anterior | * chest xray mediastinal mass anterior | ||
pleural effusion, exudate | * pleural effusion, exudate | ||
bone marrow plasma cells increased | * bone marrow plasma cells increased | ||
cryoglobulinemia | * cryoglobulinemia | ||
abdominal ultrasound, biliary tract dilatation | * abdominal ultrasound, biliary tract dilatation | ||
pleural effusion, lymphocytes increased | * pleural effusion, lymphocytes increased | ||
pleural effusion, chylous | * pleural effusion, chylous | ||
malignant ascites | * malignant ascites | ||
gallium scan increased uptake, mediastinum | * gallium scan increased uptake, mediastinum | ||
gallium scan, increased uptake, abdomen | * gallium scan, increased uptake, abdomen | ||
vitamin D, 1,25-dihydroxy, increased | * vitamin D, 1,25-dihydroxy, increased | ||
---- | ---- | ||
The following clinical manifestations (if present) would support this disease: | The following clinical manifestations (if present) would support this disease: | ||
prison inmate | * prison inmate | ||
retinal granuloma | * retinal granuloma | ||
erythema nodosum | * erythema nodosum | ||
Haiti | * Haiti | ||
immunosuppressive therapy | * immunosuppressive therapy | ||
weight loss, severe | * weight loss, severe | ||
corticosteroid use | * corticosteroid use | ||
chest pain, pleuritic | * chest pain, pleuritic | ||
dyspnea, progressive | * dyspnea, progressive | ||
fever unknown origin | * fever unknown origin | ||
retinitis | * retinitis | ||
tuberculosis exposure | * tuberculosis exposure | ||
The following lab data (if present) would be useful in establishing the presence of the disease: | The following lab data (if present) would be useful in establishing the presence of the disease: | ||
pancytopenia | * pancytopenia | ||
PPD positive | * PPD positive | ||
nucleated red cells | * nucleated red cells | ||
gallium scan, increased uptake, abdomen | * gallium scan, increased uptake, abdomen | ||
abdominal CT: multiple hypodense liver lesions | * abdominal CT: multiple hypodense liver lesions | ||
bone marrow granulomas | * bone marrow granulomas | ||
AFB smear positive | * AFB smear positive | ||
chest xray multiple pulmonary nodules, non-calcified | * chest xray multiple pulmonary nodules, non-calcified | ||
granulomas on biopsy | * granulomas on biopsy | ||
---- | ---- | ||
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The following clinical manifestations (if present) would support this disease: | The following clinical manifestations (if present) would support this disease: | ||
optic neuritis | * optic neuritis | ||
epitrochlear lymph node enlargement | * epitrochlear lymph node enlargement | ||
periorbital edema | * periorbital edema | ||
pharyngeal petechia | * pharyngeal petechia | ||
spleen enlargement | * spleen enlargement | ||
spleen palpable | * spleen palpable | ||
tonsillitis | * tonsillitis | ||
abdominal tenderness, left upper quadrant | * abdominal tenderness, left upper quadrant | ||
axillary lymph node enlargement | * axillary lymph node enlargement | ||
inguinal lymph node enlargement | * inguinal lymph node enlargement | ||
mesenteric lymph node enlargement | * mesenteric lymph node enlargement | ||
pharyngeal exudate | * pharyngeal exudate | ||
pharyngeal erythema | * pharyngeal erythema | ||
spleen tenderness | * spleen tenderness | ||
tonsillar exudate | * tonsillar exudate | ||
generalized diffuse lymph node enlargement | * generalized diffuse lymph node enlargement | ||
cervical lymph node enlargement | * cervical lymph node enlargement | ||
pharyngeal swelling | * pharyngeal swelling | ||
sore throat | * sore throat | ||
The following lab data (if present) would be useful in establishing the presence of the disease: | The following lab data (if present) would be useful in establishing the presence of the disease: | ||
SGPT (ALT), marked elevation | * SGPT (ALT), marked elevation | ||
SGPT (ALT), elevated | * SGPT (ALT), elevated | ||
lymphocytes increased | * lymphocytes increased | ||
atypical lymphocytes increased | * atypical lymphocytes increased | ||
heterophile antibody positive | * heterophile antibody positive | ||
monocytes, increased | * monocytes, increased | ||
Epstein-Barr virus titre positive | * Epstein-Barr virus titre positive | ||
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The following clinical manifestations (if present) would support this disease: | The following clinical manifestations (if present) would support this disease: | ||
cocaine use | * cocaine use | ||
Turner syndrome | * Turner syndrome | ||
Pemberton sign positive | * Pemberton sign positive | ||
marfan syndrome | * marfan syndrome | ||
aortic valve regurgitation | * aortic valve regurgitation | ||
superior vena cava obstruction | * superior vena cava obstruction | ||
aortic dilation, ascending | * aortic dilation, ascending | ||
The following lab data (if present) would be useful in establishing the presence of the disease: | The following lab data (if present) would be useful in establishing the presence of the disease: | ||
chest xray mediastinal mass middle | * chest xray mediastinal mass middle | ||
chest xray mediastinal mass posterior | * chest xray mediastinal mass posterior | ||
mediastinal widening | * mediastinal widening | ||
chest xray aorta prominent or enlarged | * chest xray aorta prominent or enlarged | ||
chest xray mediastinal mass anterior | * chest xray mediastinal mass anterior | ||
chest xray mediastinal mass, adenopathy, or widening | * chest xray mediastinal mass, adenopathy, or widening | ||
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The following clinical manifestations (if present) would support this disease: | The following clinical manifestations (if present) would support this disease: | ||
upper extremity edema | * upper extremity edema | ||
chest mass | * chest mass | ||
neck mass | * neck mass | ||
thyroid enlargement | * thyroid enlargement | ||
tracheal compression | * tracheal compression | ||
Pemberton sign positive | * Pemberton sign positive | ||
The following lab data (if present) would be useful in establishing the presence of the disease: | The following lab data (if present) would be useful in establishing the presence of the disease: | ||
TSH elevated | * TSH elevated | ||
chest xray mediastinal mass, adenopathy, or widening | * chest xray mediastinal mass, adenopathy, or widening | ||
chest xray mediastinal mass anterior | * chest xray mediastinal mass anterior | ||
---- | ---- | ||
Evidence of "THYMOMA" (RARE) | Evidence of "THYMOMA" (RARE) | ||
The following clinical manifestations (if present) would support this disease: | The following clinical manifestations (if present) would support this disease: | ||
bulbar palsy | * bulbar palsy | ||
facial candida infection | * facial candida infection | ||
facial cyanosis | * facial cyanosis | ||
jugular venous distention | * jugular venous distention | ||
mouth candida infection | * mouth candida infection | ||
superior vena cava obstruction | * superior vena cava obstruction | ||
diplopia | * diplopia | ||
Pemberton sign positive | * Pemberton sign positive | ||
The following lab data (if present) would be useful in establishing the presence of the disease: | The following lab data (if present) would be useful in establishing the presence of the disease: | ||
pancytopenia | * pancytopenia | ||
antistriational antibodies | * antistriational antibodies | ||
chest xray mediastinal mass, adenopathy, or widening | * chest xray mediastinal mass, adenopathy, or widening | ||
chest xray mediastinal mass anterior | * chest xray mediastinal mass anterior | ||
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Evidence of "ACTINOMYCOSIS" (RARE) | Evidence of "ACTINOMYCOSIS" (RARE) | ||
The following clinical manifestations (if present) would support this disease: | The following clinical manifestations (if present) would support this disease: | ||
* tongue mass | |||
tongue mass | * trismus | ||
trismus | * pericardial constriction | ||
pericardial constriction | * pharyngeal swelling | ||
pharyngeal swelling | * pharyngeal tenderness | ||
pharyngeal tenderness | * abdominal fistula | ||
abdominal fistula | * bronchial fistula | ||
bronchial fistula | * empyema | ||
empyema | * lung abscess | ||
lung abscess | * abdominal mass, right lower quadrant | ||
abdominal mass, right lower quadrant | * chest wall suppuration | ||
chest wall suppuration | * gingival fistula | ||
gingival fistula | * chest wall fistula | ||
chest wall fistula | * gingival swelling | ||
gingival swelling | * gingival tenderness | ||
gingival tenderness | * jaw induration | ||
jaw induration | * mandibular swelling | ||
mandibular swelling | |||
The following lab data (if present) would be useful in establishing the presence of the disease: | The following lab data (if present) would be useful in establishing the presence of the disease: | ||
* echocardiogram: intracardiac mass | |||
echocardiogram: intracardiac mass | * hepatic cyst(s) | ||
hepatic cyst(s) | * mediastinal lymph node enlargement | ||
mediastinal lymph node enlargement | * chest xray mediastinal mass, adenopathy, or widening | ||
chest xray mediastinal mass, adenopathy, or widening | * Gram stain: branching Gram-positive bacilli | ||
Gram stain: branching Gram-positive bacilli | * sulfur granule | ||
sulfur granule | |||
---- | ---- | ||
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The following clinical manifestations (if present) would support this disease: | The following clinical manifestations (if present) would support this disease: | ||
skin infiltration | * skin infiltration | ||
sternal tenderness | * sternal tenderness | ||
lymph node firmness | * lymph node firmness | ||
The following lab data (if present) would be useful in establishing the presence of the disease: | The following lab data (if present) would be useful in establishing the presence of the disease: | ||
hemolysis | * hemolysis | ||
mediastinal lymph node enlargement | * mediastinal lymph node enlargement | ||
prolonged bleeding time | * prolonged bleeding time | ||
chest xray mediastinal mass, adenopathy, or widening | * chest xray mediastinal mass, adenopathy, or widening | ||
monoclonal gammopathy | * monoclonal gammopathy | ||
cryoglobulinemia | * cryoglobulinemia | ||
leukocytes, marked increase | * leukocytes, marked increase | ||
flow cytometry: clonal B-lymphocytes | * flow cytometry: clonal B-lymphocytes | ||
lymphocytes increased | * lymphocytes increased | ||
The following findings (if present) would make this disease less likely: | The following findings (if present) would make this disease less likely: | ||
left shift | * left shift | ||
metamyelocytes increased | * metamyelocytes increased | ||
---- | ---- | ||
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The following clinical manifestations (if present) would support this disease: | The following clinical manifestations (if present) would support this disease: | ||
stridor | * stridor | ||
facial erythema | * facial erythema | ||
forehead vein distention | * forehead vein distention | ||
lymphoma | * lymphoma | ||
tracheal displacement | * tracheal displacement | ||
chest vein distention | * chest vein distention | ||
facial cyanosis | * facial cyanosis | ||
collateral circulation increase | * collateral circulation increase | ||
conjunctival edema | * conjunctival edema | ||
conjunctival vein distention | * conjunctival vein distention | ||
upper extremity edema | * upper extremity edema | ||
upper extremity erythema | * upper extremity erythema | ||
head edema | * head edema | ||
jugular venous distention with inspiration | * jugular venous distention with inspiration | ||
lung tumor | * lung tumor | ||
extremity cyanosis | * extremity cyanosis | ||
upper extremity vein distention | * upper extremity vein distention | ||
facial edema | * facial edema | ||
neck edema | * neck edema | ||
jugular venous distention | * jugular venous distention | ||
lung cancer | * lung cancer | ||
upper extremity cyanosis | * upper extremity cyanosis | ||
facial vein distention | * facial vein distention | ||
superior vena cava obstruction | * superior vena cava obstruction | ||
The following lab data (if present) would be useful in establishing the presence of the disease: | The following lab data (if present) would be useful in establishing the presence of the disease: | ||
mediastinal lymph node enlargement | * mediastinal lymph node enlargement | ||
chest xray pulmonary nodule (< 4 cm), non-calcified | * chest xray pulmonary nodule (< 4 cm), non-calcified | ||
chest xray mediastinal mass, adenopathy, or widening | * chest xray mediastinal mass, adenopathy, or widening | ||
The following findings (if present) would exclude this disease: | The following findings (if present) would exclude this disease: | ||
hepatojugular reflux | * hepatojugular reflux | ||
---- | ---- | ||
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Evidence of "UNICENTRIC CASTLEMAN DISEASE" (RARE) | Evidence of "UNICENTRIC CASTLEMAN DISEASE" (RARE) | ||
The following lab data (if present) would be useful in establishing the presence of the disease: | * The following lab data (if present) would be useful in establishing the presence of the disease: | ||
mediastinal lymph node enlargement | * mediastinal lymph node enlargement | ||
chest xray mediastinal mass, adenopathy, or widening | * chest xray mediastinal mass, adenopathy, or widening | ||
---- | ---- | ||
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The following clinical manifestations (if present) would support this disease: | The following clinical manifestations (if present) would support this disease: | ||
ankylosis | * ankylosis | ||
hepatosplenomegaly | * hepatosplenomegaly | ||
weight loss, severe | * weight loss, severe | ||
fever, recurrent | * fever, recurrent | ||
night sweats | * night sweats | ||
wrist pain | * wrist pain | ||
generalized diffuse lymph node enlargement | * generalized diffuse lymph node enlargement | ||
fever unknown origin | * fever unknown origin | ||
fever, remittent | * fever, remittent | ||
fever, high grade | * fever, high grade | ||
polyarticular | * polyarticular | ||
rash, evanescent | * rash, evanescent | ||
The following lab data (if present) would be useful in establishing the presence of the disease: | The following lab data (if present) would be useful in establishing the presence of the disease: | ||
leukocytes, marked increase | * leukocytes, marked increase | ||
ESR markedly increased | * ESR markedly increased | ||
serum ferritin greatly increased | * serum ferritin greatly increased | ||
The following findings (if present) would make this disease less likely: | The following findings (if present) would make this disease less likely: | ||
monoarticular | * monoarticular | ||
The following findings (if present) would exclude this disease: | The following findings (if present) would exclude this disease: | ||
asymptomatic | * asymptomatic | ||
---- | ---- | ||
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The following clinical manifestations (if present) would support this disease: | The following clinical manifestations (if present) would support this disease: | ||
acanthosis nigricans | * acanthosis nigricans | ||
axillary lymph node enlargement | * axillary lymph node enlargement | ||
axillary lymph node pain | * axillary lymph node pain | ||
dysphagia | * dysphagia | ||
esophageal obstruction | * esophageal obstruction | ||
heart tamponade | * heart tamponade | ||
pericardial effusion | * pericardial effusion | ||
rib tenderness, lower | * rib tenderness, lower | ||
tracheal displacement | * tracheal displacement | ||
hoarseness | * hoarseness | ||
digital clubbing | * digital clubbing | ||
airway compression or obstruction | * airway compression or obstruction | ||
Pemberton sign positive | * Pemberton sign positive | ||
palms, velvet | * palms, velvet | ||
Horner syndrome | * Horner syndrome | ||
superior vena cava obstruction | * superior vena cava obstruction | ||
bone pain | * bone pain | ||
spinal cord compression | * spinal cord compression | ||
supraclavicular lymph node enlargement | * supraclavicular lymph node enlargement | ||
intracranial metastatic tumor | * intracranial metastatic tumor | ||
acute symmetrical peripheral neuropathy | * acute symmetrical peripheral neuropathy | ||
hemoptysis | * hemoptysis | ||
right supraclavicular lymph node enlargement | * right supraclavicular lymph node enlargement | ||
tobacco smoking | * tobacco smoking | ||
The following lab data (if present) would be useful in establishing the presence of the disease: | The following lab data (if present) would be useful in establishing the presence of the disease: | ||
bone destruction | * bone destruction | ||
chest xray unilateral diaphragm elevation | * chest xray unilateral diaphragm elevation | ||
chest xray pulmonary nodule (< 4 cm), non-calcified | * chest xray pulmonary nodule (< 4 cm), non-calcified | ||
chest xray mediastinal mass, adenopathy, or widening | * chest xray mediastinal mass, adenopathy, or widening | ||
pleural effusion | * pleural effusion | ||
pleural effusion, bloody | * pleural effusion, bloody | ||
chest xray pulmonary mass (>= 4 cm), non-calcified | * chest xray pulmonary mass (>= 4 cm), non-calcified | ||
hyponatremia | * hyponatremia | ||
bone marrow tumor cells | * bone marrow tumor cells | ||
serum calcitonin, increased | * serum calcitonin, increased | ||
chest xray hilar lymph node enlargement | * chest xray hilar lymph node enlargement | ||
The following findings (if present) would make this disease less likely: | The following findings (if present) would make this disease less likely: | ||
chest xray normal | * chest xray normal | ||
chest CT (contrast enhanced) normal | * chest CT (contrast enhanced) normal | ||
---- | ---- | ||
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The following clinical manifestations (if present) would support this disease: | The following clinical manifestations (if present) would support this disease: | ||
tendon xanthoma | * tendon xanthoma | ||
xanthoma | * xanthoma | ||
tuberous xanthoma | * tuberous xanthoma | ||
planar xanthoma | * planar xanthoma | ||
palmar planar xanthoma | * palmar planar xanthoma | ||
hepatosplenomegaly | * hepatosplenomegaly | ||
spleen enlargement | * spleen enlargement | ||
panniculitis | * panniculitis | ||
generalized diffuse lymph node enlargement | * generalized diffuse lymph node enlargement | ||
The following lab data (if present) would be useful in establishing the presence of the disease: | The following lab data (if present) would be useful in establishing the presence of the disease: | ||
ESR markedly increased | * ESR markedly increased | ||
serum ferritin greatly increased | * serum ferritin greatly increased | ||
ESR mildly or moderately increased | * ESR mildly or moderately increased | ||
C-reactive protein elevated | * C-reactive protein elevated | ||
Revision as of 18:12, 13 August 2015
Differential Diagnosis
The following conditions must be considered in the differential diagnosis of Hodgkin's lymphoma:
DDx [1][2][3][4][5][6][7]- Sarcoidosis
DDx - Lymphocytic lymphoma
DDx - Miliary tuberculosis
DDx - Infectious mononucleosis
DDx - Thoracic aortic aneurysm
DDx - Substernal goiter
DDx - Thymoma
DDx - Actinomycosis
DDx - Chronic lymphocytic leukemia
DDx - Superior vena cava syndrome
DDx - Unicentric Castleman disease
DDx - Adult Still disease
DDx - Small cell lung carcinoma
DDx - Malignant histiocytosis
DDx
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Mahshid Mir, M.D. [2]
| Differential Diagnosis | |
|---|---|
| DDx Alphabetic Order | |
| A | B |
| C | D |
| E | F |
| G | H |
| I | J |
| K | L |
| M | N |
| O | P |
| Q | R |
| S | T |
| U | V |
| W | X |
| Y | Z |
Clinical manifestations
- mental nerve neuropathy
- alcohol intolerance
- dermatitis, exfoliative
- epitrochlear lymph node enlargement
- inguinal lymph node enlargement
- hepatomegaly
- liver mass
- superior vena cava obstruction
- inferior vena cava obstruction
- femoral lymph node enlargement
- popliteal lymph node enlargement
- Pemberton sign positive
- fever, Pel-Ebstein
- ascites, chylous
- axillary lymph node enlargement
- erythema multiforme
- erythema nodosum
- hepatosplenomegaly
- mesenteric lymph node enlargement
- paraplegia
- pruritus
- spinal cord compression
- spleen enlargement
- urinary tract obstruction
- generalized diffuse lymph node enlargement
- airway compression or obstruction
- cryptococcosis
- bone pain
- cervical lymph node enlargement
- fever, recurrent
- recurrent infection
- lymph node, fixed
- neck mass
- night sweats
- anergy
- supraclavicular lymph node enlargement
- sweating increase
- fever unknown origin
- fever, remittent
- painless lymphadenopathy
- regional lymph node enlargement
Laboratory abnormalities
- nucleated red cells
- hypogammaglobulinemia
- pancytopenia
- lymphocytes decreased
- granulomas on biopsy
Radiographic features
- retroperitoneal lymph node enlargement
- abdominal ultrasound, biliary tract dilatation
- bone lesion
- chest xray mediastinal mass, adenopathy, or widening
- chest xray mediastinal mass middle
- mediastinal lymph node enlargement
- Anterior mediastinal mass on chest radiograph
- gallium scan, increased uptake, abdomen
- ivory vertebra
- gallium scan increased uptake, mediastinum
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [3] Mahshid Mir, M.D. [4]
| Differential Diagnosis | |
|---|---|
| DDx Alphabetic Order | |
| A | B |
| C | D |
| E | F |
| G | H |
| I | J |
| K | L |
| M | N |
| O | P |
| Q | R |
| S | T |
| U | V |
| W | X |
| Y | Z |
Clinical manifestations
Laboratory abnormalities
Radiographic features
Evidence of "SARCOIDOSIS" (COMMON)
The following clinical manifestations (if present) would support this disease:
- corneal deposit
- corneal opacity
- parotid gland swelling
- polyneuropathy
- cranial nerve paralysis
- airway compression or obstruction
- retinal granuloma
- erythema nodosum
- uveitis
- ankle pain
- facial paralysis
- salivary gland swelling
- splenomegaly, massive
- cryptococcosis
- generalized rash, papules (elevated, <0.5cm)
- iridocyclitis
- iritis
- cough, dry
- night sweats
- spleen enlargement
- uveitis, bilateral
- generalized diffuse lymph node enlargement
- polyarthritis
The following lab data (if present) would be useful in establishing the presence of the disease:
- heart conduction abnormality, electrocardiographic
- atrioventricular block
- hypercalcemia
- retroperitoneal lymph node enlargement
- pleural effusion, lymphocytes increased
- CXR lung cyst
- lymphocytes decreased
- chest xray interstitial infiltrate ( incl. reticulonodular )
- hypercalciuria
- alkaline phosphatase, mild-moderate elevation
- gallium scan increased uptake, mediastinum
- gallium scan increased uptake, lungs
- PFT's: restrictive defect
- PFT's: diffusion capacity decreased
- mediastinal lymph node enlargement
- bone marrow granulomas
- serum angiotensin-converting enzyme elevated
- vitamin D, 1,25-dihydroxy, increased
- chest xray mediastinal mass, adenopathy, or widening
- granulomas on biopsy
- chest xray hilar lymph node enlargement
Evidence of "LYMPHOCYTIC LYMPHOMA" (COMMON)
The following clinical manifestations (if present) would support this disease:
- mental nerve neuropathy
- dermatitis, exfoliative
- extremity paralysis, lower
- gout
- esophageal candidiasis
- abdominal mass
- biliary tract obstruction
- breast mass
- epitrochlear lymph node enlargement
- erythema multiforme
- erythema nodosum
- esophageal obstruction
- facial edema
- gastric obstruction
- thyroid nodule
- hepatosplenomegaly
- intestinal obstruction
- intussusception
- liver mass
- mesenteric lymph node enlargement
- mucous membrane bleeding
- night sweats
- paraplegia
- pruritus
- anergy
- spinal cord compression
- stool clay color
- stool color yellow
- superior vena cava obstruction
- supraclavicular lymph node enlargement
- testicular mass
- urinary tract obstruction
- inferior vena cava obstruction
- generalized diffuse lymph node enlargement
- splenomegaly, massive
- femoral lymph node enlargement
- popliteal lymph node enlargement
- airway compression or obstruction
- cryptococcosis
- recurrent infection
- lymph node, fixed
- neck mass
- spleen enlargement
- fever unknown origin
- regional lymph node enlargement
- painless lymphadenopathy
- cancer
- lymphoma
- non-Hodgkin lymphoma
The following lab data (if present) would be useful in establishing the presence of the disease:
- IVP bladder mass or abnormal shape
- hypercalcemia, extreme (>14 mg/dl)
- bone destruction
- kidney mass
- mediastinal lymph node enlargement
- prolonged bleeding time
- ESR markedly increased
- retroperitoneal lymph node enlargement
- hypogammaglobulinemia
- bone lesion
- pancytopenia
- lymphocytes decreased
- chest xray mediastinal mass, adenopathy, or widening
- chest xray mediastinal mass anterior
- pleural effusion, exudate
- bone marrow plasma cells increased
- cryoglobulinemia
- abdominal ultrasound, biliary tract dilatation
- pleural effusion, lymphocytes increased
- pleural effusion, chylous
- malignant ascites
- gallium scan increased uptake, mediastinum
- gallium scan, increased uptake, abdomen
- vitamin D, 1,25-dihydroxy, increased
The following clinical manifestations (if present) would support this disease:
- prison inmate
- retinal granuloma
- erythema nodosum
- Haiti
- immunosuppressive therapy
- weight loss, severe
- corticosteroid use
- chest pain, pleuritic
- dyspnea, progressive
- fever unknown origin
- retinitis
- tuberculosis exposure
The following lab data (if present) would be useful in establishing the presence of the disease:
- pancytopenia
- PPD positive
- nucleated red cells
- gallium scan, increased uptake, abdomen
- abdominal CT: multiple hypodense liver lesions
- bone marrow granulomas
- AFB smear positive
- chest xray multiple pulmonary nodules, non-calcified
- granulomas on biopsy
Evidence of "INFECTIOUS MONONUCLEOSIS" (COMMON) The following clinical manifestations (if present) would support this disease:
- optic neuritis
- epitrochlear lymph node enlargement
- periorbital edema
- pharyngeal petechia
- spleen enlargement
- spleen palpable
- tonsillitis
- abdominal tenderness, left upper quadrant
- axillary lymph node enlargement
- inguinal lymph node enlargement
- mesenteric lymph node enlargement
- pharyngeal exudate
- pharyngeal erythema
- spleen tenderness
- tonsillar exudate
- generalized diffuse lymph node enlargement
- cervical lymph node enlargement
- pharyngeal swelling
- sore throat
The following lab data (if present) would be useful in establishing the presence of the disease:
- SGPT (ALT), marked elevation
- SGPT (ALT), elevated
- lymphocytes increased
- atypical lymphocytes increased
- heterophile antibody positive
- monocytes, increased
- Epstein-Barr virus titre positive
Evidence of "THORACIC AORTIC ANEURYSM" (RARE)
The following clinical manifestations (if present) would support this disease:
- cocaine use
- Turner syndrome
- Pemberton sign positive
- marfan syndrome
- aortic valve regurgitation
- superior vena cava obstruction
- aortic dilation, ascending
The following lab data (if present) would be useful in establishing the presence of the disease:
- chest xray mediastinal mass middle
- chest xray mediastinal mass posterior
- mediastinal widening
- chest xray aorta prominent or enlarged
- chest xray mediastinal mass anterior
- chest xray mediastinal mass, adenopathy, or widening
Evidence of "SUBSTERNAL GOITER" (RARE)
The following clinical manifestations (if present) would support this disease:
- upper extremity edema
- chest mass
- neck mass
- thyroid enlargement
- tracheal compression
- Pemberton sign positive
The following lab data (if present) would be useful in establishing the presence of the disease:
- TSH elevated
- chest xray mediastinal mass, adenopathy, or widening
- chest xray mediastinal mass anterior
Evidence of "THYMOMA" (RARE)
The following clinical manifestations (if present) would support this disease:
- bulbar palsy
- facial candida infection
- facial cyanosis
- jugular venous distention
- mouth candida infection
- superior vena cava obstruction
- diplopia
- Pemberton sign positive
The following lab data (if present) would be useful in establishing the presence of the disease:
- pancytopenia
- antistriational antibodies
- chest xray mediastinal mass, adenopathy, or widening
- chest xray mediastinal mass anterior
Evidence of "ACTINOMYCOSIS" (RARE)
The following clinical manifestations (if present) would support this disease:
- tongue mass
- trismus
- pericardial constriction
- pharyngeal swelling
- pharyngeal tenderness
- abdominal fistula
- bronchial fistula
- empyema
- lung abscess
- abdominal mass, right lower quadrant
- chest wall suppuration
- gingival fistula
- chest wall fistula
- gingival swelling
- gingival tenderness
- jaw induration
- mandibular swelling
The following lab data (if present) would be useful in establishing the presence of the disease:
- echocardiogram: intracardiac mass
- hepatic cyst(s)
- mediastinal lymph node enlargement
- chest xray mediastinal mass, adenopathy, or widening
- Gram stain: branching Gram-positive bacilli
- sulfur granule
Evidence of "CHRONIC LYMPHOCYTIC LEUKEMIA" (RARE)
The following clinical manifestations (if present) would support this disease:
- skin infiltration
- sternal tenderness
- lymph node firmness
The following lab data (if present) would be useful in establishing the presence of the disease:
- hemolysis
- mediastinal lymph node enlargement
- prolonged bleeding time
- chest xray mediastinal mass, adenopathy, or widening
- monoclonal gammopathy
- cryoglobulinemia
- leukocytes, marked increase
- flow cytometry: clonal B-lymphocytes
- lymphocytes increased
The following findings (if present) would make this disease less likely:
- left shift
- metamyelocytes increased
Evidence of "SUPERIOR VENA CAVA SYNDROME" (RARE - Urgent action required) The following clinical manifestations (if present) would support this disease:
- stridor
- facial erythema
- forehead vein distention
- lymphoma
- tracheal displacement
- chest vein distention
- facial cyanosis
- collateral circulation increase
- conjunctival edema
- conjunctival vein distention
- upper extremity edema
- upper extremity erythema
- head edema
- jugular venous distention with inspiration
- lung tumor
- extremity cyanosis
- upper extremity vein distention
- facial edema
- neck edema
- jugular venous distention
- lung cancer
- upper extremity cyanosis
- facial vein distention
- superior vena cava obstruction
The following lab data (if present) would be useful in establishing the presence of the disease:
- mediastinal lymph node enlargement
- chest xray pulmonary nodule (< 4 cm), non-calcified
- chest xray mediastinal mass, adenopathy, or widening
The following findings (if present) would exclude this disease:
- hepatojugular reflux
Evidence of "UNICENTRIC CASTLEMAN DISEASE" (RARE)
- The following lab data (if present) would be useful in establishing the presence of the disease:
- mediastinal lymph node enlargement
- chest xray mediastinal mass, adenopathy, or widening
Evidence of "ADULT STILL DISEASE" (RARE)
The following clinical manifestations (if present) would support this disease:
- ankylosis
- hepatosplenomegaly
- weight loss, severe
- fever, recurrent
- night sweats
- wrist pain
- generalized diffuse lymph node enlargement
- fever unknown origin
- fever, remittent
- fever, high grade
- polyarticular
- rash, evanescent
The following lab data (if present) would be useful in establishing the presence of the disease:
- leukocytes, marked increase
- ESR markedly increased
- serum ferritin greatly increased
The following findings (if present) would make this disease less likely:
- monoarticular
The following findings (if present) would exclude this disease:
- asymptomatic
Evidence of "SMALL CELL LUNG CARCINOMA" (COMMON)
The following clinical manifestations (if present) would support this disease:
- acanthosis nigricans
- axillary lymph node enlargement
- axillary lymph node pain
- dysphagia
- esophageal obstruction
- heart tamponade
- pericardial effusion
- rib tenderness, lower
- tracheal displacement
- hoarseness
- digital clubbing
- airway compression or obstruction
- Pemberton sign positive
- palms, velvet
- Horner syndrome
- superior vena cava obstruction
- bone pain
- spinal cord compression
- supraclavicular lymph node enlargement
- intracranial metastatic tumor
- acute symmetrical peripheral neuropathy
- hemoptysis
- right supraclavicular lymph node enlargement
- tobacco smoking
The following lab data (if present) would be useful in establishing the presence of the disease:
- bone destruction
- chest xray unilateral diaphragm elevation
- chest xray pulmonary nodule (< 4 cm), non-calcified
- chest xray mediastinal mass, adenopathy, or widening
- pleural effusion
- pleural effusion, bloody
- chest xray pulmonary mass (>= 4 cm), non-calcified
- hyponatremia
- bone marrow tumor cells
- serum calcitonin, increased
- chest xray hilar lymph node enlargement
The following findings (if present) would make this disease less likely:
- chest xray normal
- chest CT (contrast enhanced) normal
Evidence of "MALIGNANT HISTIOCYTOSIS" (RARE)
The following clinical manifestations (if present) would support this disease:
- tendon xanthoma
- xanthoma
- tuberous xanthoma
- planar xanthoma
- palmar planar xanthoma
- hepatosplenomegaly
- spleen enlargement
- panniculitis
- generalized diffuse lymph node enlargement
The following lab data (if present) would be useful in establishing the presence of the disease:
- ESR markedly increased
- serum ferritin greatly increased
- ESR mildly or moderately increased
- C-reactive protein elevated
- ↑ Ferri, Fred (2011). Ferri's differential diagnosis: a practical guide to the differential diagnosis of symptoms, signs, and clinical disorders. Philadelphia, PA: Elsevier/Mosby. ISBN 978-0323076999.
- ↑ Siegenthaler, Walter (2007). Differential diagnosis in internal medicine: from symptom to diagnosis. Stuttgart New York: Thieme. ISBN 978-1588905512.
- ↑ Mesko, Dusan (2002). Differential diagnosis by laboratory medicine: a quick reference for physicians. Berlin New York: Springer-Verlag. ISBN 978-3540430575.
- ↑ Reeder and Felson's gamuts in radiology: comprehensive lists of roentgen differential diagnosis. Place of publication not identified: Springer. 2014. ISBN 978-1475781229.
- ↑ Burgener, Francis (2008). Differential diagnosis in conventional radiology. Stuttgart New York: Thieme. ISBN 978-1588902757.
- ↑ Gattuso, Paolo (2015). Differential diagnosis in surgical pathology. Philadelphia, PA: Saunders/Elsevier. ISBN 978-1455770137.
- ↑ "DXplain".