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==Differential Diagnosis==
'''==Differential Diagnosis==
{{ddx0|Hodgkin's lymphoma}}
{{ddx0|Hodgkin's lymphoma}}
{{ddx1|Sarcoidosis}}
{{ddx1|Sarcoidosis}}
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=====Clinical manifestations=====
=====Clinical manifestations=====
* mental nerve neuropathy  
* Mental nerve neuropathy  
* alcohol intolerance  
* Alcohol intolerance  
* dermatitis, exfoliative
* Exfoliative dermatitis
* epitrochlear lymph node enlargement  
* Epitrochlear lymph node enlargement  
* inguinal lymph node enlargement  
* Inguinal lymph node enlargement  
* hepatomegaly
* Hepatomegaly
* liver mass  
* Liver mass  
* superior vena cava obstruction  
* Superior vena cava obstruction  
* inferior vena cava obstruction  
* Inferior vena cava obstruction  
* femoral lymph node enlargement  
* Femoral lymph node enlargement  
* popliteal lymph node enlargement  
* Popliteal lymph node enlargement  
* Pemberton sign positive  
* Pemberton sign positive  
* fever, Pel-Ebstein  
* Pel-Ebstein fever
* ascites, chylous
* Chylous ascites
* axillary lymph node enlargement  
* Axillary lymph node enlargement  
* erythema multiforme  
* Erythema multiforme  
* erythema nodosum  
* Erythema nodosum  
* hepatosplenomegaly
* Hepatosplenomegaly
* mesenteric lymph node enlargement  
* Mesenteric lymph node enlargement  
* paraplegia
* Paraplegia
* pruritus
* Pruritus
* spinal cord compression  
* Spinal cord compression  
* spleen enlargement  
* Spleen enlargement  
* urinary tract obstruction  
* Urinary tract obstruction  
* generalized diffuse lymph node enlargement  
* Generalized diffuse lymph node enlargement  
* airway compression or obstruction  
* Airway compression or obstruction  
* cryptococcosis
* Cryptococcosis
* bone pain  
* Bone pain  
* cervical lymph node enlargement  
* Cervical lymph node enlargement  
* fever, recurrent
* Recurrent fever
* recurrent infection  
* Recurrent infection  
* lymph node, fixed
* Fixed lymph node
* neck mass  
* Neck mass  
* night sweats  
* Night sweats  
* anergy
* Anergy
* supraclavicular lymph node enlargement  
* Supraclavicular lymph node enlargement  
* sweating increase  
* Sweating increase  
* fever unknown origin  
* Fever unknown origin  
* fever, remittent
* Remittent fever  
* painless lymphadenopathy  
* Painless lymphadenopathy  
* regional lymph node enlargement  
* Regional lymph node enlargement  


=====Laboratory abnormalities=====
=====Laboratory abnormalities=====
* nucleated red cells  
* Nucleated red cells  
* hypogammaglobulinemia
* Hypogammaglobulinemia
* pancytopenia
* Pancytopenia
* lymphocytes decreased  
* Lymphocytes decreased  
* granulomas on biopsy  
* Granulomas on biopsy  


=====Radiographic features=====
=====Radiographic features=====
* retroperitoneal lymph node enlargement  
* Retroperitoneal lymph node enlargement  
* abdominal ultrasound, biliary tract dilatation
* Biliary tract dilatation on abdominal ultrasound  
* bone lesion  
* Bone lesion  
* chest xray mediastinal mass, adenopathy, or widening  
* Mediastinal mass,adenopathy, or widening on chest xray 
* chest xray mediastinal mass middle
* Middle mediastinal mass on chest xray  
* mediastinal lymph node enlargement  
* Mediastinal lymph node enlargement  
* Anterior mediastinal mass on chest radiograph
* Anterior mediastinal mass on chest radiograph
* gallium scan, increased uptake, abdomen
* Increased uptake on abdomen gallium scan
* ivory vertebra  
* Ivory vertebra  
* gallium scan increased uptake, mediastinum
* Increased uptake on mediastinum gallium scan




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=====Clinical manifestations=====
=====Clinical manifestations=====
 
* 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
* Massive splenomegaly
* Cryptococcosis
* Generalized rash, papules (elevated, <0.5cm)
* Iridocyclitis
* Iritis
* Dry cough
* Night sweats
* Spleen enlargement
* Bilateral uveitis 
* Generalized diffuse lymph node enlargement
* Polyarthritis


=====Laboratory abnormalities=====
=====Laboratory abnormalities=====
 
* Hypercalcemia
* Increased lymphocytes in pleural effusion
* Decreased Lymphocytes
* Hypercalciuria
* Mild-moderate elevation  of alkaline phosphatase 
* PFT's: restrictive defect
* PFT's: diffusion capacity decreased
* Elevated serum angiotensin-converting enzyme
* Increased vitamin D, 1,25-dihydroxy


=====Radiographic features=====
=====Radiographic features=====
 
* Heart conduction abnormality on electrocardiographic
 
* Atrioventricular block
* Retroperitoneal lymph node enlargement
* Lung cyst on chest radiography
* Interstitial infiltrate ( incl. reticulonodular )on chest radiography
* Increased mediastinal uptake on gallium scan
* Increased lung uptake on gallium scan
* Mediastinal lymph node enlargement
* Bone marrow granulomas
* Mediastinal mass, adenopathy, or widening on chest radiography
* Granulomas on biopsy
* Hilar lymph node enlargement on chest radiography


----
----


{{ddx|Lymphocytic lymphoma}}


 
=====Clinical manifestations=====
Evidence of "SARCOIDOSIS"  (COMMON)   
* Mental nerve neuropathy
* Exfoliative dermatitis
* Lower extremity paralysis
* 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
* Massive splenomegaly 
* Femoral lymph node enlargement
* Popliteal lymph node enlargement
* Airway compression or obstruction
* Cryptococcosis
* Recurrent infection
* Fixed lymph node
* Neck mass
* Spleen enlargement
* Fever unknown origin
* Regional lymph node enlargement
* Painless lymphadenopathy
* Cancer
* Lymphoma
* Non-Hodgkin lymphoma
   
   
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


----
=====Laboratory abnormalities=====
* Extreme hypercalcemia  (>14 mg/dl)
* Prolonged bleeding time
* Markedly increased ESR 
* Hypogammaglobulinemia
* Pancytopenia
* Lymphocytes decreased
* Pleural effusion (Exudate) 
* Bone marrow plasma cells increased
* Lymphocytes increased in pleural effusion 
* Pleural effusion (Chylous)
* Malignant ascites
* Cryoglobulinemia
* Vitamin D, 1,25-dihydroxy increased


Evidence of "LYMPHOCYTIC LYMPHOMA"  (COMMON)   
=====Radiographic features=====
* Bladder mass or abnormal shape on IVP
* Bone destruction
* Kidney mass
* Mediastinal lymph node enlargement
* Bone lesion
* Retroperitoneal lymph node enlargement
* Mediastinal mass, adenopathy, or widening on chest radiography
* Anterior mediastinal mass on chest radiography
* Biliary tract dilatation on abdominal ultrasound
* Increased mediastinal uptake on gallium scan
* Increased abdominal uptake on gallium scan
   
   
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


----
{{ddx|Miliary tuberculosis}}


=====Clinical manifestations=====
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
* Severe weight loss  
* corticosteroid use  
* Corticosteroid use  
* chest pain, pleuritic
* Pleuritic chest pain
* dyspnea, progressive
* Progressive dyspnea
* 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:
=====Laboratory abnormalities=====
* pancytopenia
* Pancytopenia
* PPD positive  
* PPD positive  
* nucleated red cells  
* Nucleated red cells  
* gallium scan, increased uptake, abdomen
* Bone marrow granulomas  
* abdominal CT: multiple hypodense liver lesions
* bone marrow granulomas  
* AFB smear positive  
* AFB smear positive  
* chest xray multiple pulmonary nodules, non-calcified  
* Granulomas on biopsy
* granulomas on biopsy
 
=====Radiographic features=====
* Increased abdominal uptake on gallium scan
* Multiple hypodense liver lesions on abdominal CT
* Multiple non-calcified pulmonary nodules on chest radiography


----
----


Evidence of "INFECTIOUS MONONUCLEOSIS"  (COMMON)
{{ddx|Infectious mononucleosis}}
The following clinical manifestations (if present) would support this disease:


* optic neuritis  
=====Clinical manifestations=====
* epitrochlear lymph node enlargement  
* Optic neuritis  
* periorbital edema  
* Epitrochlear lymph node enlargement  
* pharyngeal petechia  
* Periorbital edema  
* spleen enlargement  
* Pharyngeal petechia  
* spleen palpable  
* Spleen enlargement  
* tonsillitis
* Spleen palpable  
* abdominal tenderness, left upper quadrant
* Tonsillitis
* axillary lymph node enlargement  
* Left upper quadrant abdominal tenderness  
* inguinal lymph node enlargement  
* Axillary lymph node enlargement  
* mesenteric lymph node enlargement  
* Inguinal lymph node enlargement  
* pharyngeal exudate  
* Pesenteric lymph node enlargement  
* pharyngeal erythema  
* Pharyngeal exudate  
* spleen tenderness  
* Pharyngeal erythema  
* tonsillar exudate  
* Spleen tenderness  
* generalized diffuse lymph node enlargement  
* Tonsillar exudate  
* cervical lymph node enlargement  
* Generalized diffuse lymph node enlargement  
* pharyngeal swelling  
* Cervical lymph node enlargement  
* sore throat  
* Pharyngeal swelling  
* Sore throat  


The following lab data (if present) would be useful in establishing the presence of the disease:
=====Laboratory abnormalities=====
 
* Marked elevationSGPT (ALT)  
* 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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----
----


 
{{ddx|Thoracic aortic aneurysm}}
Evidence of "THORACIC AORTIC ANEURYSM"  (RARE)   
   
=====Clinical manifestations=====
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
* Ascending aortic dilation  
   
   
The following lab data (if present) would be useful in establishing the presence of the disease:
=====Radiographic features=====
* chest xray mediastinal mass middle
* Anterior mediastinal mass on chest radiography
* chest xray mediastinal mass posterior
* Middle mediastinal mass on chest radiography
* mediastinal widening
* Posterior mediastinal mass on chest radiography 
* chest xray aorta prominent or enlarged  
* Aorta prominent or enlarged on chest radiography
* chest xray mediastinal mass anterior
* chest xray mediastinal mass, adenopathy, or widening
 


----
----


Evidence of "SUBSTERNAL GOITER"  (RARE)   
{{ddx|Substernal goiter}}
   
The following clinical manifestations (if present) would support this disease:
=====Clinical manifestations=====
* 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:
=====Laboratory abnormalities=====
* TSH elevated  
* TSH elevated  
* chest xray mediastinal mass, adenopathy, or widening  
 
* chest xray mediastinal mass anterior
 
=====Radiographic features=====
* Mediastinal mass, adenopathy, or widening on chest radiograph


----
----
 
{{ddx|Thymoma}}
=====Clinical manifestations=====
* Bulbar palsy
* Facial candida infection
* Facial cyanosis
* Jugular venous distention
* Mouth candida infection
* Superior vena cava obstruction
* Diplopia
* Pemberton sign positive
=====Laboratory abnormalities=====
* Pancytopenia
* Antistriational antibodies


Evidence of "THYMOMA"  (RARE)   
=====Radiographic features=====
* Mediastinal mass, adenopathy, or widening on chest radiograph
The following clinical manifestations (if present) would support this disease:
* Anterior mediastinal mass on chest radiograph 
* 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




----
----


{{ddx|Actinomycosis}}


Evidence of "ACTINOMYCOSIS"  (RARE)
=====Clinical manifestations=====
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  
* Right lower quadrant abdominal mass
* 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:
=====Laboratory abnormalities=====
* echocardiogram: intracardiac mass
* Branching Gram-positive bacilli on Gram stain
* hepatic cyst(s)
* Sulfur granule
* mediastinal lymph node enlargement
 
* chest xray mediastinal mass, adenopathy, or widening  
=====Radiographic features=====
* Gram stain: branching Gram-positive bacilli
* Mediastinal mass, adenopathy, or widening on chest radiography 
* sulfur granule
* Intracardiac mass on echocardiogram
* Hepatic cyst(s)


----
----


{{ddx|Chronic lymphocytic leukemia}}
 
=====Clinical manifestations=====
* Skin infiltration
* Sternal tenderness
* Lymph node firmness


Evidence of "CHRONIC LYMPHOCYTIC LEUKEMIA"  (RARE)   
  =====Laboratory abnormalities=====
   
* Hemolysis
The following clinical manifestations (if present) would support this disease:
* Prolonged bleeding time
* skin infiltration
* Monoclonal gammopathy
* sternal tenderness
* Cryoglobulinemia
* lymph node firmness
* Marked increase of leukocytes
* Clonal B-lymphocytes on flow cytometry
The following lab data (if present) would be useful in establishing the presence of the disease:
* Lymphocytes increased
* hemolysis
 
* mediastinal lymph node enlargement
=====Radiographic features=====
* prolonged bleeding time
* Mediastinal mass, adenopathy, or widening on chest radiography
* 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:
The following findings (if present) would make this disease less likely:
* left shift  
* Left shift  
* metamyelocytes increased  
* Metamyelocytes increased  


----
----


Evidence of "SUPERIOR VENA CAVA SYNDROME"  (RARE - Urgent action required)
The following clinical manifestations (if present) would support this disease:


* stridor
{{ddx|Superior vena cava syndrome}}
* 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:
=====Clinical manifestations=====
* 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


* mediastinal lymph node enlargement  
 
* chest xray pulmonary nodule (< 4 cm), non-calcified
=====Radiographic features=====
* chest xray mediastinal mass, adenopathy, or widening  
* Mediastinal lymph node enlargement  
* Non-calcified pulmonary nodule (< 4 cm) on chest radiography
* Mediastinal mass, adenopathy, or widening on chest radiography


The following findings (if present) would exclude this disease:
The following findings (if present) would exclude this disease:
* hepatojugular reflux
* hepatojugular reflux


----
----


Evidence of "UNICENTRIC CASTLEMAN DISEASE"  (RARE)   
{{ddx|Unicentric Castleman disease}}
   
* The following lab data (if present) would be useful in establishing the presence of the disease:
=====Radiographic features=====
* mediastinal lymph node enlargement
* Mediastinal mass, adenopathy, or widening on chest radiography
* chest xray mediastinal mass, adenopathy, or widening  
 
----
----


Evidence of "ADULT STILL DISEASE"  (RARE)   
 
   
{{ddx|Adult Still disease}}
The following clinical manifestations (if present) would support this disease:
   
* ankylosis
  =====Clinical manifestations=====
* hepatosplenomegaly
* Ankylosis
* weight loss, severe
* Hepatosplenomegaly
* fever, recurrent
* Severe weight loss
* night sweats  
* Recurrent fever  
* wrist pain  
* Night sweats  
* generalized diffuse lymph node enlargement  
* Wrist pain  
* fever unknown origin  
* Generalized diffuse lymph node enlargement  
* fever, remittent
* Fever unknown origin  
* fever, high grade
* Remittent fever
* polyarticular
* High grade fever  
* rash, evanescent
* Polyarticular
* Evanescent rash  
The following lab data (if present) would be useful in establishing the presence of the disease:
 
* leukocytes, marked increase  
=====Laboratory abnormalities=====
* 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:
Line 492: Line 487:
----
----


Evidence of "SMALL CELL LUNG CARCINOMA"  (COMMON)   
{{ddx|Small cell lung carcinoma}}
   
The following clinical manifestations (if present) would support this disease:
=====Clinical manifestations=====
* 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
* Lower rib tenderness
* 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
* Velvet palms
* 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:
=====Laboratory abnormalities=====
* bone destruction  
* Bone destruction  
* chest xray unilateral diaphragm elevation  
* Unilateral diaphragm elevation on chest radiography
* chest xray pulmonary nodule (< 4 cm), non-calcified
* Non-calcified pulmonary nodule (< 4 cm) on chest radiography 
* chest xray mediastinal mass, adenopathy, or widening  
* Mediastinal mass, adenopathy, or widening on chest radiography
* pleural effusion  
* Pleural effusion  
* pleural effusion, bloody  
* Pleural effusion (bloody)
* chest xray pulmonary mass (>= 4 cm), non-calcified
* Non-calcified pulmonary mass (>= 4 cm)on chest radiography
* hyponatremia
* Hyponatremia
* bone marrow tumor cells  
* Bone marrow tumor cells  
* serum calcitonin, increased  
* Serum calcitonin increased  
* chest xray hilar lymph node enlargement  
* Hilar lymph node enlargement on chest radiography
   
   
The following findings (if present) would make this disease less likely:
=====Radiographic features=====
* chest xray normal
* Normal on chest radiography
* chest CT (contrast enhanced) normal
* Normal on chest CT (contrast enhanced)  


----
----


Evidence of "MALIGNANT HISTIOCYTOSIS"  (RARE)    
{{ddx|Malignant histiocytosis}}
    
The following clinical manifestations (if present) would support this disease:
=====Clinical manifestations=====
* 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:
=====Laboratory abnormalities=====
* 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


==References==
==References==
{{reflist|2}}
{{reflist|2}}'''

Revision as of 21:05, 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


Template:WikiDoc Sources

Clinical manifestations
  • Mental nerve neuropathy
  • Alcohol intolerance
  • Exfoliative dermatitis
  • 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
  • Pel-Ebstein fever
  • Chylous ascites
  • 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
  • Recurrent fever
  • Recurrent infection
  • Fixed lymph node
  • Neck mass
  • Night sweats
  • Anergy
  • Supraclavicular lymph node enlargement
  • Sweating increase
  • Fever unknown origin
  • Remittent fever
  • Painless lymphadenopathy
  • Regional lymph node enlargement
Laboratory abnormalities
  • Nucleated red cells
  • Hypogammaglobulinemia
  • Pancytopenia
  • Lymphocytes decreased
  • Granulomas on biopsy
Radiographic features
  • Retroperitoneal lymph node enlargement
  • Biliary tract dilatation on abdominal ultrasound
  • Bone lesion
  • Mediastinal mass,adenopathy, or widening on chest xray
  • Middle mediastinal mass on chest xray
  • Mediastinal lymph node enlargement
  • Anterior mediastinal mass on chest radiograph
  • Increased uptake on abdomen gallium scan
  • Ivory vertebra
  • Increased uptake on mediastinum gallium scan



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


Template:WikiDoc Sources

Clinical manifestations
  • 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
  • Massive splenomegaly
  • Cryptococcosis
  • Generalized rash, papules (elevated, <0.5cm)
  • Iridocyclitis
  • Iritis
  • Dry cough
  • Night sweats
  • Spleen enlargement
  • Bilateral uveitis
  • Generalized diffuse lymph node enlargement
  • Polyarthritis
Laboratory abnormalities
  • Hypercalcemia
  • Increased lymphocytes in pleural effusion
  • Decreased Lymphocytes
  • Hypercalciuria
  • Mild-moderate elevation of alkaline phosphatase
  • PFT's: restrictive defect
  • PFT's: diffusion capacity decreased
  • Elevated serum angiotensin-converting enzyme
  • Increased vitamin D, 1,25-dihydroxy
Radiographic features
  • Heart conduction abnormality on electrocardiographic
  • Atrioventricular block
  • Retroperitoneal lymph node enlargement
  • Lung cyst on chest radiography
  • Interstitial infiltrate ( incl. reticulonodular )on chest radiography
  • Increased mediastinal uptake on gallium scan
  • Increased lung uptake on gallium scan
  • Mediastinal lymph node enlargement
  • Bone marrow granulomas
  • Mediastinal mass, adenopathy, or widening on chest radiography
  • Granulomas on biopsy
  • Hilar lymph node enlargement on chest radiography


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [5] Mahshid Mir, M.D. [6]

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


Template:WikiDoc Sources

Clinical manifestations
  • Mental nerve neuropathy
  • Exfoliative dermatitis
  • Lower extremity paralysis
  • 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
  • Massive splenomegaly
  • Femoral lymph node enlargement
  • Popliteal lymph node enlargement
  • Airway compression or obstruction
  • Cryptococcosis
  • Recurrent infection
  • Fixed lymph node
  • Neck mass
  • Spleen enlargement
  • Fever unknown origin
  • Regional lymph node enlargement
  • Painless lymphadenopathy
  • Cancer
  • Lymphoma
  • Non-Hodgkin lymphoma


Laboratory abnormalities
  • Extreme hypercalcemia (>14 mg/dl)
  • Prolonged bleeding time
  • Markedly increased ESR
  • Hypogammaglobulinemia
  • Pancytopenia
  • Lymphocytes decreased
  • Pleural effusion (Exudate)
  • Bone marrow plasma cells increased
  • Lymphocytes increased in pleural effusion
  • Pleural effusion (Chylous)
  • Malignant ascites
  • Cryoglobulinemia
  • Vitamin D, 1,25-dihydroxy increased
Radiographic features
  • Bladder mass or abnormal shape on IVP
  • Bone destruction
  • Kidney mass
  • Mediastinal lymph node enlargement
  • Bone lesion
  • Retroperitoneal lymph node enlargement
  • Mediastinal mass, adenopathy, or widening on chest radiography
  • Anterior mediastinal mass on chest radiography
  • Biliary tract dilatation on abdominal ultrasound
  • Increased mediastinal uptake on gallium scan
  • Increased abdominal uptake on gallium scan


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [7] Mahshid Mir, M.D. [8]

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


Template:WikiDoc Sources

Clinical manifestations
  • Prison inmate
  • Retinal granuloma
  • Erythema nodosum
  • Haiti
  • Immunosuppressive therapy
  • Severe weight loss
  • Corticosteroid use
  • Pleuritic chest pain
  • Progressive dyspnea
  • Fever unknown origin
  • Retinitis
  • Tuberculosis exposure
Laboratory abnormalities
  • Pancytopenia
  • PPD positive
  • Nucleated red cells
  • Bone marrow granulomas
  • AFB smear positive
  • Granulomas on biopsy
Radiographic features
  • Increased abdominal uptake on gallium scan
  • Multiple hypodense liver lesions on abdominal CT
  • Multiple non-calcified pulmonary nodules on chest radiography


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [9] Mahshid Mir, M.D. [10]

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


Template:WikiDoc Sources

Clinical manifestations
  • Optic neuritis
  • Epitrochlear lymph node enlargement
  • Periorbital edema
  • Pharyngeal petechia
  • Spleen enlargement
  • Spleen palpable
  • Tonsillitis
  • Left upper quadrant abdominal tenderness
  • Axillary lymph node enlargement
  • Inguinal lymph node enlargement
  • Pesenteric lymph node enlargement
  • Pharyngeal exudate
  • Pharyngeal erythema
  • Spleen tenderness
  • Tonsillar exudate
  • Generalized diffuse lymph node enlargement
  • Cervical lymph node enlargement
  • Pharyngeal swelling
  • Sore throat
Laboratory abnormalities
  • Marked elevationSGPT (ALT)
  • SGPT (ALT) elevated
  • Lymphocytes increased
  • Atypical lymphocytes increased
  • Heterophile antibody positive
  • Monocytes increased
  • Epstein-Barr virus titre positive



Editor-In-Chief: C. Michael Gibson, M.S., M.D. [11] Mahshid Mir, M.D. [12]

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


Template:WikiDoc Sources

Clinical manifestations
  • Cocaine use
  • Turner syndrome
  • Pemberton sign positive
  • Marfan syndrome
  • Aortic valve regurgitation
  • Superior vena cava obstruction
  • Ascending aortic dilation
Radiographic features
  • Anterior mediastinal mass on chest radiography
  • Middle mediastinal mass on chest radiography
  • Posterior mediastinal mass on chest radiography
  • Aorta prominent or enlarged on chest radiography


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [13] Mahshid Mir, M.D. [14]

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


Template:WikiDoc Sources

Clinical manifestations
  • Upper extremity edema
  • Chest mass
  • Neck mass
  • Thyroid enlargement
  • Tracheal compression
  • Pemberton sign positive
Laboratory abnormalities
  • TSH elevated


Radiographic features
  • Mediastinal mass, adenopathy, or widening on chest radiograph



Editor-In-Chief: C. Michael Gibson, M.S., M.D. [15] Mahshid Mir, M.D. [16]

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


Template:WikiDoc Sources 

=====Clinical manifestations=====
  • Bulbar palsy
  • Facial candida infection
  • Facial cyanosis
  • Jugular venous distention
  • Mouth candida infection
  • Superior vena cava obstruction
  • Diplopia
  • Pemberton sign positive
=====Laboratory abnormalities=====
  • Pancytopenia
  • Antistriational antibodies


Radiographic features
  • Mediastinal mass, adenopathy, or widening on chest radiograph
  • Anterior mediastinal mass on chest radiograph



Editor-In-Chief: C. Michael Gibson, M.S., M.D. [17] Mahshid Mir, M.D. [18]

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


Template:WikiDoc Sources

Clinical manifestations
  • Tongue mass
  • Trismus
  • Pericardial constriction
  • Pharyngeal swelling
  • Pharyngeal tenderness
  • Abdominal fistula
  • Bronchial fistula
  • Empyema
  • Lung abscess
  • Right lower quadrant abdominal mass
  • Chest wall suppuration
  • Gingival fistula
  • Chest wall fistula
  • Gingival swelling
  • Gingival tenderness
  • Jaw induration
  • Mandibular swelling
Laboratory abnormalities
  • Branching Gram-positive bacilli on Gram stain
  • Sulfur granule
Radiographic features
  • Mediastinal mass, adenopathy, or widening on chest radiography
  • Intracardiac mass on echocardiogram
  • Hepatic cyst(s)


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [19] Mahshid Mir, M.D. [20]

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


Template:WikiDoc Sources 

=====Clinical manifestations=====
  • Skin infiltration
  • Sternal tenderness
  • Lymph node firmness
=====Laboratory abnormalities=====
  • Hemolysis
  • Prolonged bleeding time
  • Monoclonal gammopathy
  • Cryoglobulinemia
  • Marked increase of leukocytes
  • Clonal B-lymphocytes on flow cytometry
  • Lymphocytes increased
Radiographic features
  • Mediastinal mass, adenopathy, or widening on chest radiography

The following findings (if present) would make this disease less likely:

  • Left shift
  • Metamyelocytes increased


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [21] Mahshid Mir, M.D. [22]

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


Template:WikiDoc Sources

Clinical manifestations
  • 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


Radiographic features
  • Mediastinal lymph node enlargement
  • Non-calcified pulmonary nodule (< 4 cm) on chest radiography
  • Mediastinal mass, adenopathy, or widening on chest radiography

The following findings (if present) would exclude this disease:

  • hepatojugular reflux


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [23] Mahshid Mir, M.D. [24]

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


Template:WikiDoc Sources

Radiographic features
  • Mediastinal mass, adenopathy, or widening on chest radiography


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [25] Mahshid Mir, M.D. [26]

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


Template:WikiDoc Sources 

=====Clinical manifestations=====
  • Ankylosis
  • Hepatosplenomegaly
  • Severe weight loss
  • Recurrent fever
  • Night sweats
  • Wrist pain
  • Generalized diffuse lymph node enlargement
  • Fever unknown origin
  • Remittent fever
  • High grade fever
  • Polyarticular
  • Evanescent rash
Laboratory abnormalities
  • 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


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [27] Mahshid Mir, M.D. [28]

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


Template:WikiDoc Sources

Clinical manifestations
  • Acanthosis nigricans
  • Axillary lymph node enlargement
  • Axillary lymph node pain
  • Dysphagia
  • Esophageal obstruction
  • Heart tamponade
  • Pericardial effusion
  • Lower rib tenderness
  • Tracheal displacement
  • Hoarseness
  • Digital clubbing
  • Airway compression or obstruction
  • Pemberton sign positive
  • Velvet palms
  • 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
=====Laboratory abnormalities=====
  • Bone destruction
  • Unilateral diaphragm elevation on chest radiography
  • Non-calcified pulmonary nodule (< 4 cm) on chest radiography
  • Mediastinal mass, adenopathy, or widening on chest radiography
  • Pleural effusion
  • Pleural effusion (bloody)
  • Non-calcified pulmonary mass (>= 4 cm)on chest radiography
  • Hyponatremia
  • Bone marrow tumor cells
  • Serum calcitonin increased
  • Hilar lymph node enlargement on chest radiography
=====Radiographic features=====
  • Normal on chest radiography
  • Normal on chest CT (contrast enhanced)


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [29] Mahshid Mir, M.D. [30]

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


Template:WikiDoc Sources

Clinical manifestations
  • Tendon xanthoma
  • Xanthoma
  • Tuberous xanthoma
  • Planar xanthoma
  • Palmar planar xanthoma
  • Hepatosplenomegaly
  • Spleen enlargement
  • Panniculitis
  • Generalized diffuse lymph node enlargement
Laboratory abnormalities
  • ESR markedly increased
  • Serum ferritin greatly increased
  • ESR mildly or moderately increased
  • C-reactive protein elevated

References

  1. ↑ 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.
  2. ↑ Siegenthaler, Walter (2007). Differential diagnosis in internal medicine: from symptom to diagnosis. Stuttgart New York: Thieme. ISBN 978-1588905512.
  3. ↑ Mesko, Dusan (2002). Differential diagnosis by laboratory medicine: a quick reference for physicians. Berlin New York: Springer-Verlag. ISBN 978-3540430575.
  4. ↑ Reeder and Felson's gamuts in radiology: comprehensive lists of roentgen differential diagnosis. Place of publication not identified: Springer. 2014. ISBN 978-1475781229.
  5. ↑ Burgener, Francis (2008). Differential diagnosis in conventional radiology. Stuttgart New York: Thieme. ISBN 978-1588902757.
  6. ↑ Gattuso, Paolo (2015). Differential diagnosis in surgical pathology. Philadelphia, PA: Saunders/Elsevier. ISBN 978-1455770137.
  7. ↑ "DXplain".

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