Small intestine cancer differential diagnosis: Difference between revisions

Latest revision as of 14:04, 14 May 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Qurrat-ul-ain Abid, M.D.[2]

Overview

Small intestine cancer must be differentiated from Crohn's disease, intestinal tuberculosis, ulcerative colitis, large intestine cancer, peptic ulcer disease, and irritable bowel syndrome (IBS).

Differential Diagnosis

Table for Differential Diagnosis of Small Intestine Cancer

ABBREVIATIONS:

N/A: Not available, NL: Normal, Hb: Hemoglobin, Abd: Abdominal

	Symptoms				Lab Findings		Imaging			Histopathology
Diseases	Clinical manifestations				Para-clinical findings						Gold standard
	Symptoms				Para-clinical findings
	Bowel Frequency	Blood in stool	Abd pain	Other symptoms	Hb	Tumor marker	Endoscopy	CT scan	Other diagnostic study	Histopathology
Adenocarcinoma of small intestine^[1]	↑↓	+	+/-	Tenesmus Diminished caliber of stools Mucus in stools	↓	CEA+	Polyps (villous, tubular, tubulo-villous) Ulcerating polyps cancerous lesions	Luminal narrowing and bowel obstruction Circumferential thickening of the bowel wall Enlarged lymph nodes Pulmonary metastases Peritoneal metastases Hepatic metastases	PET scans: Detailed images and metastasis Barium enema: Cancer or a precancerous polyp Genetic testing: hereditary nonpolyposis colorectal cancer (HNPCC) or familial adenomatous polyposis (FAP)	Different grades of differentiation of glandular structures Sheets or cords of malignant cells, Cellular atypia, pleomorphism High mitotic rate Necrotic debris in glandular lumina Desmoplastic reaction (sign of invasion)	Biopsy and histopathological analysis
Carcinoids^[2]^[3]^[4]^[5]^[6]	↑	+/-	+	Flushing Wheezing Shortness of breath Palpitations Weight gain Hirsutism Weakness Leg edema	↓	Urinary 5-hydroxyindoleacetic acid (5-HIAA) Chromogranin A (CgA) Other biochemical markers include: Substance P Neurotensin Bradykinin Human chorionic gonadotropin Neuropeptide L Pancreatic polypeptide	Infiltrating, ulcerating or fungating lesions in the wall of colon	Well-defined single or multiple lesions Round or ovoid in shape Variable in size ranges between 2-5 cm	PET scan 11C-5-hydroxytryptophan (11C-5-HTP): Deetects metastasis MRI: Nodular mass originating from the bowel wall or regional uniform bowel wall thickening with moderate intense enhancement on post gadolinium T1-weighted fat-suppressed images Mesenteric metastases presents as nodular masses with mesenteric stranding Liver metastases may show hypointense precontrast T1- and hyperintense T2-weighted images Liver metastases are commonly hypervascular Ki-67 index	Solid or spongy nests of cells accentuated by neatly outlined luminal spaces Peripheral nuclear palisading Granular eosinophilic cytoplasm.	Biopsy and histopathological analysis
Intestinal Lymphoma^[7]^[8]	-	+/-	+	Weight loss	↓	Non-Hodgkin lymphomas: CD-20	Polypoid or ulcerated mass, intramural lesion, aphthous ulcer, stricture, extraluminal mass, or diffuse, multiple polypoid lesions	CT scan: polypoid mass, circumferential-cavitary lesions, focal mucosal nodularity, diffuse ulcerative or nodular lesions, regional lymph node involvement	Biopsy: Diffuse large B-cell lymphoma Extranodal marginal zone lymphoma (MALT) Mantle cell lymphoma Burkitt’s lymphoma Follicular lymphoma Double-contrast enema: Subtle mucosal changes, gross tumor morphology	Diffuse large B-cell lymphoma: Extranodal marginal zone lymphoma (MALT) Mantle cell lymphoma Burkitt’s lymphoma Follicular lymphoma	Biopsy and histopathological analysis
Gastrointestinal Stromal Tumors (GIST) ^[9]^[10]^[11] ^[12]^[13]^[14]^[15]	↑↓	+/-	-	Mostly asymptomatic Are discovered incidentally Non-specific symptoms Early satiety and bloating	↓/-	KIT protein CD 117 antigen	Subepithelial round masses Smooth margins Normal overlying mucosa may be intact or ulcerated Bulging into gastrointestinal lumen	Small GIST (< 5 cms) are homogeneous with clear boundaries and have an intraluminal pattern of growth. Intermediate GIST (size of 5-10 cms) are heterogeneous with irregular borders and intra or extra-luminal pattern of growth. Large GISTs (>10 cms) are heterogeneous with irregular borders and have local or distant spread Malignant GIST with metastasis: Size greater than 10 cm Calcifications Irregular margins Heterogeneous and lobulated Lymphadenopathy Ulceration Extraluminal and mesenteric fat infiltration	MRI: Hemorrhage, necrosis, surrounding structures and metastasis. Endoscopic ultrasonography: Mucosal ulceration or bleeding Smooth submucosal mass as hypoechoic mass Malignant GIST lesions present with: Heterogeneous mass >4 cm in size Irregular borders Intra and extraluminal growth Multiple cysts within the main lesion	Spindle cell type are eosinophilic cells arranged in the form of whorls or fascicles. Epithelioid GISTs are rounded cells with oval nuclei and vesicular chromatin and appears nested On immunohistochemical staining they are positive for molecular markers CD117 antigen and KIT protein.	Endoscopic ultrasound withBiopsy and histopathological analysis
Peutz-Jeghers syndrome^[16] ^[17]^[18]^[19]^[20]	↑↓	+	+	Mucocutaneous hyperpigmentation (mouth, hands, and feet) Fatigue Weight loss Rectal prolapse	↓	N/A	Multiple polyps mucocutaneous pigmentation	Multiple polyps Intussusception Bowel obstruction	Barium enema: Multiple polyps. MRI: Multiple hamartomatous polyps	Hamartomatous mucosal polyps with central core of branching smooth muscle associated with mucosa Smaller polyps may lack the prominent arborizing smooth muscle	Genetic testing for STK11 Colonoscopy
Juvenile Polyposis Coli ^[21]^[22]^[23]^[24]^[25]	↑	+	+	Prolapsing polyp Intussusception Macrocephalus Hypotonia Bowel obstruction Heart or brain abnormalities Cleft palate Polydactyly Abnormalities of the genitalia or urinary tract.	↓	N/A	>5 juvenile polyps in the colon and rectum Multiple juvenile polyps in gastrointestinal tract	Multiple polyps in gastrointestinal tract	Barium study: Multiple polyps in GI tract Stool DNA test: SMAD4 or BMPR1A Diagnose if any of the following positive: More than five juvenile polyps of the colorectum Multiple juvenile polyps throughout the GI tract Any number of juvenile polyps and a family history of juvenile polyposis Heterozygous pathogenic variant in SMAD4 or BMPR1A	Numerous cystic and dilated crypts or glands with inspissated mucin and intraluminal neutrophils Lamina propria edematous with associated lymphocytes, plasma cells, eosinophils and neutrophils Filiform, multilobated forms with increased glandular-to-stroma ratio in nonclassic or atypical polyps Areas of conventional dysplasia	If any of the following positive: More than five juvenile polyps of the colorectum Multiple juvenile polyps throughout the GI tract Any number of juvenile polyps and a family history of juvenile polyposis Heterozygous pathogenic variant in SMAD4 or BMPR1A
Kaposi's sarcoma^[26]	↑	+	+	Melena Hematochezia Abdominal pain N/V	↓	CD34 CD31 D2-40 HHV-8 FHI-1 antibody LANA-1	Localized purpuric lesion	N/A	Electrophoresis: antibodies against Kaposi sarcoma herpes virus (HHV-8) Biopsy: Vascular proliferation, red blood cell and hemosiderin extravasation,lymphocytes and monocytes, neovascular lesion wrapped around a pre-existing space, intracytoplasmic PAS +ve hyaline globules	Vascular proliferation Red blood cell and hemosiderin extravasation Lymphocytes and monocytes Premonitory sign (a neovascular lesion wrapped around a pre-existing space) Intracytoplasmic PAS +ve hyaline globules	Biopsy
Arteriovenous malformation^[27]	-	+	-	N/A	↓	N/A	Bright red, flat lesions Rarely, polypoid	N/A	N/A	Aberrant vessels with thickened, hypertrophic walls in the mucosa and the submucosa. Arteries directly connected to veins without capillary beds	Accidental fining
Infectious colitis^[28]	↑	+	+	Fever, chills N/V Bloating	-	N/A	Patchy or diffuse erythematous mucosa Edema, hemorrhage, with or without ulcers of mucosa	N/A	Stool cultures in adequate culture media Stool analysis: Leukocytosis	N/A	Stool culture
Hamartoma^[29]	↑	+	+	Tenesmus	-	S100 (mucosal Schwann cell hamartoma (MSCH)	Large polypoid mass	Isodense or hypodense solid masses Heterogeneous mass Presence of fat in a well circumscribed nodule Calcification	Biopsy: Proliferation of bland spindle cells in the lamina propria (mucosal schwann cell hamartoma (MSCH))	poorly circumscribed, short fascicles of uniform spindle cells replacing the colonic lamina propria, separating and entrapping the crypts The nuclei are bland and mostly uniform, occasional larger nuclei are found. The cytoplasmic borders are indistinct Involvement of mucosa but never the submucosa	Biopsy
Ulcerative colitis^[30]^[31]	↑	+	+	Diarrhea mixed with blood and mucus Weight loss Urgency Tenesmus	↓	N/A	Continuous lesions Erythema (or redness of the mucosa) and friability of the mucosa Crypts, formation of residual mucosal tissue Pseudopolyps	N/A	N/A	Mucosal and submucosal inflammation Hemorrhage or inflammatory polymorphonuclear cells aggregate in the lamina propria Distorted crypts Crypt abscess	Endoscopy and a mucosal biopsy
Crohn's disease^[30]	↑	+	+	Tenesmus N/V Bowel obstruction Fever	↓	N/A	Discontinuous lesions Strictures Linear ulcerations	N/A	N/A	Transmural pattern of inflammation Mucosal damage Focal infiltration of leukocytes into the epithelium Granulomas	Endoscopy and a mucosal biopsy
Irritable bowel syndrome^[32]	↑↓	+	+	Straining during defecation Urgency Sensation of incomplete evacuation Mucus passage Bloating Weight loss	-	N/A	Not recommended	N/A	Diagnosis of exclusion with fulfillment of Rome criteria	N/A	Clinical diagnosis (Rome criteria)
Bowel endometriosis^[33]	↓↑	+	+	Dyschezia Tenesmus	↓	N/A	N/A	N/A	Transvaginal ultrasonography: heterogeneous, hypoechoic, spiculated mass Barium enema: Extrinsic mass compressing the bowel, fine crenulation of the mucosa, bowel strictures at the rectosigmoid junction T1-weighted or fat-suppression T1-weighted MRIs: Contrast enhanced mass or hyperintense foci, hemorrhagic foci or hyperintense cavities	N/A	Transvaginal ultrasonography
Intestinal tuberculosis^[34] ^[35]^[36]^[37]^[38]^[39]	Chronic ↑	+/-	+	Fever Fatigue, Weight loss Anorexia Night sweats Bowel obstruction Abdominal distension Lymph node enlargement	↓	N/A	To get sample for histolopathology and culture Forms on endoscopy: Hypertrophic Ulcerative Endoscopic findings: Ulcers in mucosa Nodules in mucosa Strictures in intestinal wall Pseudopolyps formation Adhesions Fistulas Deformed ileocecal valve	Concentric thickening at the site of lesion with proximal intestinal dilatation asymmetric thickening of the intestinal wall Lymphadenopathy Thickening of the peritoneum Ascites	Small bowel follow-through or barium enema: Mucosal ulcerations Strictures in the intestinal wall Cecal deformations Incompetency of ileocecal valve Ultrasound: Bowel thickening Peritoneal nodules Peritoneal thickening Lymphadenopathy Ascitic fluid analysis: Straw-colored ascites Lymphocytes in ascitic fluid Cell count is 150 to 4000 cells/mcL with leukocyte count of 150 to 4000 cells/mm3 AFB smear ADA level Protein >3.0 g/dL Mycobacterial culture NAAT for M. tuberculosis SAAG <1.1 g/dL Ascitic fluid NAAT Ascitic fluid polymerase chain reaction (PCR)	Submucosal caseation granulomas	Endoscopic biopsy and histopathology analysis
Peptic ulcer disease^[40]^[41] ^[42]^[43]^[44]^[45]	↑↓	+ Melena	+	Heartburn Asymptomatic Chest discomfort Early satiety Nausea and vomiting Anorexia Bloating Perforation	↓	N/A	Smooth ulcers in mucosa of intestine Ulcers with round edges Flat ulcer base filled with exudate	Shows ulcers (perforated or non-perforated) when done for the investigation of abdominal pain	.Barium swallow (infrequent) H. Pylori testing Hydrogen breath test	Endoscopic biopsy sample may show positive H. Pylori by H&E stain	Endoscopic visualization of ulcer
Pancreatic cancer^[46]^[47]^[48] ^[49]^[50]^[51]^[52]^[53] ^[54]^[55]^[55]^[56]	Chronic ↑	+	+	Asthenia and depression Jaundice Anorexia Weight loss Nausea and vomiting Steatorrhea Dark urine Back pain Thrombophlebitis	↓	Cancer-associated antigen 19-9 (CA 19-9)	Endoscopic retrograde cholangiopancreatography (ERCP) is used: To collect tissue sample For imaging of biliary tree and pancreatic ducts Obstruction and strictures of common bile duct and pancreatic duct is suggestive of cancer ("double duct" sign)	Mass within the pancreatic parenchyma or duct Atrophy of the parenchyma	Transabdominal US Billiary dilatation Mass in pancreas Hypoechoic hypovascular mass with irregular borders Magnetic resonance cholangiopancreatography(MRCP) : Better than CT to visualize pancreatic and billiary anatomy and hepatic lesions Biopsy: Percutaneous FNA biopsy Transduodenal Endo US-guided FNA biopsy	Pancreatic tumor can show two type of histology depending on the location: Intraductal papillary mucinous neoplasms Papillary lesions Disseminated or segmental dilation of the pancreatic duct Pancreatic ductal adenocarcinoma Duct-like structures Mucin production Cell atypia Dense stromal fibrosis	Biopsy and histological analysis
Gastric cancer ^[57]^[58]^[59]^[60]^[61] ^[62]^[63]^[64]^[65]^[66] ^[67]^[68]^[69]^[70]	↓/-	+ Melena	+	Weight loss Early satiety Dysphagia Anorexia Weakness and fatigue	↓	Carcinoembryonic antigen (CEA) Glycoprotein CA 125 Carbohydrate antigen 19-9 (CA 19-9) Alpha-fetoprotein (AFP)	On endoscopy gastric cancer may appear as: Polypoid mass Ulcerating lesion Infiltrating lesion Diffuse thickening	CT is used to stage the disease extent CT can also visulaize primary lesion: Polypoid mass Ulcerating lesion Diffuse thickening (tunica plastica) Infiltrating mass	PET scan: Useful to confirm malignant involvement of CT-detected lymphadenopathy. Directly visualizes the liver surface, the peritoneum, and local lymph nodes for metastasis MRI: Better T staging of stomach cancer (better soft tissue visualization and of individual layers of stomach wall) Ultrasonography	Histologically, there are two major types of gastric cancer: Intestinal type adenocarcinoma Irregular tubular structures Multiple lumens Reduced stroma ntestinal metaplasia cellular pleomorphism Diffuse type adenocarcinoma Discohesive Secrete mucus Pools of mucus/colloid Signet ring cell appearance	Biopsy and histopathological analysis

Differentiating small intestine cancer from other causes of abdominal pain and diarrhea

Small intestine cancer must be differentiated from other causes of abdominal pain and diarrhea.

		Symptoms						Physical examination						Lab Findings			Imaging						Histopathology
Diseases		Clinical manifestations												Para-clinical findings										Gold standard	Additional findings
		Symptoms						Physical examination						Para-clinical findings
		Abdominal pain	Diarrhea	Flushing	Dyspnea	Palpitations	Other symptoms	Wheezing	Telangiectasia	Hypotension	Tachycardia	Systolic murmur of tricuspid regurgitation	Other physical findings	Urinary 5-hydroxyindoleacetic acid (5-HIAA)	Serum Chromogranin A (CgA)	Other markers	Abdominal computed tomography (CT)	Abdominal MRI	Somatostatin receptor scintigraphy [SRS], or Octreoscan	Metaiodobenzylguanidine (MIBG) scintigraphy	Other diagnostic studies	Transthoracic echocardiography	Histopathology
Carcinoid Syndrome^[71]^[72]^[73]^[74]^[75]^[76]^[77]^[78]^[79]	Neuroendocrine tumor of midgut ^[80]^[81]^[6]^[82]	+ Mild	+ Intermittent Secretory diarrhea	+	+	+	Pellagra Dermatitis Diarrhea Dementia Metastatic tumors in the liver: Right upper quadrant pain, hepatomegaly, and early satiety	+	+/-	+/-	+	+	-	+	+	NT-proBNP Screening of carcinoid heart disease Blood Serotonin levels	Neuroendocrine tumor of midgut are difficult to identify on CT because of their small size. Findings: mass-like process with soft tissue "spokes" radiating into the mesenteric fat toward the small bowel causing retraction. Liver metastases	Sensitive for detection of liver metastases	+ Localization of carcinoid tumor	+	68-Ga DOTATATE PET scan Positron emission tomography-computed tomography (PET-CT) using 18-fluoro-dihydroxyphenylalanine Ki-67 labeling index Endoscopy for metastatic Neuroendocrine tumour with an unknown primary site.	Valve thickening with retraction and reduction in the mobility of the tricuspid valve	Enterochromaffin cells stain with potassium chromate (chromaffin). On electron microscopy ,the cells in tumors are found to contain membrane-bound secretory granules with dense-core granules in the cytoplasm.	Somatostatin receptor scintigraphy [SRS], or Octreoscan Biopsy and histopathology	Mesenteric fibrosis Pathognomonic radiological sign of midgut NET.
	Neuroendocrine tumor of lung^[83]^[84]^[85]^[86]	+	+	+	+	+	Cough Hemoptysis Chest pain Fever due to post -obstructuve pneuomnia	+	+/-	+/-	+	+	-	+	+	Immunohistochemical stains: Synaptophysin Neuron-specific enolase NT-proBNP Low serotonin content as compared to midgut tumors.	Atypical neuroendocrine tumors have a greater tendency to metastasize to liver,hypervascular, and becomies isodense relative to the liver parenchyma after contrast administration.		Sensitive for detection of liver metastases if present	+	+	Chest X ray: round or oval opacities from 2-5cm with sharp and notched margins Chest CT : Hilar or Perihilar Masses, Endobronchial Nodules,Related to bronchial Obstruction:peripheral atelectasis and postobstructive pneumonia Pulmonary funcation test Bronchoscopy 68-Ga DOTATATE PET scan Fluorodeoxyglucose PET scans for atypical lung NETs .	-	Typical low-grade:bland cells containing regular round nuclei with finely dispersed chromatin and inconspicuous small nucleoli.Mitotic figures are scarce and necrosis is absent. Intermediate-grade atypical: presence of Neuroendocrine morphology and either necrosis or 2 to 10 mitoses per 10 HPF	Biopsy and histopathology
Irritable Bowel Syndrome^[87]^[88]^[89]^[90]		+ Perioidic	Intermittent Chronic history of diarhea alternating with constipation	-	-	-	Fibromyalgia Chronic fatigue syndrome Gastroesophageal reflux disease, Functional dyspepsia Non-cardiac chest pain, Major depression ,Anxiety	-	-	-	-	-		-	-		-	-	-	-	Bristol stool form scale should to record stool consistency Abdominal radiograph to assess for stool accumulation and determine the severity. Age-appropriate colorectal cancer screening in all patients	-	-	Rome IV criteria Recurrent abdominal pain, at least 1day/week in the last 3 months, a/s with 2 or more of the following criteria: •Related to defecation •Associated with a change in stool frequency •Associated with a change in stool form (appearance)
Malignant neoplasms of small intestine^[91]^[92]^[93]		+/-	+/-	-	-	+/-	Constipation Fatigue Early satiety	-	-	+/-	-	* Abdominal mass Ascites	-	+	Abdominal CT scan may be diagnostic of small intestine cancer. Findings on CT scan suggestive of small intestine cancer include intrinsic mass with a short segment of bowel wall thickening	MRI and MRI enteroscopy are other advance modalities to diagnose and stage small intestinal cancers	-	-	Enteroscopy, capsule endoscopy and double balloon enteroscopy		Adenocarcinomas may be polypoid, infiltrating, or as annular constricting lesions is small intestine. Polyps and adenomas of small intestine are considered precursor lesions of adenocarcinoma. Lymphomas of small intestine present with suspicious growths in submucosa with normal appearing muscosa. Endoscopic evaluation may show multifocal involvement and large biopsies are required for diagnoses	Biopsy and histopathology
Crohn disease^[94]^[95]^[96]^[97]		Right lower quadrant pain	+/-	-	-	-	Gross bloody diarrhea +/- Weight loss Fatigue	-	-	-	-	-	Weight loss Pallor Oral lesions Odynophagia Dysphagia Perianal skin tags Sinus tracts Gallstones Extraintestinal manifestations Arthritis Uveitis, Iritis, and Episcleritis Erythema nodosum and Pyoderma gangrenosum Primary sclerosing cholangitis Secondary amyloidosis Thromboembolism Renal stones Osteoporosis Vitamin B12 deficiency	-	-	CRP may be high p-ANCA and ASCA	CT enterography Small bowel inflammation by displaying mural hyperenhancement and thickening; engorged vasa recta; and perienteric inflammatory changes.		-	-	CBC Blood chemistry including electrolytes Renal function tests liver enzymes Blood glucose ESR CRP Serum iron Vitamin D & vitamin B12 levels Stool D/R and culture for ova and parasites, C. difficile toxin	-	Focal ulcerations and acute and chronic inflammation Granulomas	Colonoscopy:focal ulcerations adjacent to areas of normal appearing mucosa along with polypoid mucosal,skip lesions,pseudopolyps,
Benign cutaneous flushing^[98]		-	-	+	-	-		-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-	-
Systemic mastocytosis^[99]^[100]^[101]^[102]^[103]		+	+	+	+	-	Maculopapular rash Pruritus	+/-	+/-	+	-	-	Diffuse musculoskeletal pain Neuropsychiatric symptoms	-	-	Activating mutations of KIT Serum Tryptase levels			-	-
Asthma exacerbation^[104]^[105]^[106]^[107]		-	-	-	+	+		+	-	-	+	-	Tachypnea Prolonged expiratory phase of respiration (decreased I:E ratio) Seated position with use of extended arms to support the upper chest (tripod position) +/- Pulsus paradoxus	-	-	-	--	-	-	-	Chest X ray	-	Loss of the normal pseudostratified structure of airway epithelium Increase in the proportion of goblet cells Fibrotic thickening of the sub-epithelial reticular basement membrane Increased numbers of myofibroblasts Increased vascularity Increased airway smooth muscle mass Increased extracellular matrix
Anaphylaxis^[108]^[109]^[110]^[111]^[112]		+	-/+	+	+	+	Vomiting Generalized hives, Pruritus Itching	+/-	-	+	+	-	Swollen lips-tongue-uvula Periorbital edema, Conjunctival swelling	-	-	-	-	-	-	-	plasma tryptase Plasma histamine levels Take proper clinical history and medication history specially beta blockers,ACE-inhibitors,opioids Skin testing with allergen extracts enzyme-linked immunosorbent assays (ELISAs) for quantification of allergen-specific IgE levels	-	-		History of exposure to insect stings,food alllergy,rubber latex,food additives,,allergy to medications,physical factors such s excercise and cold
Histaminergic Angioedema^[113]^[114]^[115]^[116]^[117]		+/-	+/-	+	+	+	Generalized pruritus Throat tightness Hoarse voice Difficulty swallowing	+	-	+	+	-	Urticaria Localized swelling of skin	-	-	-	Bowel wall edema Circumferential thickening of the small bowel wall with ascites or incomplete obstruction	-	-	-	CBC with differential, Electrolytes Liver function tests C-reactive protein Erythrocyte sedimentation rate Levels of the complement protein C4 Serum total tryptase Allergen-specific IgE immunoassays	-	-	-	Take proper clinical history of previous similar episodes Medication history Any allergy to insects stings , foods or any ingestion within previous 24 hours
Medullary Thyroid Carcinoma^[118]^[119]^[120]^[121]		-	+/-	+/-	+/-	-	Neck pain Hoarseness Cough Difficulty swallowing Difficulty breathing Lethargy Bone pain from metastasis	-	-	-	-	-	Solitary thyroid nodule Cervical lymph node involvement Weight loss	-	-	Basal serum calcitonin concentrations Carcinoembryonic antigen (CEA) concentration Thyroid function tests: normal Germline RET testing Serum calcium Plasma fractionated metanephrines	-	-	-	-	Ultrasonography of the neck For metastasis Chest computed tomography Neck CT Three-phase contrast-enhanced liver CT Axial MRI Bone scintigraphy.	-	Immunohistochemical staining for calcitonin Spindle-shaped and frequently pleomorphic cells without follicle development	Fine-needle aspiration (FNA) biopsy TNM staging American Thyroid Association (ATA) Guidelines for Management and evaluation of Medullary Thyroid Cancer

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@@ Line 1: / Line 1: @@
 __NOTOC__
-{{Small intestine cancer}}
+[[Image:Home_logo1.png|right|250px|link=http://www.wikidoc.org/index.php/Small_intestine_cancer]]
 {{CMG}}; {{AE}}{{Qurrat}}
 ==Overview==
@@ Line 19: / Line 19: @@
 *[[Gastric cancer]]
-== tab ==
+==Table for Differential Diagnosis of Small Intestine Cancer==
+'''<small>ABBREVIATIONS''':
+'''N/A''': Not available, '''NL''': Normal, '''Hb''': Hemoglobin, '''Abd''': Abdominal</small>
 {| class="wikitable"
 |- style="background: #4479BA; color: #FFFFFF; text-align: center;"
 ! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
-| colspan="4" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Clinical manifestations'''
+| colspan="4" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''<small>Clinical manifestations</small>'''
-! colspan="6" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Para-clinical findings
+! colspan="6" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |<small>Para-clinical findings</small>
-| colspan="1" rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Gold standard'''
+| colspan="1" rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''<small>Gold standard</small>'''
 |-
-| colspan="4" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Symptoms'''
+| colspan="4" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''<small>Symptoms</small>'''
 |-
-! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
+! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |<small>Lab Findings</small>
-! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
+! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |<small>Imaging</small>
-! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
+! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |<small>Histopathology</small>
 |-
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Constipation/Diarrhea
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |<small>Bowel</small>
-! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Blood in stool
+<small>Frequency</small>
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Abdominal pain
+! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |<small>Blood in stool</small>
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other symptoms
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |<small>Abd pain</small>
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Anemia
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |<small>Other symptoms</small>
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Tumor marker
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |<small>Hb</small>
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Endoscopy
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |<small>Tumor marker</small>
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |CT scan
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |<small>Endoscopy</small>
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other diagnostic study
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |<small>CT scan</small>
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |<small>Other diagnostic study</small>
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Adenocarcinoma]]<ref name="pmid8265100">{{cite journal |vauthors=Secco GB, Fardelli R, Campora E, Lapertosa G, Gentile R, Zoli S, Prior C |title=Primary mucinous adenocarcinomas and signet-ring cell carcinomas of colon and rectum |journal=Oncology |volume=51 |issue=1 |pages=30–4 |date=1994 |pmid=8265100 |doi=10.1159/000227306 |url=}}</ref>
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Adenocarcinoma|<small>Adenocarcinoma</small>]]
-| style="background: #F5F5F5; padding: 5px;" |
+<small>of</small>
-* [[Constipation]]
-and/or
+<small>small</small>
-* [[Diarrhea]]
-| style="background: #F5F5F5; padding: 5px;" | +
+<small>intestine</small><ref name="pmid8265100">{{cite journal |vauthors=Secco GB, Fardelli R, Campora E, Lapertosa G, Gentile R, Zoli S, Prior C |title=Primary mucinous adenocarcinomas and signet-ring cell carcinomas of colon and rectum |journal=Oncology |volume=51 |issue=1 |pages=30–4 |date=1994 |pmid=8265100 |doi=10.1159/000227306 |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |↑↓
-* Diffuse abdominal pain +/-
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Tenesmus]]
-*Diminished caliber of stools
-*[[Mucus]] in stools
 | style="background: #F5F5F5; padding: 5px;" | +
+| style="background: #F5F5F5; padding: 5px;" | +/-
 | style="background: #F5F5F5; padding: 5px;" |
-* [[CEA]]+
+*[[Tenesmus|<small>Tenesmus</small>]]
+*<small>Diminished caliber of stools</small>
+*<small>[[Mucus]] in stools</small>
+| style="background: #F5F5F5; padding: 5px;" | [[Anemia|↓]]
+| style="background: #F5F5F5; padding: 5px;" |<small>[[CEA]]+</small>
 | style="background: #F5F5F5; padding: 5px;" |
-*[[Polyp|Polyps]] (villous, tubular, tubulo-villous)
+*<small>[[Polyp|Polyps]] (villous, tubular, tubulo-villous)</small>
-*[[Ulcer|Ulcerating polyps]]
+*[[Ulcer|<small>Ulcerating polyps</small>]]
-*[[cancerous]] [[lesions]]
+*<small>[[cancerous]] [[lesions]]</small>
 | style="background: #F5F5F5; padding: 5px;" |
-*Luminal narrowing and [[bowel obstruction]]
+*<small>[[Luminal]] narrowing and [[bowel obstruction]]</small>
-*Circumferential thickening of the bowel wall
+*<small>Circumferential thickening of the [[Bowel|bowel wall]]</small>
-*[[Enlarged lymph nodes]]
+*[[Enlarged lymph nodes|<small>Enlarged lymph nodes</small>]]
-*Pulmonary [[metastases]]
+*<small>[[Pulmonary]] [[metastases]]</small>
-*Peritoneal metastases
+*<small>[[Peritoneum|Peritoneal]] [[metastases]]</small>
-*[[Metastases|Hepatic metastases]]
+*[[Metastases|<small>Hepatic metastases</small>]]
 | style="background: #F5F5F5; padding: 5px;" |
-*[[PET scan|PET scans]]: Detailed images and metastasis
+*<small>[[PET scan|PET scans]]: Detailed images and metastasis</small>
-*[[Barium enema]]: Cancer or a precancerous polyp
+*<small>[[Barium enema]]: [[Cancer]] or a precancerous [[polyp]]</small>
-*[[Genetic testing]]: [[hereditary nonpolyposis colorectal cancer]] (HNPCC) or [[familial adenomatous polyposis]] (FAP)
+*<small>[[Genetic testing]]: [[hereditary nonpolyposis colorectal cancer]] (HNPCC) or [[familial adenomatous polyposis]] (FAP)</small>
 | style="background: #F5F5F5; padding: 5px;" |
-* Different grades of differentiation of glandular structures
+* <small>Different grades of differentiation of glandular structures</small>
-** Sheets or cords of malignant cells,
+** <small>Sheets or cords of [[Malignant|malignant cells]],</small>
-**Cellular atypia, pleomorphism
+**<small>[[Atypia|Cellular atypia]], pleomorphism</small>
-**High mitotic rate
+**<small>High mitotic rate</small>
-* Necrotic debris in glandular lumina
+* <small>[[Necrosis|Necrotic debris]] in [[glandular]] lumina</small>
-* Desmoplastic reaction (sign of invasion)
+* <small>Desmoplastic reaction (sign of invasion)</small>
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |<small>[[Biopsy]] and [[histopathological]] analysis</small>
-* [[Biopsy]] and [[histopathological]] analysis
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Carcinoid|Carcinoids]]<ref name="pmid20011309">{{cite journal |vauthors=Chung TP, Hunt SR |title=Carcinoid and neuroendocrine tumors of the colon and rectum |journal=Clin Colon Rectal Surg |volume=19 |issue=2 |pages=45–8 |date=May 2006 |pmid=20011309 |pmc=2780103 |doi=10.1055/s-2006-942343 |url=}}</ref><ref name="diagnostics">Diagnostics: Biochemical Markers, Imaging, and Approach. National cancer institute. http://www.cancer.gov/types/gi-carcinoid-tumors/hp/gi-carcinoid-treatment-pdq</ref><ref name="pmid22525418">{{cite journal |vauthors=Rindi G, Falconi M, Klersy C, Albarello L, Boninsegna L, Buchler MW, Capella C, Caplin M, Couvelard A, Doglioni C, Delle Fave G, Fischer L, Fusai G, de Herder WW, Jann H, Komminoth P, de Krijger RR, La Rosa S, Luong TV, Pape U, Perren A, Ruszniewski P, Scarpa A, Schmitt A, Solcia E, Wiedenmann B |title=TNM staging of neoplasms of the endocrine pancreas: results from a large international cohort study |journal=J. Natl. Cancer Inst. |volume=104 |issue=10 |pages=764–77 |date=May 2012 |pmid=22525418 |doi=10.1093/jnci/djs208 |url=}}</ref><ref name="pmid28637502">{{cite journal |vauthors=Fang C, Wang W, Zhang Y, Feng X, Sun J, Zeng Y, Chen Y, Li Y, Chen M, Zhou Z, Chen J |title=Clinicopathologic characteristics and prognosis of gastroenteropancreatic neuroendocrine neoplasms: a multicenter study in South China |journal=Chin J Cancer |volume=36 |issue=1 |pages=51 |date=June 2017 |pmid=28637502 |pmc=5480192 |doi=10.1186/s40880-017-0218-3 |url=}}</ref><ref name="symptoms">Signs and symptoms of carcinoid syndrome. National Cancer Institute. http://www.cancer.gov/types/gi-carcinoid-tumors/patient/gi-carcinoid-treatment-pdq</ref>
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Carcinoid|C<small>arcinoids</small>]]<small><ref name="pmid20011309">{{cite journal |vauthors=Chung TP, Hunt SR |title=Carcinoid and neuroendocrine tumors of the colon and rectum |journal=Clin Colon Rectal Surg |volume=19 |issue=2 |pages=45–8 |date=May 2006 |pmid=20011309 |pmc=2780103 |doi=10.1055/s-2006-942343 |url=}}</ref><ref name="diagnostics">Diagnostics: Biochemical Markers, Imaging, and Approach. National cancer institute. http://www.cancer.gov/types/gi-carcinoid-tumors/hp/gi-carcinoid-treatment-pdq</ref><ref name="pmid22525418">{{cite journal |vauthors=Rindi G, Falconi M, Klersy C, Albarello L, Boninsegna L, Buchler MW, Capella C, Caplin M, Couvelard A, Doglioni C, Delle Fave G, Fischer L, Fusai G, de Herder WW, Jann H, Komminoth P, de Krijger RR, La Rosa S, Luong TV, Pape U, Perren A, Ruszniewski P, Scarpa A, Schmitt A, Solcia E, Wiedenmann B |title=TNM staging of neoplasms of the endocrine pancreas: results from a large international cohort study |journal=J. Natl. Cancer Inst. |volume=104 |issue=10 |pages=764–77 |date=May 2012 |pmid=22525418 |doi=10.1093/jnci/djs208 |url=}}</ref><ref name="pmid28637502">{{cite journal |vauthors=Fang C, Wang W, Zhang Y, Feng X, Sun J, Zeng Y, Chen Y, Li Y, Chen M, Zhou Z, Chen J |title=Clinicopathologic characteristics and prognosis of gastroenteropancreatic neuroendocrine neoplasms: a multicenter study in South China |journal=Chin J Cancer |volume=36 |issue=1 |pages=51 |date=June 2017 |pmid=28637502 |pmc=5480192 |doi=10.1186/s40880-017-0218-3 |url=}}</ref><ref name="symptoms">Signs and symptoms of carcinoid syndrome. National Cancer Institute. http://www.cancer.gov/types/gi-carcinoid-tumors/patient/gi-carcinoid-treatment-pdq</ref></small>
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |↑
-* [[Diarrhea]]
 | style="background: #F5F5F5; padding: 5px;" | +/-
-| style="background: #F5F5F5; padding: 5px;" |
-* Abdominal pain
-| style="background: #F5F5F5; padding: 5px;" |
-*[[Flushing (physiology)|Flushing]]
-*[[Wheezing]]
-*[[Shortness of breath]]
-*[[Palpitations]]
-*[[Weight gain]]
-*[[Hirsutism]]
-*[[Weakness]]
-*[[Leg edema]]
 | style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" |
-* Urinary [[5-hydroxyindoleacetic acid]] (5-HIAA)
+*[[Flushing (physiology)|<small>Flushing</small>]]
-* Chromogranin A (CgA)
+*[[Wheezing|<small>Wheezing</small>]]
-* Other biochemical markers include:
+*[[Shortness of breath|<small>Shortness of breath</small>]]
-**[[Substance P]]
+*[[Palpitations|<small>Palpitations</small>]]
-**[[Neurotensin]]
+*[[Weight gain|<small>Weight gain</small>]]
-**[[Bradykinin]]
+*[[Hirsutism|<small>Hirsutism</small>]]
-**[[Human chorionic gonadotropin]]
+*[[Weakness|<small>Weakness</small>]]
-**Neuropeptide L
+*[[Leg edema|<small>Leg edema</small>]]
-**[[Pancreatic polypeptide]]
+| style="background: #F5F5F5; padding: 5px;" | [[Anemia of chronic disease|↓]]
 | style="background: #F5F5F5; padding: 5px;" |
-* Infiltrating, ulcerating or fungating lesions in the wall of colon
+* <small>Urinary [[5-hydroxyindoleacetic acid]] (5-HIAA)</small>
+* <small>Chromogranin A (CgA)</small>
+* <small>Other biochemical markers include:</small>
+**[[Substance P|<small>Substance P</small>]]
+**[[Neurotensin|<small>Neurotensin</small>]]
+**[[Bradykinin|<small>Bradykinin</small>]]
+**[[Human chorionic gonadotropin|<small>Human chorionic gonadotropin</small>]]
+**<small>Neuropeptide L</small>
+**[[Pancreatic polypeptide|<small>Pancreatic polypeptide</small>]]
+| style="background: #F5F5F5; padding: 5px;" |<small>Infiltrating, [[Ulceration|ulcerating]] or fungating [[Lesion|lesions]] in the wall of [[colon]]</small>
 | style="background: #F5F5F5; padding: 5px;" |
-* Well-defined single or multiple lesions
+* <small>Well-defined single or multiple [[lesions]]</small>
-* Round or ovoid in shape
+* <small>Round or ovoid in shape</small>
-* Variable in size ranges between 2-5 cm
+* <small>Variable in size ranges between 2-5 cm</small>
 | style="background: #F5F5F5; padding: 5px;" |
-* [[PET scan]] 11C-5-hydroxytryptophan (11C-5-HTP): Deetects metastasis
+* <small>[[PET scan]] 11C-5-hydroxytryptophan (11C-5-HTP): Deetects [[metastasis]]</small>
-* [[MRI]]:
+* <small>[[MRI]]:</small>
-** Nodular mass originating from the bowel wall or regional uniform bowel wall thickening with moderate intense enhancement on post gadolinium T1-weighted fat-suppressed images
+** <small>Nodular [[mass]] originating from the [[bowel]] wall or regional uniform [[bowel]] wall thickening with moderate intense enhancement on post gadolinium T1-weighted fat-suppressed images</small>
-** Mesenteric metastases presents as nodular masses with [[mesenteric]] stranding
+** <small>[[Mesenteric]] [[metastases]] presents as nodular [[Mass|masses]] with [[mesenteric]] stranding</small>
-** [[Liver]] metastases may show hypointense precontrast T1- and hyperintense T2-weighted images
+** <small>[[Liver]] [[metastases]] may show hypointense precontrast T1- and hyperintense T2-weighted images</small>
-** [[Liver]] metastases are commonly hypervascular
+** <small>[[Liver]] [[metastases]] are commonly hypervascular</small>
-* Ki-67 index
+* <small>Ki-67 index</small>
 | style="background: #F5F5F5; padding: 5px;" |
-* Solid or spongy nests of cells accentuated by neatly outlined luminal spaces
+* <small>Solid or spongy nests of [[cells]] accentuated by neatly outlined [[Luminal|luminal spaces]]</small>
-* Peripheral nuclear palisading
+* <small>Peripheral nuclear palisading</small>
-* Granular eosinophilic cytoplasm.
+* <small>Granular [[eosinophilic]] cytoplasm.</small>
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |<small>[[Biopsy]] and [[Histopathology|histopathological analysis]]</small>
-* [[Biopsy]] and [[Histopathology|histopathological analysis]]
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[MALT lymphoma|Intestinal Lymphoma]]<ref name="pmid20011310">{{cite journal |vauthors=Quayle FJ, Lowney JK |title=Colorectal lymphoma |journal=Clin Colon Rectal Surg |volume=19 |issue=2 |pages=49–53 |date=May 2006 |pmid=20011310 |pmc=2780105 |doi=10.1055/s-2006-942344 |url=}}</ref><ref name="QuayleLowney2006">{{cite journal|last1=Quayle|first1=Frank|last2=Lowney|first2=Jennifer|title=Colorectal Lymphoma|journal=Clinics in Colon and Rectal Surgery|volume=19|issue=2|year=2006|pages=049–053|issn=1531-0043|doi=10.1055/s-2006-942344}}</ref>
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |<small>[[MALT lymphoma|Intestinal Lymphoma]]<ref name="pmid20011310">{{cite journal |vauthors=Quayle FJ, Lowney JK |title=Colorectal lymphoma |journal=Clin Colon Rectal Surg |volume=19 |issue=2 |pages=49–53 |date=May 2006 |pmid=20011310 |pmc=2780105 |doi=10.1055/s-2006-942344 |url=}}</ref></small><ref name="QuayleLowney2006">{{cite journal|last1=Quayle|first1=Frank|last2=Lowney|first2=Jennifer|title=Colorectal Lymphoma|journal=Clinics in Colon and Rectal Surgery|volume=19|issue=2|year=2006|pages=049–053|issn=1531-0043|doi=10.1055/s-2006-942344}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" | -
-* Normal
 | style="background: #F5F5F5; padding: 5px;" | +/-
-| style="background: #F5F5F5; padding: 5px;" |
-* Depending on location
-| style="background: #F5F5F5; padding: 5px;" |
-* Weight loss
 | style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" |
-* Non-Hodgkin’s lymphomas: CD-20
+* <small>Weight loss</small>
+| style="background: #F5F5F5; padding: 5px;" | [[Anemia of chronic disease|↓]]
+| style="background: #F5F5F5; padding: 5px;" |<small>[[Non-Hodgkin lymphoma|Non-Hodgkin lymphomas]]: CD-20</small>
 | style="background: #F5F5F5; padding: 5px;" |
-* Polypoid or ulcerated mass, intramural lesion, aphthous ulcer, stricture, extraluminal mass, or diffuse, multiple polypoid lesions
+* <small>[[Polyp|Polypoid]] or ulcerated [[mass]], intramural [[lesion]], aphthous [[Ulcer|ulcer,]] [[stricture]], extraluminal mass, or diffuse, multiple [[Polyp|polypoi]]<nowiki/>d [[Lesion|lesions]]</small>
 | style="background: #F5F5F5; padding: 5px;" |
-* CT scan: polypoid mass, circumferential-cavitary lesions, focal mucosal nodularity, diffuse ulcerative or nodular lesions, regional lymph node involvement
+* <small>[[CT scan]]: [[Polyp|polypoid]] [[mass]], circumferential-cavitary [[lesions]], focal [[mucosal]] nodularity, diffuse [[Ulceration|ulcerative]] or nodular [[lesions]], regional [[lymph node]] involvement</small>
 | style="background: #F5F5F5; padding: 5px;" |
-* Biopsy:
+* <small>Biopsy:</small>
-** [[Diffuse large B cell lymphoma|Diffuse large B-cell lymphoma]]
+** [[Diffuse large B cell lymphoma|<small>Diffuse large B-cell lymphoma</small>]]
-** [[MALT lymphoma|Extranodal marginal zone lymphoma (MALT)]]
+** [[MALT lymphoma|<small>Extranodal marginal zone lymphoma (MALT)</small>]]
-** [[Mantle cell lymphoma]]
+** [[Mantle cell lymphoma|<small>Mantle cell lymphoma</small>]]
-** [[Burkitt's lymphoma|Burkitt’s lymphoma]]
+** [[Burkitt's lymphoma|<small>Burkitt’s lymphoma</small>]]
-** [[Follicular lymphoma]]
+** [[Follicular lymphoma|<small>Follicular lymphoma</small>]]
-* Double-contrast enema: Subtle mucosal changes, gross tumor morphology
+* <small>Double-contrast [[enema]]: Subtle [[mucosal]] changes, gross [[tumor]] morphology</small>
 | style="background: #F5F5F5; padding: 5px;" |
-* [[Diffuse large B cell lymphoma|Diffuse large B-cell lymphoma]]:
+* <small>[[Diffuse large B cell lymphoma|Diffuse large B-cell lymphoma]]:</small>
-* [[MALT lymphoma|Extranodal marginal zone lymphoma (MALT)]]
+* [[MALT lymphoma|<small>Extranodal marginal zone lymphoma (MALT)</small>]]
-* [[Mantle cell lymphoma]]
+* [[Mantle cell lymphoma|<small>Mantle cell lymphoma</small>]]
-* [[Burkitt's lymphoma|Burkitt’s lymphoma]]
+* [[Burkitt's lymphoma|<small>Burkitt’s lymphoma</small>]]
-* [[Follicular lymphoma]]
+* [[Follicular lymphoma|<small>Follicular lymphoma</small>]]
 *
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |<small>[[Biopsy]] and [[histopathological]] analysis</small>
-* Biopsy
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Gastrointestinal stromal tumor|Gastrointestinal Stromal Tumors (GIST)]]<ref name="pmid24778074">{{cite journal |vauthors=Niazi AK, Kaley K, Saif MW |title=Gastrointestinal stromal tumor of colon: a case report and review of literature |journal=Anticancer Res. |volume=34 |issue=5 |pages=2547–50 |date=May 2014 |pmid=24778074 |doi= |url=}}</ref><ref name="pmid247780742">{{cite journal |vauthors=Niazi AK, Kaley K, Saif MW |title=Gastrointestinal stromal tumor of colon: a case report and review of literature |journal=Anticancer Res. |volume=34 |issue=5 |pages=2547–50 |date=May 2014 |pmid=24778074 |doi= |url=}}</ref><ref name="pmid15223958">{{cite journal |vauthors=Medeiros F, Corless CL, Duensing A, Hornick JL, Oliveira AM, Heinrich MC, Fletcher JA, Fletcher CD |title=KIT-negative gastrointestinal stromal tumors: proof of concept and therapeutic implications |journal=Am. J. Surg. Pathol. |volume=28 |issue=7 |pages=889–94 |date=July 2004 |pmid=15223958 |doi= |url=}}</ref><ref name="pmid16222452">{{cite journal |vauthors=Kamiyama Y, Aihara R, Nakabayashi T, Mochiki E, Asao T, Kuwano H, Oriuchi N, Endo K |title=18F-fluorodeoxyglucose positron emission tomography: useful technique for predicting malignant potential of gastrointestinal stromal tumors |journal=World J Surg |volume=29 |issue=11 |pages=1429–35 |date=November 2005 |pmid=16222452 |doi=10.1007/s00268-005-0045-6 |url=}}</ref><ref name="pmid15613856">{{cite journal |vauthors=Miettinen M, Sobin LH, Lasota J |title=Gastrointestinal stromal tumors of the stomach: a clinicopathologic, immunohistochemical, and molecular genetic study of 1765 cases with long-term follow-up |journal=Am. J. Surg. Pathol. |volume=29 |issue=1 |pages=52–68 |date=January 2005 |pmid=15613856 |doi= |url=}}</ref>
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Gastrointestinal stromal tumor|<small>Gastrointestinal</small>]]
-| style="background: #F5F5F5; padding: 5px;" | +/-
-| style="background: #F5F5F5; padding: 5px;" | +/-
+[[Gastrointestinal stromal tumor|<small>Stromal</small>]]
-| style="background: #F5F5F5; padding: 5px;" |
-* No pain
+[[Gastrointestinal stromal tumor|<small>Tumors (GIST)</small>]]
-| style="background: #F5F5F5; padding: 5px;" |
-* Mostly [[asymptomatic]]
+<small><ref name="pmid24778074">{{cite journal |vauthors=Niazi AK, Kaley K, Saif MW |title=Gastrointestinal stromal tumor of colon: a case report and review of literature |journal=Anticancer Res. |volume=34 |issue=5 |pages=2547–50 |date=May 2014 |pmid=24778074 |doi= |url=}}</ref><ref name="pmid247780742">{{cite journal |vauthors=Niazi AK, Kaley K, Saif MW |title=Gastrointestinal stromal tumor of colon: a case report and review of literature |journal=Anticancer Res. |volume=34 |issue=5 |pages=2547–50 |date=May 2014 |pmid=24778074 |doi= |url=}}</ref><ref name="pmid15223958">{{cite journal |vauthors=Medeiros F, Corless CL, Duensing A, Hornick JL, Oliveira AM, Heinrich MC, Fletcher JA, Fletcher CD |title=KIT-negative gastrointestinal stromal tumors: proof of concept and therapeutic implications |journal=Am. J. Surg. Pathol. |volume=28 |issue=7 |pages=889–94 |date=July 2004 |pmid=15223958 |doi= |url=}}</ref></small>
-* Are discovered incidentally
-* Non-specific symptoms
+<small><ref name="pmid16222452">{{cite journal |vauthors=Kamiyama Y, Aihara R, Nakabayashi T, Mochiki E, Asao T, Kuwano H, Oriuchi N, Endo K |title=18F-fluorodeoxyglucose positron emission tomography: useful technique for predicting malignant potential of gastrointestinal stromal tumors |journal=World J Surg |volume=29 |issue=11 |pages=1429–35 |date=November 2005 |pmid=16222452 |doi=10.1007/s00268-005-0045-6 |url=}}</ref><ref name="pmid15613856">{{cite journal |vauthors=Miettinen M, Sobin LH, Lasota J |title=Gastrointestinal stromal tumors of the stomach: a clinicopathologic, immunohistochemical, and molecular genetic study of 1765 cases with long-term follow-up |journal=Am. J. Surg. Pathol. |volume=29 |issue=1 |pages=52–68 |date=January 2005 |pmid=15613856 |doi= |url=}}</ref><ref name="pmid12075401">{{cite journal |vauthors=Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, Miettinen M, O'Leary TJ, Remotti H, Rubin BP, Shmookler B, Sobin LH, Weiss SW |title=Diagnosis of gastrointestinal stromal tumors: a consensus approach |journal=Int. J. Surg. Pathol. |volume=10 |issue=2 |pages=81–9 |date=April 2002 |pmid=12075401 |doi=10.1177/106689690201000201 |url=}}</ref><ref name="pmid120754012">{{cite journal |vauthors=Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, Miettinen M, O'Leary TJ, Remotti H, Rubin BP, Shmookler B, Sobin LH, Weiss SW |title=Diagnosis of gastrointestinal stromal tumors: a consensus approach |journal=Int. J. Surg. Pathol. |volume=10 |issue=2 |pages=81–9 |date=April 2002 |pmid=12075401 |doi=10.1177/106689690201000201 |url=}}</ref></small>
-* Early satiety and bloating
+| style="background: #F5F5F5; padding: 5px;" | ↑↓
 | style="background: #F5F5F5; padding: 5px;" | +/-
+| style="background: #F5F5F5; padding: 5px;" | -
 | style="background: #F5F5F5; padding: 5px;" |
-* KIT protein
+* <small>Mostly [[asymptomatic]]</small>
-* [[CD117|CD 117 antigen]]
+* <small>Are discovered incidentally</small>
+* <small>Non-specific symptoms</small>
+* <small>Early satiety and bloating</small>
+| style="background: #F5F5F5; padding: 5px;" | [[Anemia|↓]]/-
 | style="background: #F5F5F5; padding: 5px;" |
-* Subepithelial round masses
+* <small>KIT protein</small>
-* Smooth margins
+* [[CD117|<small>CD 117 antigen</small>]]
-* Normal overlying [[mucosa]] may be intact or [[Ulcerated lesion|ulcerated]]
-* Bulging into [[Gastrointestinal tract|gastrointestinal]] [[lumen]]
 | style="background: #F5F5F5; padding: 5px;" |
-* Small GIST (< 5 cms) are [[homogeneous]] with clear boundaries and have an [[intraluminal]] pattern of growth.
+* <small>Subepithelial round masses</small>
-* Intermediate GIST (size of 5-10 cms) are [[heterogeneous]] with irregular borders and [[Intraluminal|intra]] or extra-luminal pattern of [[growth]].
+* <small>Smooth margins</small>
-* Large GISTs (>10 cms) are [[heterogeneous]] with irregular borders and have local or distant spread
+* <small>Normal overlying [[mucosa]] may be intact or [[Ulcerated lesion|ulcerated]]</small>
-* Malignant GIST with metastasis:
+* <small>Bulging into [[Gastrointestinal tract|gastrointestinal]] [[lumen]]</small>
-** Size greater than 10 cm
-** [[Calcification|Calcifications]]
-** Irregular margins
-** [[Heterogeneous]] and lobulated
-** [[Lymphadenopathy]]
-** [[Ulceration]]
-** Extraluminal and [[mesenteric]] fat infiltration
 | style="background: #F5F5F5; padding: 5px;" |
-* [[MRI]]: [[Hemorrhage]], [[necrosis]], surrounding structures and [[metastasis]].
+* <small>Small [[GIST]] (< 5 cms) are [[homogeneous]] with clear boundaries and have an [[intraluminal]] pattern of growth.</small>
-* [[Endoscopic ultrasound|Endoscopic]] [[ultrasonography]]:
+* <small>Intermediate [[Gastrointestinal stromal tumor|GIST]] (size of 5-10 cms) are [[heterogeneous]] with irregular borders and [[Intraluminal|intra]] or extra-[[luminal]] pattern of [[growth]].</small>
-** [[Mucosal]] [[ulceration]] or [[bleeding]]
+* <small>Large [[Gastrointestinal stromal tumor|GISTs]] (>10 cms) are [[heterogeneous]] with irregular borders and have local or distant spread</small>
-** Smooth [[submucosal]] mass as hypoechoic mass
+* <small>[[Malignant]] [[Gastrointestinal stromal tumor|GIST]] with [[metastasis]]:</small>
-** [[Malignant]] GIST lesions present with:
+** <small>Size greater than 10 cm</small>
-*** [[Heterogeneous]] mass >4 cm in size
+** [[Calcification|<small>Calcifications</small>]]
-*** Irregular borders
+** <small>Irregular margins</small>
-*** [[Intraluminal|Intra]] and extraluminal growth
+** <small>[[Heterogeneous]] and lobulated</small>
-*** Multiple [[cysts]] within the main [[lesion]]
+** [[Lymphadenopathy|<small>Lymphadenopathy</small>]]
+** [[Ulceration|<small>Ulceration</small>]]
+** <small>Extraluminal and [[mesenteric]] fat infiltration</small>
 | style="background: #F5F5F5; padding: 5px;" |
-*[[Spindle cells|Spindle cell]] type are [[eosinophilic]] cells arranged in the form of whorls or fascicles.<ref name="pmid12075401">{{cite journal |vauthors=Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, Miettinen M, O'Leary TJ, Remotti H, Rubin BP, Shmookler B, Sobin LH, Weiss SW |title=Diagnosis of gastrointestinal stromal tumors: a consensus approach |journal=Int. J. Surg. Pathol. |volume=10 |issue=2 |pages=81–9 |date=April 2002 |pmid=12075401 |doi=10.1177/106689690201000201 |url=}}</ref><ref name="pmid120754012">{{cite journal |vauthors=Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, Miettinen M, O'Leary TJ, Remotti H, Rubin BP, Shmookler B, Sobin LH, Weiss SW |title=Diagnosis of gastrointestinal stromal tumors: a consensus approach |journal=Int. J. Surg. Pathol. |volume=10 |issue=2 |pages=81–9 |date=April 2002 |pmid=12075401 |doi=10.1177/106689690201000201 |url=}}</ref>
+* <small>[[MRI]]: [[Hemorrhage]], [[necrosis]], surrounding structures and [[metastasis]].</small>
-*[[Epithelioid]] [[GIST|GISTs]] are rounded cells with oval nuclei and vesicular chromatin and appears nested
+* <small>[[Endoscopic ultrasound|Endoscopic]] [[ultrasonography]]:</small>
-*On [[immunohistochemical staining]] they are positive for [[Molecular marker|molecular markers]] [[CD117]] antigen and KIT protein.
+** <small>[[Mucosal]] [[ulceration]] or [[bleeding]]</small>
+** <small>Smooth [[submucosal]] [[mass]] as hypoechoic [[mass]]</small>
+** <small>[[Malignant]] GIST lesions present with:</small>
+*** <small>[[Heterogeneous]] [[mass]] >4 cm in size</small>
+*** <small>Irregular borders</small>
+*** <small>[[Intraluminal|Intra]] and extraluminal growth</small>
+*** <small>Multiple [[cysts]] within the main [[lesion]]</small>
 | style="background: #F5F5F5; padding: 5px;" |
-* Endoscopic ultrasound with[[Biopsy]] and [[Histopathological|histopathological analysis]]
+*<small>[[Spindle cells|Spindle cell]] type are [[eosinophilic]] cells arranged in the form of whorls or fascicles.</small>
+*<small>[[Epithelioid]] [[GIST|GISTs]] are rounded [[Cell (biology)|cells]] with oval [[Cell nucleus|nuclei]] and vesicular [[chromatin]] and appears nested</small>
+*<small>On [[immunohistochemical staining]] they are positive for [[Molecular marker|molecular markers]] [[CD117]] antigen and KIT protein.</small>
+| style="background: #F5F5F5; padding: 5px;" |<small>Endoscopic ultrasound with[[Biopsy]] and [[Histopathological|histopathological analysis]]</small>
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Peutz-Jeghers syndrome]]<ref name="pmid27298573">{{cite journal |vauthors=Zhong ME, Niu BZ, Ji WY, Wu B |title=Laparoscopic restorative proctocolectomy with ileal pouch-anal anastomosis for Peutz-Jeghers syndrome with synchronous rectal cancer |journal=World J. Gastroenterol. |volume=22 |issue=22 |pages=5293–6 |date=June 2016 |pmid=27298573 |doi=10.3748/wjg.v22.i22.5293 |url=}}</ref><ref name="KopacovaTacheci20092">{{cite journal|last1=Kopacova|first1=Marcela|last2=Tacheci|first2=Ilja|last3=Rejchrt|first3=Stanislav|last4=Bures|first4=Jan|title=Peutz-Jeghers syndrome: Diagnostic and therapeuticapproach|journal=World Journal of Gastroenterology|volume=15|issue=43|year=2009|pages=5397|issn=1007-9327|doi=10.3748/wjg.15.5397}}</ref><ref name="GiardielloTrimbath2006">{{cite journal|last1=Giardiello|first1=F|last2=Trimbath|first2=J|title=Peutz-Jeghers Syndrome and Management Recommendations|journal=Clinical Gastroenterology and Hepatology|volume=4|issue=4|year=2006|pages=408–415|issn=15423565|doi=10.1016/j.cgh.2005.11.005}}</ref><ref name="BeggsLatchford2010">{{cite journal|last1=Beggs|first1=A. D.|last2=Latchford|first2=A. R.|last3=Vasen|first3=H. F. A.|last4=Moslein|first4=G.|last5=Alonso|first5=A.|last6=Aretz|first6=S.|last7=Bertario|first7=L.|last8=Blanco|first8=I.|last9=Bulow|first9=S.|last10=Burn|first10=J.|last11=Capella|first11=G.|last12=Colas|first12=C.|last13=Friedl|first13=W.|last14=Moller|first14=P.|last15=Hes|first15=F. J.|last16=Jarvinen|first16=H.|last17=Mecklin|first17=J.-P.|last18=Nagengast|first18=F. M.|last19=Parc|first19=Y.|last20=Phillips|first20=R. K. S.|last21=Hyer|first21=W.|last22=Ponz de Leon|first22=M.|last23=Renkonen-Sinisalo|first23=L.|last24=Sampson|first24=J. R.|last25=Stormorken|first25=A.|last26=Tejpar|first26=S.|last27=Thomas|first27=H. J. W.|last28=Wijnen|first28=J. T.|last29=Clark|first29=S. K.|last30=Hodgson|first30=S. V.|title=Peutz-Jeghers syndrome: a systematic review and recommendations for management|journal=Gut|volume=59|issue=7|year=2010|pages=975–986|issn=0017-5749|doi=10.1136/gut.2009.198499}}</ref><ref name="KopacovaTacheci20093">{{cite journal|last1=Kopacova|first1=Marcela|last2=Tacheci|first2=Ilja|last3=Rejchrt|first3=Stanislav|last4=Bures|first4=Jan|title=Peutz-Jeghers syndrome: Diagnostic and therapeuticapproach|journal=World Journal of Gastroenterology|volume=15|issue=43|year=2009|pages=5397|issn=1007-9327|doi=10.3748/wjg.15.5397}}</ref>
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Peutz-Jeghers syndrome|<small>Peutz-Jeghers</small>]]
-| style="background: #F5F5F5; padding: 5px;" |
-* [[Constipation]]
+<small>[[Peutz-Jeghers syndrome|syndrome]]<ref name="pmid27298573">{{cite journal |vauthors=Zhong ME, Niu BZ, Ji WY, Wu B |title=Laparoscopic restorative proctocolectomy with ileal pouch-anal anastomosis for Peutz-Jeghers syndrome with synchronous rectal cancer |journal=World J. Gastroenterol. |volume=22 |issue=22 |pages=5293–6 |date=June 2016 |pmid=27298573 |doi=10.3748/wjg.v22.i22.5293 |url=}}</ref></small>
-and/or
-* [[Diarrhea]]
+<small><ref name="KopacovaTacheci20092">{{cite journal|last1=Kopacova|first1=Marcela|last2=Tacheci|first2=Ilja|last3=Rejchrt|first3=Stanislav|last4=Bures|first4=Jan|title=Peutz-Jeghers syndrome: Diagnostic and therapeuticapproach|journal=World Journal of Gastroenterology|volume=15|issue=43|year=2009|pages=5397|issn=1007-9327|doi=10.3748/wjg.15.5397}}</ref><ref name="GiardielloTrimbath2006">{{cite journal|last1=Giardiello|first1=F|last2=Trimbath|first2=J|title=Peutz-Jeghers Syndrome and Management Recommendations|journal=Clinical Gastroenterology and Hepatology|volume=4|issue=4|year=2006|pages=408–415|issn=15423565|doi=10.1016/j.cgh.2005.11.005}}</ref><ref name="BeggsLatchford2010">{{cite journal|last1=Beggs|first1=A. D.|last2=Latchford|first2=A. R.|last3=Vasen|first3=H. F. A.|last4=Moslein|first4=G.|last5=Alonso|first5=A.|last6=Aretz|first6=S.|last7=Bertario|first7=L.|last8=Blanco|first8=I.|last9=Bulow|first9=S.|last10=Burn|first10=J.|last11=Capella|first11=G.|last12=Colas|first12=C.|last13=Friedl|first13=W.|last14=Moller|first14=P.|last15=Hes|first15=F. J.|last16=Jarvinen|first16=H.|last17=Mecklin|first17=J.-P.|last18=Nagengast|first18=F. M.|last19=Parc|first19=Y.|last20=Phillips|first20=R. K. S.|last21=Hyer|first21=W.|last22=Ponz de Leon|first22=M.|last23=Renkonen-Sinisalo|first23=L.|last24=Sampson|first24=J. R.|last25=Stormorken|first25=A.|last26=Tejpar|first26=S.|last27=Thomas|first27=H. J. W.|last28=Wijnen|first28=J. T.|last29=Clark|first29=S. K.|last30=Hodgson|first30=S. V.|title=Peutz-Jeghers syndrome: a systematic review and recommendations for management|journal=Gut|volume=59|issue=7|year=2010|pages=975–986|issn=0017-5749|doi=10.1136/gut.2009.198499}}</ref><ref name="KopacovaTacheci20093">{{cite journal|last1=Kopacova|first1=Marcela|last2=Tacheci|first2=Ilja|last3=Rejchrt|first3=Stanislav|last4=Bures|first4=Jan|title=Peutz-Jeghers syndrome: Diagnostic and therapeuticapproach|journal=World Journal of Gastroenterology|volume=15|issue=43|year=2009|pages=5397|issn=1007-9327|doi=10.3748/wjg.15.5397}}</ref></small>
+| style="background: #F5F5F5; padding: 5px;" |↑↓
 | style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" |
-* Abdominal pain
-| style="background: #F5F5F5; padding: 5px;" |
-* [[Mucocutaneous]]   [[hyperpigmentation]] (mouth, hands, and feet)
-* [[Fatigue]]
-* [[Weight loss]]
-* [[Rectal prolapse]]
 | style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" |
-* N/A
+* <small>[[Mucocutaneous]]   [[hyperpigmentation]] (mouth, hands, and feet)</small>
+* [[Fatigue|<small>Fatigue</small>]]
+* [[Weight loss|<small>Weight loss</small>]]
+* [[Rectal prolapse|<small>Rectal prolapse</small>]]
+| style="background: #F5F5F5; padding: 5px;" | [[Anemia|↓]]
+| style="background: #F5F5F5; padding: 5px;" |<small>N/A</small>
 | style="background: #F5F5F5; padding: 5px;" |
 * [[Hamartomatous intestinal polyposis|Multiple polyps]]
 * [[mucocutaneous]] [[pigmentation]]
 | style="background: #F5F5F5; padding: 5px;" |
-*[[Polyps|Multiple polyps]]
+*[[Polyps|<small>Multiple polyps</small>]]
-*[[Intussusception]]
+*[[Intussusception|<small>Intussusception</small>]]
-*[[Bowel obstruction]]
+*[[Bowel obstruction|<small>Bowel obstruction</small>]]
 | style="background: #F5F5F5; padding: 5px;" |
-* [[Barium enema]]: Multiple [[Polyp|polyps]].
+* <small>[[Barium enema]]: Multiple [[Polyp|polyps]].</small>
-* [[MRI]]: Multiple [[Hamartoma|hamartomatous]] polyps
+* <small>[[MRI]]: Multiple [[Hamartoma|hamartomatous]] polyps</small>
 | style="background: #F5F5F5; padding: 5px;" |
-** [[Hamartoma|Hamartomatous]] [[Polyps|mucosal polyps]] with central core of branching smooth muscle associated with mucosa
+* <small>[[Hamartoma|Hamartomatous]] [[Polyps|mucosal polyps]] with central core of branching smooth muscle associated with mucosa</small>
-** Smaller [[Polyp|polyps]] may lack the prominent arborizing smooth muscle
+* <small>Smaller [[Polyp|polyps]] may lack the prominent arborizing smooth muscle</small>
 | style="background: #F5F5F5; padding: 5px;" |
-*[[Genetic testing]] for [[STK11]]
+* <small>[[Genetic testing]] for [[STK11]]</small>
-*[[Colonoscopy]]
+* [[Colonoscopy|<small>Colonoscopy</small>]]
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Juvenile polyposis syndrome|Juvenile Polyposis Coli]]<ref name="pmid7054044">{{cite journal |vauthors=Grotsky HW, Rickert RR, Smith WD, Newsome JF |title=Familial juvenile polyposis coli. A clinical and pathologic study of a large kindred |journal=Gastroenterology |volume=82 |issue=3 |pages=494–501 |date=March 1982 |pmid=7054044 |doi= |url=}}</ref><ref name="pmid22171123">{{cite journal |vauthors=Brosens LA, Langeveld D, van Hattem WA, Giardiello FM, Offerhaus GJ |title=Juvenile polyposis syndrome |journal=World J. Gastroenterol. |volume=17 |issue=44 |pages=4839–44 |date=November 2011 |pmid=22171123 |pmc=3235625 |doi=10.3748/wjg.v17.i44.4839 |url=}}</ref><ref name="pmid22965402">{{cite journal |vauthors=Latchford AR, Neale K, Phillips RK, Clark SK |title=Juvenile polyposis syndrome: a study of genotype, phenotype, and long-term outcome |journal=Dis. Colon Rectum |volume=55 |issue=10 |pages=1038–43 |date=October 2012 |pmid=22965402 |doi=10.1097/DCR.0b013e31826278b3 |url=}}</ref><ref name="pmid229654023">{{cite journal |vauthors=Latchford AR, Neale K, Phillips RK, Clark SK |title=Juvenile polyposis syndrome: a study of genotype, phenotype, and long-term outcome |journal=Dis. Colon Rectum |volume=55 |issue=10 |pages=1038–43 |date=October 2012 |pmid=22965402 |doi=10.1097/DCR.0b013e31826278b3 |url=}}</ref><ref name="pmid229654022">{{cite journal |vauthors=Latchford AR, Neale K, Phillips RK, Clark SK |title=Juvenile polyposis syndrome: a study of genotype, phenotype, and long-term outcome |journal=Dis. Colon Rectum |volume=55 |issue=10 |pages=1038–43 |date=October 2012 |pmid=22965402 |doi=10.1097/DCR.0b013e31826278b3 |url=}}</ref>
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Juvenile polyposis syndrome|<small>Juvenile</small>]]
-| style="background: #F5F5F5; padding: 5px;" |
-* [[Diarrhea]]
+[[Juvenile polyposis syndrome|<small>Polyposis</small>]]
+[[Juvenile polyposis syndrome|<small>Coli</small>]]
+<small><ref name="pmid7054044">{{cite journal |vauthors=Grotsky HW, Rickert RR, Smith WD, Newsome JF |title=Familial juvenile polyposis coli. A clinical and pathologic study of a large kindred |journal=Gastroenterology |volume=82 |issue=3 |pages=494–501 |date=March 1982 |pmid=7054044 |doi= |url=}}</ref><ref name="pmid22171123">{{cite journal |vauthors=Brosens LA, Langeveld D, van Hattem WA, Giardiello FM, Offerhaus GJ |title=Juvenile polyposis syndrome |journal=World J. Gastroenterol. |volume=17 |issue=44 |pages=4839–44 |date=November 2011 |pmid=22171123 |pmc=3235625 |doi=10.3748/wjg.v17.i44.4839 |url=}}</ref><ref name="pmid22965402">{{cite journal |vauthors=Latchford AR, Neale K, Phillips RK, Clark SK |title=Juvenile polyposis syndrome: a study of genotype, phenotype, and long-term outcome |journal=Dis. Colon Rectum |volume=55 |issue=10 |pages=1038–43 |date=October 2012 |pmid=22965402 |doi=10.1097/DCR.0b013e31826278b3 |url=}}</ref><ref name="pmid229654023">{{cite journal |vauthors=Latchford AR, Neale K, Phillips RK, Clark SK |title=Juvenile polyposis syndrome: a study of genotype, phenotype, and long-term outcome |journal=Dis. Colon Rectum |volume=55 |issue=10 |pages=1038–43 |date=October 2012 |pmid=22965402 |doi=10.1097/DCR.0b013e31826278b3 |url=}}</ref><ref name="pmid229654022">{{cite journal |vauthors=Latchford AR, Neale K, Phillips RK, Clark SK |title=Juvenile polyposis syndrome: a study of genotype, phenotype, and long-term outcome |journal=Dis. Colon Rectum |volume=55 |issue=10 |pages=1038–43 |date=October 2012 |pmid=22965402 |doi=10.1097/DCR.0b013e31826278b3 |url=}}</ref></small>
+| style="background: #F5F5F5; padding: 5px;" |[[Diarrhea|↑]]
 | style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" |
-* Diffuse abdominal pain
-| style="background: #F5F5F5; padding: 5px;" |
-* Prolapsing [[polyp]]
-* [[Intussusception]]
-* [[Macrocephalus]]
-* [[Hypotonia]]
-* [[Intestinal obstruction|Bowel obstruction]]
-* Heart or brain abnormalities
-* Cleft palate
-* Polydactyly
-* Abnormalities of the genitalia or urinary tract.
 | style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" |
-* N/A
+* <small>Prolapsing [[polyp]]</small>
+* [[Intussusception|<small>Intussusception</small>]]
+* [[Macrocephalus|<small>Macrocephalus</small>]]
+* [[Hypotonia|<small>Hypotonia</small>]]
+* [[Intestinal obstruction|<small>Bowel obstruction</small>]]
+* <small>Heart or brain abnormalities</small>
+* <small>Cleft palate</small>
+* <small>Polydactyly</small>
+* <small>Abnormalities of the genitalia or urinary tract.</small>
+| style="background: #F5F5F5; padding: 5px;" | [[Anemia|↓]]
+| style="background: #F5F5F5; padding: 5px;" |<small>N/A</small>
 | style="background: #F5F5F5; padding: 5px;" |
 * >5 juvenile [[Polyp|polyps]] in the [[colon]] and [[rectum]]
 * Multiple [[Polyps|juvenile polyps]] in [[gastrointestinal tract]]
 | style="background: #F5F5F5; padding: 5px;" |
-* M[[Polyps|ultiple polyps]] in [[gastrointestinal tract]]
+* <small>M[[Polyps|ultiple polyps]] in [[gastrointestinal tract]]</small>
 | style="background: #F5F5F5; padding: 5px;" |
-* Barium study: Multiple polyps in GI tract
+* <small>[[Barium]] study: Multiple [[polyps]] in [[Gastrointestinal tract|GI tract]]</small>
-* Stool DNA test: ''SMAD4'' or ''BMPR1A''
+* <small>[[Stool]] [[DNA test]]: ''SMAD4'' or ''BMPR1A''</small>
-* Diagnose if any of the following positive:
+* <small>Diagnose if any of the following positive:</small>
-** More than five juvenile polyps of the colorectum
+** <small>More than five [[Polyps|juvenile polyps]] of the [[Colon|colorectum]]</small>
-** Multiple juvenile polyps throughout the GI tract
+** <small>Multiple juvenile [[Polyp|polyps]] throughout the [[GI tract]]</small>
-** Any number of juvenile polyps and a family history of juvenile polyposis
+** <small>Any number of juvenile [[polyps]] and a family history of [[Juvenile polyposis syndrome|juvenile polyposis]]</small>
-** Heterozygous pathogenic variant in ''SMAD4'' or ''BMPR1A''
+** <small>[[Heterozygous]] pathogenic variant in ''SMAD4'' or ''BMPR1A''</small>
 | style="background: #F5F5F5; padding: 5px;" |
-* Numerous cystic and dilated crypts or glands with inspissated mucin and intraluminal neutrophils
+* <small>Numerous cystic and dilated crypts or [[glands]] with inspissated mucin and intraluminal [[Neutrophil|neutrophils]]</small>
-* Lamina propria edematous with associated lymphocytes, plasma cells, eosinophils and neutrophils
+* <small>[[Lamina propria]] edematous with associated [[lymphocytes]], [[plasma cells]], [[eosinophils]] and [[neutrophils]]</small>
-* Filiform, multilobated forms with increased glandular-to-stroma ratio in nonclassic or atypical polyps
+* <small>Filiform, multilobated forms with increased glandular-to-stroma ratio in nonclassic or atypical [[polyps]]</small>
-* Areas of conventional dysplasia
+* <small>Areas of conventional [[dysplasia]]</small>
 | style="background: #F5F5F5; padding: 5px;" |
-* If any of the following positive:
+* <small>If any of the following positive:</small>
-** More than five juvenile polyps of the colorectum
+** <small>More than five juvenile polyps of the colorectum</small>
-** Multiple juvenile polyps throughout the GI tract
+** <small>Multiple juvenile polyps throughout the GI tract</small>
-** Any number of juvenile polyps and a family history of juvenile polyposis
+** <small>Any number of juvenile polyps and a family history of juvenile polyposis</small>
-** Heterozygous pathogenic variant in ''SMAD4'' or ''BMPR1A''
+** <small>Heterozygous pathogenic variant in ''SMAD4'' or ''BMPR1A''</small>
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Kaposi's sarcoma]]<ref name="pmid20827371">{{cite journal |vauthors=Arora M, Goldberg EM |title=Kaposi sarcoma involving the gastrointestinal tract |journal=Gastroenterol Hepatol (N Y) |volume=6 |issue=7 |pages=459–62 |date=July 2010 |pmid=20827371 |pmc=2933764 |doi= |url=}}</ref>
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |<small>[[Kaposi's sarcoma]]<ref name="pmid20827371">{{cite journal |vauthors=Arora M, Goldberg EM |title=Kaposi sarcoma involving the gastrointestinal tract |journal=Gastroenterol Hepatol (N Y) |volume=6 |issue=7 |pages=459–62 |date=July 2010 |pmid=20827371 |pmc=2933764 |doi= |url=}}</ref></small>
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |[[Diarrhea|↑]]
-* [[Diarrhea]]
+| style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" |
-* Diffuse abdominal pain
+* [[Melena|<small>Melena</small>]]
-| style="background: #F5F5F5; padding: 5px;" |
-* [[Melena]]
-* [[Hematochezia]]
+* [[Hematochezia|<small>Hematochezia</small>]]
-* [[Abdominal pain]]
+* [[Abdominal pain|<small>Abdominal pain</small>]]
-* [[Nausea and vomiting|N/V]]
+* [[Nausea and vomiting|<small>N/V</small>]]
-| style="background: #F5F5F5; padding: 5px;" | +
+| style="background: #F5F5F5; padding: 5px;" | [[Anemia|↓]]
-| style="background: #F5F5F5; padding: 5px;" |
-* [[CD34]]
-* [[CD31]]
-* [[D2-40]]
-* [[HHV-8]]
-* [[FHI-1]] antibody
-* [[LANA-1]]
-| style="background: #F5F5F5; padding: 5px;" |
-* Localized purpuric lesion
-| style="background: #F5F5F5; padding: 5px;" |
-* N/A
 | style="background: #F5F5F5; padding: 5px;" |
-* Electrophoresis: [[antibodies]] against Kaposi sarcoma herpes virus  (HHV-8)
+* [[CD34|<small>CD34</small>]]
-* Biopsy: [[Vascular]] proliferation, red blood cell and [[hemosiderin]] extravasation,[[Lymphocyte|lymphocytes]] and [[Monocyte|monocytes]], neovascular lesion wrapped around a pre-existing space, intracytoplasmic PAS +ve [[hyaline]] globules
+* [[CD31|<small>CD31</small>]]
+* [[D2-40|<small>D2-40</small>]]
+* [[HHV-8|<small>HHV-8</small>]]
+* <small>[[FHI-1]] antibody</small>
+* [[LANA-1|<small>LANA-1</small>]]
+| style="background: #F5F5F5; padding: 5px;" |<small>Localized purpuric [[lesion]]</small>
+| style="background: #F5F5F5; padding: 5px;" |<small>N/A</small>
 | style="background: #F5F5F5; padding: 5px;" |
-* [[Vascular]] proliferation
+* <small>[[Electrophoresis]]: [[antibodies]] against [[Kaposi sarcoma]] [[Herpes virus|herpes virus  (HHV-8)]]</small>
-* Red blood cell and [[hemosiderin]] extravasation
+* <small>[[Biopsy|Biopsy:]] [[Vascular]] proliferation, [[red blood cell]] and [[hemosiderin]] extravasation,[[Lymphocyte|lymphocytes]] and [[Monocyte|monocytes]], neovascular [[lesion]] wrapped around a pre-existing space, intracytoplasmic [[PAS stain|PAS]] +ve [[hyaline]] globules</small>
-* [[Lymphocyte|Lymphocytes]] and [[Monocyte|monocytes]]
-* Premonitory sign (a neovascular lesion wrapped around a pre-existing space)
-* Intracytoplasmic PAS +ve [[hyaline]] globules
 | style="background: #F5F5F5; padding: 5px;" |
-* Biopsy
+* <small>[[Vascular]] proliferation</small>
+* <small>Red blood cell and [[hemosiderin]] extravasation</small>
+* <small>[[Lymphocyte|Lymphocytes]] and [[Monocyte|monocytes]]</small>
+* <small>Premonitory [[Sign (medicine)|sign]] (a [[neovascular]] lesion wrapped around a pre-existing space)</small>
+* <small>Intracytoplasmic PAS +ve [[hyaline]] globules</small>
+| style="background: #F5F5F5; padding: 5px;" |<small>Biopsy</small>
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Arteriovenous malformation]]<ref name="pmid28139503">{{cite journal |vauthors=Lee HH, Kwon HM, Gil S, Kim YS, Cho M, Seo KJ, Chae HS, Cho YS |title=Endoscopic resection of asymptomatic, colonic, polypoid arteriovenous malformations: Two case reports and a literature review |journal=Saudi J Gastroenterol |volume=23 |issue=1 |pages=67–70 |date=2017 |pmid=28139503 |pmc=5329980 |doi=10.4103/1319-3767.199111 |url=}}</ref>
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |<small>[[Arteriovenous malformation]]<ref name="pmid28139503">{{cite journal |vauthors=Lee HH, Kwon HM, Gil S, Kim YS, Cho M, Seo KJ, Chae HS, Cho YS |title=Endoscopic resection of asymptomatic, colonic, polypoid arteriovenous malformations: Two case reports and a literature review |journal=Saudi J Gastroenterol |volume=23 |issue=1 |pages=67–70 |date=2017 |pmid=28139503 |pmc=5329980 |doi=10.4103/1319-3767.199111 |url=}}</ref></small>
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" | -
-* Normal
 | style="background: #F5F5F5; padding: 5px;" | +
+| style="background: #F5F5F5; padding: 5px;" | -
 | style="background: #F5F5F5; padding: 5px;" |
-* No pain
+* <small>N/A</small>
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" | [[Anemia|↓]]
-* N/A
+| style="background: #F5F5F5; padding: 5px;" |<small>N/A</small>
-| style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" |
-* N/A
-| style="background: #F5F5F5; padding: 5px;" |
-* Bright red, flat lesions
-* Rarely, polypoid
-| style="background: #F5F5F5; padding: 5px;" |
-* N/A
-| style="background: #F5F5F5; padding: 5px;" |
-* N/A
 | style="background: #F5F5F5; padding: 5px;" |
-* Aberrant vessels with thickened, hypertrophic walls in the mucosa and the submucosa.
+* <small>Bright red, flat lesions</small>
-* Arteries directly connected to veins without capillary beds
+* <small>Rarely, polypoid</small>
+| style="background: #F5F5F5; padding: 5px;" |<small>N/A</small>
+| style="background: #F5F5F5; padding: 5px;" |<small>N/A</small>
 | style="background: #F5F5F5; padding: 5px;" |
-* Accidental fining
+* <small>Aberrant [[vessels]] with thickened, [[hypertrophic]] walls in the [[mucosa]] and the [[submucosa]].</small>
+* <small>[[Arteries]] directly connected to [[veins]] without [[Capillary bed|capillary beds]]</small>
+| style="background: #F5F5F5; padding: 5px;" |<small>Accidental fining</small>
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Infectious colitis]]<ref name="pmid22080825">{{cite journal |vauthors=DuPont HL |title=Approach to the patient with infectious colitis |journal=Curr. Opin. Gastroenterol. |volume=28 |issue=1 |pages=39–46 |date=January 2012 |pmid=22080825 |doi=10.1097/MOG.0b013e32834d3208 |url=}}</ref>
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Infectious colitis|Infectious <small>colitis</small>]]<small><ref name="pmid22080825">{{cite journal |vauthors=DuPont HL |title=Approach to the patient with infectious colitis |journal=Curr. Opin. Gastroenterol. |volume=28 |issue=1 |pages=39–46 |date=January 2012 |pmid=22080825 |doi=10.1097/MOG.0b013e32834d3208 |url=}}</ref></small>
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |[[Diarrhea|↑]]
-* [[Diarrhea]]
+| style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" |
-* Diffuse abdominal
+* <small>[[Fever]], [[Rigor|chills]]</small>
-| style="background: #F5F5F5; padding: 5px;" |
+* [[Nausea and vomiting|<small>N/V</small>]]
-* [[Fever]], [[Rigor|chills]]
+* [[Bloating|<small>Bloating</small>]]
-* [[Nausea and vomiting|N/V]]
-* [[Bloating]]
 | style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" |<small>N/A</small>
 | style="background: #F5F5F5; padding: 5px;" |
-* N/A
+* <small>Patchy or diffuse [[Erythematous|erythematous mucosa]]</small>
+* <small>Edema, [[hemorrhage]], with or without [[ulcers]] of mucosa</small>
+| style="background: #F5F5F5; padding: 5px;" |<small>N/A</small>
 | style="background: #F5F5F5; padding: 5px;" |
-* Patchy or diffuse [[Erythematous|erythematous mucosa]]
+* <small>[[Stool culture|Stool cultures]] in adequate [[culture media]]</small>
-* Edema, [[hemorrhage]], with or without [[ulcers]] of mucosa
+* <small>[[Stool test|Stool analysis]]: [[Leukocytosis]]</small>
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |<small>N/A</small>
-* N/A
+| style="background: #F5F5F5; padding: 5px;" |<small>Stool culture</small>
-| style="background: #F5F5F5; padding: 5px;" |
-* [[Stool culture|Stool cultures]] in adequate [[culture media]]
-* Stool analysis: [[Leukocytosis]]
-| style="background: #F5F5F5; padding: 5px;" |
-* N/A
-| style="background: #F5F5F5; padding: 5px;" |
-* Stool culture
 |-
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hamartoma]]<ref name="pmid26672891">{{cite journal |vauthors=Cauchin E, Touchefeu Y, Matysiak-Budnik T |title=Hamartomatous Tumors in the Gastrointestinal Tract |journal=Gastrointest Tumors |volume=2 |issue=2 |pages=65–74 |date=September 2015 |pmid=26672891 |pmc=4668787 |doi=10.1159/000437175 |url=}}</ref>
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |<small>[[Hamartoma]]<ref name="pmid26672891">{{cite journal |vauthors=Cauchin E, Touchefeu Y, Matysiak-Budnik T |title=Hamartomatous Tumors in the Gastrointestinal Tract |journal=Gastrointest Tumors |volume=2 |issue=2 |pages=65–74 |date=September 2015 |pmid=26672891 |pmc=4668787 |doi=10.1159/000437175 |url=}}</ref></small>
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |[[Diarrhea|↑]]
-* [[Diarrhea]]
+| style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" |
-* Depending on location
+* [[Tenesmus|<small>Tenesmus</small>]]
-| style="background: #F5F5F5; padding: 5px;" |
-* [[Tenesmus]]
 | style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" |<small>S100 ([[mucosal]] [[Schwann cell|Schwann]] cell [[hamartoma]] (MSCH)</small>
+| style="background: #F5F5F5; padding: 5px;" |<small>Large [[Polyp|polypoid]] [[mass]]</small>
 | style="background: #F5F5F5; padding: 5px;" |
-* S100 (mucosal Schwann cell hamartoma (MSCH))
+* <small>Isodense or hypodense solid [[Mass|masses]]</small>
+* <small>[[Heterogeneous]] mass</small>
+* <small>Presence of [[fat]] in a well circumscribed nodule</small>
+* [[Calcification|<small>Calcification</small>]]
 | style="background: #F5F5F5; padding: 5px;" |
-* Large polypoid mass
+* <small>[[Biopsy]]: Proliferation of bland [[spindle cells]] in the [[lamina]] [[Lamina propria|propria]] ([[mucosa]]<nowiki/>l [[schwann cell]] [[hamartoma]] (MSCH))</small>
 | style="background: #F5F5F5; padding: 5px;" |
-* Isodense or hypodense solid [[Mass|masses]]
+* <small>poorly circumscribed, short fascicles of uniform [[spindle cells]] replacing the [[Colon|colonic]] [[lamina propria]], separating and entrapping the crypts</small>
-* [[Heterogeneous]] mass
+* <small>The [[nuclei]] are bland and mostly uniform, occasional larger [[nuclei]] are found. The [[cytoplasmic]] borders are indistinct</small>
-* Presence of [[fat]] in a well circumscribed nodule
+* <small>Involvement of [[mucosa]] but never the [[submucosa]]</small>
-* [[Calcification]]
+| style="background: #F5F5F5; padding: 5px;" |<small>Biopsy</small>
-| style="background: #F5F5F5; padding: 5px;" |
-* Biopsy: Proliferation of bland spindle cells in the lamina propria (mucosal Schwann cell hamartoma (MSCH))
-| style="background: #F5F5F5; padding: 5px;" |
-* poorly circumscribed, short fascicles of uniform spindle cells replacing the colonic lamina propria, separating and entrapping the crypts
-* The nuclei are bland and mostly uniform, occasional larger nuclei are found. The cytoplasmic borders are indistinct
-* Involvement of mucosa but never the submucosa
-| style="background: #F5F5F5; padding: 5px;" |
-* Biopsy
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Ulcerative colitis]]<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref>
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Ulcerative colitis|Ulcerative <small>colitis</small>]]<small><ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref><ref name="pmid16902215">{{cite journal |vauthors=Collins P, Rhodes J |title=Ulcerative colitis: diagnosis and management |journal=BMJ |volume=333 |issue=7563 |pages=340–3 |date=August 2006 |pmid=16902215 |pmc=1539087 |doi=10.1136/bmj.333.7563.340 |url=}}</ref></small>
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |[[Diarrhea|↑]]
-* [[Diarrhea]]
 | style="background: #F5F5F5; padding: 5px;" |<big>+</big>
-| style="background: #F5F5F5; padding: 5px;" |
-* Lain in LQ<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref>
-| style="background: #F5F5F5; padding: 5px;" |
-* [[Diarrhea]] mixed with blood and [[mucus]]
-* W[[Weight loss|eight loss]]
-* Urgency
-* [[Tenesmus]]
 | style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" |
-* N/A
+* <small>[[Diarrhea]] mixed with blood and [[mucus]]</small>
-| style="background: #F5F5F5; padding: 5px;" |
+* <small>W[[Weight loss|eight loss]]</small>
-* Continuous lesions<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref>
+* <small>Urgency</small>
-* [[Erythema]] (or redness of the [[mucosa]]) and friability of the [[mucosa]]
+* [[Tenesmus|<small>Tenesmus</small>]]
-* Crypts, formation of residual mucosal tissue
+| style="background: #F5F5F5; padding: 5px;" | [[Anemia|↓]]
-* [[Polyp (medicine)|Pseudopolyps]]
+| style="background: #F5F5F5; padding: 5px;" |<small>N/A</small>
-| style="background: #F5F5F5; padding: 5px;" |
-* N/A
 | style="background: #F5F5F5; padding: 5px;" |
-* N/A
+* <small>Continuous [[Lesion|lesions]]</small>
+* <small>[[Erythema]] (or redness of the [[mucosa]]) and friability of the [[mucosa]]</small>
+* <small>Crypts, formation of residual [[Mucosal|mucosa]]<nowiki/>l tissue</small>
+* [[Polyp (medicine)|<small>Pseudopolyps</small>]]
+| style="background: #F5F5F5; padding: 5px;" |<small>N/A</small>
+| style="background: #F5F5F5; padding: 5px;" |<small>N/A</small>
 | style="background: #F5F5F5; padding: 5px;" |
-* Mucosal and submucosal inflammation<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref>
+* <small>[[Mucosal]] and submucosal inflammation</small>
-* Hemorrhage or inflammatory polymorphonuclear cells aggregate in the lamina propria
+* <small>Hemorrhage or [[inflammatory]] polymorphonuclear cells aggregate in the lamina propria</small>
-* Distorted crypts
+* <small>Distorted crypts</small>
-* Crypt abscess
+* <small>Crypt abscess</small>
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |<small>Endoscopy and a mucosal biopsy</small>
-* Endoscopy and a mucosal biopsy<ref name="pmid16902215">{{cite journal |vauthors=Collins P, Rhodes J |title=Ulcerative colitis: diagnosis and management |journal=BMJ |volume=333 |issue=7563 |pages=340–3 |date=August 2006 |pmid=16902215 |pmc=1539087 |doi=10.1136/bmj.333.7563.340 |url=}}</ref>
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Crohn's disease]]<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref>
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |<small>[[Crohn's disease]]<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref></small>
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |[[Diarrhea|↑]]
-* [[Diarrhea]]
+| style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" |
-* Lain in RQ
+* [[Tenesmus|<small>Tenesmus</small>]]
-| style="background: #F5F5F5; padding: 5px;" |
+* [[Nausea and vomiting|<small>N/V</small>]]
-* [[Tenesmus]]
+* [[Bowel obstruction|<small>Bowel obstruction</small>]]
-* [[Nausea and vomiting|N/V]]
+* [[Fever|<small>Fever</small>]]
-* [[Bowel obstruction]]
-* [[Fever]]
 *
-| style="background: #F5F5F5; padding: 5px;" | +
+| style="background: #F5F5F5; padding: 5px;" | [[Anemia|↓]]
+| style="background: #F5F5F5; padding: 5px;" |<small>N/A</small>
 | style="background: #F5F5F5; padding: 5px;" |
-* N/A
+* <small>Discontinuous [[lesions]]</small>
+* <small>[[Strictures]]</small>
+* <small>Linear [[ulcerations]]</small>
+| style="background: #F5F5F5; padding: 5px;" |<small>N/A</small>
+| style="background: #F5F5F5; padding: 5px;" |<small>N/A</small>
 | style="background: #F5F5F5; padding: 5px;" |
-* Discontinuous lesions
+* <small>Transmural pattern of [[inflammation]]</small>
-* Strictures
+* <small>[[Mucosal]] damage</small>
-* Linear ulcerations
+* <small>Focal infiltration of [[leukocytes]] into the epithelium</small>
-| style="background: #F5F5F5; padding: 5px;" |
+* <small>[[Granulomas]]</small>
-* N/A
+| style="background: #F5F5F5; padding: 5px;" |<small>Endoscopy and a mucosal biopsy</small>
-| style="background: #F5F5F5; padding: 5px;" |
-* N/A
-| style="background: #F5F5F5; padding: 5px;" |
-* Transmural pattern of inflammation
-* Mucosal damage
-* Focal infiltration of leukocytes into the epithelium
-* Granulomas
-| style="background: #F5F5F5; padding: 5px;" |
-* Endoscopy and a mucosal biopsy
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Irritable bowel syndrome]]<ref name="pmid28875974">{{cite journal |vauthors=Iwańczak B, Iwańczak F |title=[Functional gastrointestinal disorders in children and adolescents. The Rome IV criteria] |language=Polish |journal=Pol. Merkur. Lekarski |volume=43 |issue=254 |pages=75–82 |date=August 2017 |pmid=28875974 |doi= |url=}}</ref>
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |<small>[[Irritable bowel syndrome]]<ref name="pmid28875974">{{cite journal |vauthors=Iwańczak B, Iwańczak F |title=[Functional gastrointestinal disorders in children and adolescents. The Rome IV criteria] |language=Polish |journal=Pol. Merkur. Lekarski |volume=43 |issue=254 |pages=75–82 |date=August 2017 |pmid=28875974 |doi= |url=}}</ref></small>
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |↑↓
-* [[Constipation]]
+| style="background: #F5F5F5; padding: 5px;" | +
-and/or
-* [[diarrhea]]
 | style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" |
-* Diffuse abdominal pain
+* <small>Straining during [[defecation]]</small>
-| style="background: #F5F5F5; padding: 5px;" |
+* [[Urgency|<small>Urgency</small>]]
-* Straining during [[defecation]]
+* <small>Sensation of incomplete evacuation</small>
-* [[Urgency]]
+* <small>[[Mucus]] passage</small>
-* Sensation of incomplete evacuation
+* [[Bloating|<small>Bloating</small>]]
-* [[Mucus]] passage
+* <small>Weight loss</small>
-* [[Bloating]]
-* Weight loss
 | style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |<small>N/A</small>
-* N/A
+| style="background: #F5F5F5; padding: 5px;" |<small>Not recommended</small>
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |<small>N/A</small>
-* Not recommended
+| style="background: #F5F5F5; padding: 5px;" |<small>[[Diagnosis]] of exclusion with fulfillment of [[Irritable bowel syndrome diagnostic criteria|Rome criteria]]</small>
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |<small>N/A</small>
-* N/A
+| style="background: #F5F5F5; padding: 5px;" |<small>Clinical diagnosis  ([[Irritable bowel syndrome Diagnostic Study of Choice|Rome criteria]])</small>
-| style="background: #F5F5F5; padding: 5px;" |
-* Diagnosis of exclusion with fulfilment of [[Irritable bowel syndrome diagnostic criteria|Rome criteria]]
-| style="background: #F5F5F5; padding: 5px;" |
-* N/A
-| style="background: #F5F5F5; padding: 5px;" |
-* Clinical diagnosis  ([[Irritable bowel syndrome Diagnostic Study of Choice|Rome criteria]])
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Endometriosis|Bowel endometriosis]]<ref name="pmid25400445">{{cite journal |vauthors=Wolthuis AM, Meuleman C, Tomassetti C, D'Hooghe T, de Buck van Overstraeten A, D'Hoore A |title=Bowel endometriosis: colorectal surgeon's perspective in a multidisciplinary surgical team |journal=World J. Gastroenterol. |volume=20 |issue=42 |pages=15616–23 |date=November 2014 |pmid=25400445 |pmc=4229526 |doi=10.3748/wjg.v20.i42.15616 |url=}}</ref>
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |<small>[[Endometriosis|Bowel endometriosis]]<ref name="pmid25400445">{{cite journal |vauthors=Wolthuis AM, Meuleman C, Tomassetti C, D'Hooghe T, de Buck van Overstraeten A, D'Hoore A |title=Bowel endometriosis: colorectal surgeon's perspective in a multidisciplinary surgical team |journal=World J. Gastroenterol. |volume=20 |issue=42 |pages=15616–23 |date=November 2014 |pmid=25400445 |pmc=4229526 |doi=10.3748/wjg.v20.i42.15616 |url=}}</ref></small>
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |[[Constipation|↓]][[Diarrhea|↑]]
-* [[Constipation]]
-and/or
-* [[Diarrhea]]
 | style="background: #F5F5F5; padding: 5px;" | +
-| style="background: #F5F5F5; padding: 5px;" |
-* Pelvic pain
-| style="background: #F5F5F5; padding: 5px;" |
-* Dyschezia
-* Tenesmus
 | style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" |
-* N/A
+* <small>Dyschezia</small>
+* <small>Tenesmus</small>
+| style="background: #F5F5F5; padding: 5px;" | [[Anemia|↓]]
+| style="background: #F5F5F5; padding: 5px;" |<small>N/A</small>
+| style="background: #F5F5F5; padding: 5px;" |<small>N/A</small>
+| style="background: #F5F5F5; padding: 5px;" |<small>N/A</small>
 | style="background: #F5F5F5; padding: 5px;" |
-* N/A
+* <small>[[Transvaginal ultrasonography]]: [[heterogeneous]], hypoechoic, spiculated [[mass]]</small>
-| style="background: #F5F5F5; padding: 5px;" |
+* <small>[[Barium enema]]: Extrinsic [[mass]] compressing the [[bowel]], fine crenulation of the [[mucosa]], bowel strictures at the rectosigmoid junction</small>
-* N/A
+* <small>T1-weighted or fat-suppression T1-weighted [[MRI]]</small><nowiki/><small>s: Contrast enhanced [[mass]] or hyperintense foci, hemorrhagic foci or hyperintense [[cavities]]</small>
-| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |<small>N/A</small>
-* Transvaginal ultrasonography: heterogeneous, hypoechoic, spiculated mass
+| style="background: #F5F5F5; padding: 5px;" |<small>Transvaginal ultrasonography</small>
-* Barium enema: Extrinsic mass compressing the bowel, fine crenulation of the mucosa, bowel strictures at the rectosigmoid junction
-* T1-weighted or fat-suppression T1-weighted MRIs: Contrast enhanced mass or hyperintense foci, hemorrhagic foci or hyperintense cavities
-| style="background: #F5F5F5; padding: 5px;" |
-* N/A
-| style="background: #F5F5F5; padding: 5px;" |
-* Transvaginal ultrasonography
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Intestinal [[tuberculosis]]<ref name="pmid879148">{{cite journal |vauthors=Bhansali SK |title=Abdominal tuberculosis. Experiences with 300 cases |journal=Am. J. Gastroenterol. |volume=67 |issue=4 |pages=324–37 |date=April 1977 |pmid=879148 |doi= |url=}}</ref>
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |<small>Intestinal [[tuberculosis]]<ref name="pmid879148">{{cite journal |vauthors=Bhansali SK |title=Abdominal tuberculosis. Experiences with 300 cases |journal=Am. J. Gastroenterol. |volume=67 |issue=4 |pages=324–37 |date=April 1977 |pmid=879148 |doi= |url=}}</ref></small>
-|[[Chronic diarrhea|Chronic]] [[diarrhea]]
+<small><ref name="pmid1009343">{{cite journal |vauthors=Das P, Shukla HS |title=Clinical diagnosis of abdominal tuberculosis |journal=Br J Surg |volume=63 |issue=12 |pages=941–6 |date=December 1976 |pmid=1009343 |doi= |url=}}</ref><ref name="pmid16469667">{{cite journal |vauthors=Petrosyan M, Mason RJ |title=Tuberculous enteritis presenting as small-bowel obstruction |journal=Clin. Gastroenterol. Hepatol. |volume=4 |issue=2 |pages=xxiii |date=February 2006 |pmid=16469667 |doi= |url=}}</ref><ref name="pmid2106212">{{cite journal |vauthors=Balthazar EJ, Gordon R, Hulnick D |title=Ileocecal tuberculosis: CT and radiologic evaluation |journal=AJR Am J Roentgenol |volume=154 |issue=3 |pages=499–503 |date=March 1990 |pmid=2106212 |doi=10.2214/ajr.154.3.2106212 |url=}}</ref><ref name="pmid27730779">{{cite journal |vauthors=Rathi P, Gambhire P |title=Abdominal Tuberculosis |journal=J Assoc Physicians India |volume=64 |issue=2 |pages=38–47 |date=February 2016 |pmid=27730779 |doi= |url=}}</ref><ref name="pmid15824946">{{cite journal |vauthors=Alvares JF, Devarbhavi H, Makhija P, Rao S, Kottoor R |title=Clinical, colonoscopic, and histological profile of colonic tuberculosis in a tertiary hospital |journal=Endoscopy |volume=37 |issue=4 |pages=351–6 |date=April 2005 |pmid=15824946 |doi=10.1055/s-2005-861116 |url=}}</ref></small>
+|[[Chronic diarrhea|Chronic]] [[diarrhea|↑]]
 |<nowiki>+/-</nowiki>
 |<nowiki>+</nowiki>
 |
-* Fever<ref name="pmid1009343">{{cite journal |vauthors=Das P, Shukla HS |title=Clinical diagnosis of abdominal tuberculosis |journal=Br J Surg |volume=63 |issue=12 |pages=941–6 |date=December 1976 |pmid=1009343 |doi= |url=}}</ref>
+* <small>Fever</small>
-* Fatigue,
+* <small>Fatigue,</small>
-* Weight loss
+* <small>Weight loss</small>
-* Anorexia
+* <small>Anorexia</small>
-* Night sweats
+* <small>Night sweats</small>
-* Bowel obstruction<ref name="pmid16469667">{{cite journal |vauthors=Petrosyan M, Mason RJ |title=Tuberculous enteritis presenting as small-bowel obstruction |journal=Clin. Gastroenterol. Hepatol. |volume=4 |issue=2 |pages=xxiii |date=February 2006 |pmid=16469667 |doi= |url=}}</ref>
+* <small>Bowel obstruction</small>
-* Abdominal distension
+* <small>Abdominal distension</small>
-* Lymph node enlargement
+* <small>Lymph node enlargement</small>
-|<nowiki>+</nowiki>
+|[[Anemia|↓]]
-|
+|<small>N/A</small>
-* N/A
 |
-* To get sample for histolopathology and culture
+* <small>To get sample for [[Histology|histolopathology]] and culture</small>
-* Forms on endoscopy:
+* <small>Forms on endoscopy:</small>
-** Hypertrophic
+** <small>Hypertrophic</small>
-** Ulcerative
+** <small>Ulcerative</small>
-* [[Endoscopy|Endoscopic]] findings:
+* <small>[[Endoscopy|Endoscopic]] findings:</small>
-** [[Ulcers]] in [[mucosa]]
+** <small>[[Ulcers]] in [[mucosa]]</small>
-** [[Nodules|Nodules in mucosa]]
+** [[Nodules|<small>Nodules in mucosa</small>]]
-** [[Strictures]] in [[intestinal wall]]
+** <small>[[Strictures]] in [[intestinal wall]]</small>
-** [[Pseudopolyps]] formation
+** <small>[[Pseudopolyps]] formation</small>
-** [[Adhesions]]<ref name="pmid15824946">{{cite journal |vauthors=Alvares JF, Devarbhavi H, Makhija P, Rao S, Kottoor R |title=Clinical, colonoscopic, and histological profile of colonic tuberculosis in a tertiary hospital |journal=Endoscopy |volume=37 |issue=4 |pages=351–6 |date=April 2005 |pmid=15824946 |doi=10.1055/s-2005-861116 |url=}}</ref>
+** [[Adhesions|<small>Adhesions</small>]]
-** [[Fistulas]]
+** [[Fistulas|<small>Fistulas</small>]]
-** Deformed [[ileocecal valve]]
+** <small>Deformed [[ileocecal valve]]</small>
-|
-* Concentric thickening at the site of lesion with proximal intestinal dilatation<ref name="pmid2106212">{{cite journal |vauthors=Balthazar EJ, Gordon R, Hulnick D |title=Ileocecal tuberculosis: CT and radiologic evaluation |journal=AJR Am J Roentgenol |volume=154 |issue=3 |pages=499–503 |date=March 1990 |pmid=2106212 |doi=10.2214/ajr.154.3.2106212 |url=}}</ref>
-* asymmetric thickening of the intestinal wall
-* Lymphadenopathy
-* Thickening of the peritoneum
-* Ascites
 |
-*[[Small bowel follow-through]] or [[barium enema]]:
+* <small>[[Concentric hypertrophy|Concentric thickening]] at the site of [[lesion]] with [[proximal]] [[intestinal]] dilatation</small>
-** [[Mucosal]] [[ulcerations]]
+* <small>asymmetric thickening of the [[intestinal wall]]</small>
-**Strictures in the [[intestinal wall]]
+* <small>[[Lymphadenopathy]]</small>
-**[[Cecum|Cecal]] deformations
+* <small>Thickening of the [[peritoneum]]</small>
-**Incompetency of [[ileocecal valve]]
+* <small>[[Ascites]]</small>
-*[[Ultrasound]]:<ref name="pmid27730779">{{cite journal |vauthors=Rathi P, Gambhire P |title=Abdominal Tuberculosis |journal=J Assoc Physicians India |volume=64 |issue=2 |pages=38–47 |date=February 2016 |pmid=27730779 |doi= |url=}}</ref>
-** [[Bowel]] thickening
-** [[Peritoneal]] nodules
-** [[Peritoneal|Peritoneal thickening]]
-**[[Lymphadenopathy]]
-*[[Ascites Paracentesis|Ascitic fluid]] analysis:
-** Straw-colored ascites
-**[[Lymphocytes]] in ascitic fluid
-**Cell count is 150 to 4000 cells/mcL with [[Leukocyte|leukocyte count]] of 150 to 4000 cells/mm3
-**[[AFB|AFB smear]]
-**ADA level
-**Protein >3.0 g/dL
-**Mycobacterial culture
-**[[NAAT]] for ''M. tuberculosis''
-**[[SAAG]] <1.1 g/dL
-*Ascitic fluid [[NAAT]]
-*Ascitic fluid [[Polymerase chain reaction|polymerase chain reaction (PCR)]]
 |
-* [[Submucosal]] [[Granuloma|caseation granulomas]]
+*<small>[[Small bowel follow-through]] or [[barium enema]]:</small>
+** <small>[[Mucosal]] [[ulcerations]]</small>
+**<small>Strictures in the [[intestinal wall]]</small>
+**<small>[[Cecum|Cecal]] deformations</small>
+**<small>Incompetency of [[ileocecal valve]]</small>
+*<small>[[Ultrasound]]:</small>
+** <small>[[Bowel]] thickening</small>
+** <small>[[Peritoneal]] nodules</small>
+** [[Peritoneal|<small>Peritoneal thickening</small>]]
+**[[Lymphadenopathy|<small>Lymphadenopathy</small>]]
+*<small>[[Ascites Paracentesis|Ascitic fluid]] analysis:</small>
+** <small>Straw-colored ascites</small>
+**<small>[[Lymphocytes]] in ascitic fluid</small>
+**<small>Cell count is 150 to 4000 cells/mcL with [[Leukocyte|leukocyte count]] of 150 to 4000 cells/mm3</small>
+**[[AFB|<small>AFB smear</small>]]
+**<small>ADA level</small>
+**<small>Protein >3.0 g/dL</small>
+**[[Mycobacterium|<small>Mycobacterial culture</small>]]
+**<small>[[NAAT]] for ''M. tuberculosis''</small>
+**<small>[[SAAG]] <1.1 g/dL</small>
+*<small>Ascitic fluid [[NAAT]]</small>
+*<small>Ascitic fluid [[Polymerase chain reaction|polymerase chain reaction (PCR)]]</small>
 |
-* [[Endoscopy|Endoscopic]] [[biopsy]] and [[Histopathology|histopathology analysis]]
+<small>[[Submucosal]] [[Granuloma|caseation granulomas]]</small>
+|<small>[[Endoscopy|Endoscopic]] [[biopsy]] and [[Histopathology|histopathology analysis]]</small>
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Peptic ulcer disease]]
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |<small>[[Peptic ulcer disease]]<ref name="pmid17956071">{{cite journal |vauthors=Ramakrishnan K, Salinas RC |title=Peptic ulcer disease |journal=Am Fam Physician |volume=76 |issue=7 |pages=1005–12 |date=October 2007 |pmid=17956071 |doi= |url=}}</ref><ref name="pmid15229422">{{cite journal |vauthors=Lu CL, Chang SS, Wang SS, Chang FY, Lee SD |title=Silent peptic ulcer disease: frequency, factors leading to "silence," and implications regarding the pathogenesis of visceral symptoms |journal=Gastrointest. Endosc. |volume=60 |issue=1 |pages=34–8 |date=July 2004 |pmid=15229422 |doi= |url=}}</ref></small>
-|<nowiki>+/-</nowiki>
+<small><ref name="pmid28138363">{{cite journal |vauthors=Chung KT, Shelat VG |title=Perforated peptic ulcer - an update |journal=World J Gastrointest Surg |volume=9 |issue=1 |pages=1–12 |date=January 2017 |pmid=28138363 |pmc=5237817 |doi=10.4240/wjgs.v9.i1.1 |url=}}</ref><ref name="pmid6378443">{{cite journal |vauthors=Cotton PB, Shorvon PJ |title=Analysis of endoscopy and radiography in the diagnosis, follow-up and treatment of peptic ulcer disease |journal=Clin Gastroenterol |volume=13 |issue=2 |pages=383–403 |date=May 1984 |pmid=6378443 |doi= |url=}}</ref><ref name="pmid28677101">{{cite journal |vauthors=Tonolini M, Ierardi AM, Bracchi E, Magistrelli P, Vella A, Carrafiello G |title=Non-perforated peptic ulcer disease: multidetector CT findings, complications, and differential diagnosis |journal=Insights Imaging |volume=8 |issue=5 |pages=455–469 |date=October 2017 |pmid=28677101 |pmc=5621988 |doi=10.1007/s13244-017-0562-5 |url=}}</ref><ref name="pmid63784432">{{cite journal |vauthors=Cotton PB, Shorvon PJ |title=Analysis of endoscopy and radiography in the diagnosis, follow-up and treatment of peptic ulcer disease |journal=Clin Gastroenterol |volume=13 |issue=2 |pages=383–403 |date=May 1984 |pmid=6378443 |doi= |url=}}</ref></small>
+|↑↓
 |<nowiki>+ </nowiki>[[Melena]]
 |<nowiki>+</nowiki>
 |
-* [[Heartburn]]<ref name="pmid17956071">{{cite journal |vauthors=Ramakrishnan K, Salinas RC |title=Peptic ulcer disease |journal=Am Fam Physician |volume=76 |issue=7 |pages=1005–12 |date=October 2007 |pmid=17956071 |doi= |url=}}</ref>
+* [[Heartburn|<small>Heartburn</small>]]
-* Asymptomatic <ref name="pmid15229422">{{cite journal |vauthors=Lu CL, Chang SS, Wang SS, Chang FY, Lee SD |title=Silent peptic ulcer disease: frequency, factors leading to "silence," and implications regarding the pathogenesis of visceral symptoms |journal=Gastrointest. Endosc. |volume=60 |issue=1 |pages=34–8 |date=July 2004 |pmid=15229422 |doi= |url=}}</ref>
+* <small>Asymptomatic</small>
-* [[Chest discomfort]]
+* [[Chest discomfort|<small>Chest discomfort</small>]]
-* Early [[satiety]]
+* <small>Early [[satiety]]</small>
-* [[Nausea and vomiting]]
+* [[Nausea and vomiting|<small>Nausea and vomiting</small>]]
-* [[Anorexia]]
+* [[Anorexia|<small>Anorexia</small>]]
-* [[Bloating]]
+* [[Bloating|<small>Bloating</small>]]
-* [[Perforation]]<ref name="pmid28138363">{{cite journal |vauthors=Chung KT, Shelat VG |title=Perforated peptic ulcer - an update |journal=World J Gastrointest Surg |volume=9 |issue=1 |pages=1–12 |date=January 2017 |pmid=28138363 |pmc=5237817 |doi=10.4240/wjgs.v9.i1.1 |url=}}</ref>
+* [[Perforation|<small>Perforation</small>]]
-|<nowiki>+</nowiki>
+|[[Anemia|↓]]
+|<small>N/A</small>
 |
-* N/A
+* <small>Smooth [[ulcers]] in [[mucosa]] of [[intestine]]</small>
+* <small>[[Ulcers]] with round edges</small>
+* <small>Flat [[ulcer]] base filled with [[exudate]]</small>
 |
-* Smooth [[ulcers]] in [[mucosa]] of [[intestine]]<ref name="pmid6378443">{{cite journal |vauthors=Cotton PB, Shorvon PJ |title=Analysis of endoscopy and radiography in the diagnosis, follow-up and treatment of peptic ulcer disease |journal=Clin Gastroenterol |volume=13 |issue=2 |pages=383–403 |date=May 1984 |pmid=6378443 |doi= |url=}}</ref>
+* <small>Shows [[ulcers]] ([[Perforated ulcer|perforated]] or non-perforated) when done for the investigation of [[abdominal]] pain</small>
-* [[Ulcers]] with round edges
-* Flat [[ulcer]] base filled with exudate
 |
-* Shows [[ulcers]] ([[Perforated ulcer|perforated]] or non-perforated) when done for the investigation of [[abdominal]] pain<ref name="pmid28677101">{{cite journal |vauthors=Tonolini M, Ierardi AM, Bracchi E, Magistrelli P, Vella A, Carrafiello G |title=Non-perforated peptic ulcer disease: multidetector CT findings, complications, and differential diagnosis |journal=Insights Imaging |volume=8 |issue=5 |pages=455–469 |date=October 2017 |pmid=28677101 |pmc=5621988 |doi=10.1007/s13244-017-0562-5 |url=}}</ref>
+* <small>.[[Barium swallow]] (infrequent)</small>
+* <small>''[[Helicobacter pylori|H. Pylori]]'' testing</small>
+* [[Hydrogen Breath Test|<small>Hydrogen breath test</small>]]
+|<small>[[Endoscopic]] [[biopsy]] sample may show positive [[Helicobacter pylori|''H. Pylori'']] by [[H&E stain]]</small>
+|<small>Endoscopic visualization of ulcer</small>
+|-
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |<small>[[Pancreatic cancer]]<ref name="pmid11342768">{{cite journal |vauthors=Hruban RH, Adsay NV, Albores-Saavedra J, Compton C, Garrett ES, Goodman SN, Kern SE, Klimstra DS, Klöppel G, Longnecker DS, Lüttges J, Offerhaus GJ |title=Pancreatic intraepithelial neoplasia: a new nomenclature and classification system for pancreatic duct lesions |journal=Am. J. Surg. Pathol. |volume=25 |issue=5 |pages=579–86 |date=May 2001 |pmid=11342768 |doi= |url=}}</ref><ref name="pmid15252303">{{cite journal |vauthors=Hruban RH, Takaori K, Klimstra DS, Adsay NV, Albores-Saavedra J, Biankin AV, Biankin SA, Compton C, Fukushima N, Furukawa T, Goggins M, Kato Y, Klöppel G, Longnecker DS, Lüttges J, Maitra A, Offerhaus GJ, Shimizu M, Yonezawa S |title=An illustrated consensus on the classification of pancreatic intraepithelial neoplasia and intraductal papillary mucinous neoplasms |journal=Am. J. Surg. Pathol. |volume=28 |issue=8 |pages=977–87 |date=August 2004 |pmid=15252303 |doi= |url=}}</ref><ref name="pmid10540649">{{cite journal |vauthors=Karlson BM, Ekbom A, Lindgren PG, Källskog V, Rastad J |title=Abdominal US for diagnosis of pancreatic tumor: prospective cohort analysis |journal=Radiology |volume=213 |issue=1 |pages=107–11 |date=October 1999 |pmid=10540649 |doi=10.1148/radiology.213.1.r99oc25107 |url=}}</ref></small>
+<small><ref name="pmid11222206">{{cite journal |vauthors=Nino-Murcia M, Jeffrey RB, Beaulieu CF, Li KC, Rubin GD |title=Multidetector CT of the pancreas and bile duct system: value of curved planar reformations |journal=AJR Am J Roentgenol |volume=176 |issue=3 |pages=689–93 |date=March 2001 |pmid=11222206 |doi=10.2214/ajr.176.3.1760689 |url=}}</ref><ref name="pmid9925389">{{cite journal |vauthors=Fulcher AS, Turner MA |title=MR pancreatography: a useful tool for evaluating pancreatic disorders |journal=Radiographics |volume=19 |issue=1 |pages=5–24; discussion 41–4; quiz 148–9 |date=1999 |pmid=9925389 |doi=10.1148/radiographics.19.1.g99ja045 |url=}}</ref><ref name="pmid1557348">{{cite journal |vauthors=Niederau C, Grendell JH |title=Diagnosis of pancreatic carcinoma. Imaging techniques and tumor markers |journal=Pancreas |volume=7 |issue=1 |pages=66–86 |date=1992 |pmid=1557348 |doi= |url=}}</ref><ref name="pmid2930108">{{cite journal |vauthors=Pleskow DK, Berger HJ, Gyves J, Allen E, McLean A, Podolsky DK |title=Evaluation of a serologic marker, CA19-9, in the diagnosis of pancreatic cancer |journal=Ann. Intern. Med. |volume=110 |issue=9 |pages=704–9 |date=May 1989 |pmid=2930108 |doi= |url=}}</ref><ref name="pmid159609302">{{cite journal |vauthors=Porta M, Fabregat X, Malats N, Guarner L, Carrato A, de Miguel A, Ruiz L, Jariod M, Costafreda S, Coll S, Alguacil J, Corominas JM, Solà R, Salas A, Real FX |title=Exocrine pancreatic cancer: symptoms at presentation and their relation to tumour site and stage |journal=Clin Transl Oncol |volume=7 |issue=5 |pages=189–97 |date=June 2005 |pmid=15960930 |doi= |url=}}</ref></small>
+<small><ref name="pmid4005804">{{cite journal |vauthors=Kalser MH, Barkin J, MacIntyre JM |title=Pancreatic cancer. Assessment of prognosis by clinical presentation |journal=Cancer |volume=56 |issue=2 |pages=397–402 |date=July 1985 |pmid=4005804 |doi= |url=}}</ref><ref name="pmid1589710">{{cite journal |vauthors=Bakkevold KE, Arnesjø B, Kambestad B |title=Carcinoma of the pancreas and papilla of Vater: presenting symptoms, signs, and diagnosis related to stage and tumour site. A prospective multicentre trial in 472 patients. Norwegian Pancreatic Cancer Trial |journal=Scand. J. Gastroenterol. |volume=27 |issue=4 |pages=317–25 |date=April 1992 |pmid=1589710 |doi= |url=}}</ref><ref name="pmid1589710" /><ref name="pmid15960930">{{cite journal |vauthors=Porta M, Fabregat X, Malats N, Guarner L, Carrato A, de Miguel A, Ruiz L, Jariod M, Costafreda S, Coll S, Alguacil J, Corominas JM, Solà R, Salas A, Real FX |title=Exocrine pancreatic cancer: symptoms at presentation and their relation to tumour site and stage |journal=Clin Transl Oncol |volume=7 |issue=5 |pages=189–97 |date=June 2005 |pmid=15960930 |doi= |url=}}</ref></small>
+|[[Chronic]] [[diarrhea|↑]]
+|<nowiki>+</nowiki>
+|<nowiki>+</nowiki>
 |
-* .[[Barium swallow]] (infrequent)
+* <small>[[Asthenia]] and [[depression]]</small>
-* ''[[Helicobacter pylori|H. Pylori]]'' testing
-* [[Hydrogen Breath Test|Hydrogen breath test]]
+* [[Jaundice|<small>Jaundice</small>]]
+* [[Anorexia|<small>Anorexia</small>]]
+* [[Weight loss|<small>Weight loss</small>]]
+* [[Nausea and vomiting|<small>Nausea and vomiting</small>]]
+* [[Steatorrhea|<small>Steatorrhea</small>]]
+* [[Dark urine|<small>Dark urine</small>]]
+* [[Back pain|<small>Back pain</small>]]
+* [[Thrombophlebitis|<small>Thrombophlebitis</small>]]
+|[[Anemia|↓]]
+|<small>Cancer-associated antigen 19-9 ([[CA 19-9]])</small>
 |
-* Endoscopic biopsy sample may show positive [[Helicobacter pylori|H. Pylori]] by [[H&E stain]]
+* <small>[[Endoscopic retrograde cholangiopancreatography]] (ERCP) is used:</small>
+** <small>To collect tissue sample</small>
+** <small>For imaging of [[biliary tree]] and [[Pancreatic duct|pancreatic ducts]]</small>
+** <small>[[Obstruction]] and [[strictures]] of [[common bile duct]] and [[pancreatic duct]] is suggestive of [[cancer]] ("double duct" [[Sign (medicine)|sign]])</small>
 |
-* Endoscopic visualization of ulcer<ref name="pmid63784432">{{cite journal |vauthors=Cotton PB, Shorvon PJ |title=Analysis of endoscopy and radiography in the diagnosis, follow-up and treatment of peptic ulcer disease |journal=Clin Gastroenterol |volume=13 |issue=2 |pages=383–403 |date=May 1984 |pmid=6378443 |doi= |url=}}</ref>
+* <small>[[Mass]] within the [[Pancreas|pancreatic]] [[parenchyma]] or [[Pancreatic duct|duct]]</small>
-|-
+* <small>[[Atrophy]] of the [[parenchyma]]</small>
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pancreatic cancer]]
+*
 |
-* [[Chronic]] [[diarrhea]]
+* [[Ultrasound|<small>Transabdominal US</small>]]
-|<nowiki>+</nowiki>
+** <small>[[Bile duct|Billiary]] dilatation</small>
+** <small>[[Mass]] in [[pancreas]]</small>
+** <small>Hypoechoic hypovascular mass with irregular borders</small>
+* <small>[[Magnetic resonance cholangiopancreatography]](MRCP) :</small>
+** <small>Better than [[CT]] to visualize [[Pancreas|pancreatic]] and [[Bile duct|billiary]] [[anatomy]] and [[hepatic]] [[lesions]]</small>
+* <small>[[Biopsy]]:</small>
+** <small>[[Percutaneous]] [[FNA|FNA biopsy]]</small>
+** <small>[[Duodenal|Transduodenal]] [[Endoscopy|Endo]] [[Ultrasound|US]]-guided [[FNA|FNA biopsy]]</small>
 |
-* Chronic groaning pain
+* <small>[[Pancreatic tumor]] can show two type of [[histology]] depending on the location:</small>
-|
-* [[Asthenia]] and [[depression]]<ref name="pmid15960930">{{cite journal |vauthors=Porta M, Fabregat X, Malats N, Guarner L, Carrato A, de Miguel A, Ruiz L, Jariod M, Costafreda S, Coll S, Alguacil J, Corominas JM, Solà R, Salas A, Real FX |title=Exocrine pancreatic cancer: symptoms at presentation and their relation to tumour site and stage |journal=Clin Transl Oncol |volume=7 |issue=5 |pages=189–97 |date=June 2005 |pmid=15960930 |doi= |url=}}</ref><ref name="pmid1589710">{{cite journal |vauthors=Bakkevold KE, Arnesjø B, Kambestad B |title=Carcinoma of the pancreas and papilla of Vater: presenting symptoms, signs, and diagnosis related to stage and tumour site. A prospective multicentre trial in 472 patients. Norwegian Pancreatic Cancer Trial |journal=Scand. J. Gastroenterol. |volume=27 |issue=4 |pages=317–25 |date=April 1992 |pmid=1589710 |doi= |url=}}</ref><ref name="pmid4005804">{{cite journal |vauthors=Kalser MH, Barkin J, MacIntyre JM |title=Pancreatic cancer. Assessment of prognosis by clinical presentation |journal=Cancer |volume=56 |issue=2 |pages=397–402 |date=July 1985 |pmid=4005804 |doi= |url=}}</ref><ref name="pmid159609302">{{cite journal |vauthors=Porta M, Fabregat X, Malats N, Guarner L, Carrato A, de Miguel A, Ruiz L, Jariod M, Costafreda S, Coll S, Alguacil J, Corominas JM, Solà R, Salas A, Real FX |title=Exocrine pancreatic cancer: symptoms at presentation and their relation to tumour site and stage |journal=Clin Transl Oncol |volume=7 |issue=5 |pages=189–97 |date=June 2005 |pmid=15960930 |doi= |url=}}</ref>
+* <small>Intraductal [[papillary]] [[mucinous]] [[neoplasms]]</small>
+** <small>[[Papilla|Papillary]] lesions</small>
+** <small>Disseminated or segmental dilation of the [[pancreatic duct]]</small>
+* <small>[[Pancreatic adenocarcinoma|Pancreatic ductal adenocarcinoma]]</small>
+** <small>Duct-like structures</small>
+** <small>Mucin production</small>
+** <small>Cell atypia</small>
+** <small>Dense [[stromal]] fibrosis</small>
+|<small>[[Biopsy]] and [[histological]] analysis</small>
+|-
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Gastric cancer|<small>Gastric cancer</small>]]
+<small><ref name="pmid26742998">{{cite journal| author=Siegel RL, Miller KD, Jemal A| title=Cancer statistics, 2016. | journal=CA Cancer J Clin | year= 2016 | volume= 66 | issue= 1 | pages= 7-30 | pmid=26742998 | doi=10.3322/caac.21332 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26742998  }}</ref><ref name="pmid23667204">{{cite journal| author=Ajani JA, Bentrem DJ, Besh S, D'Amico TA, Das P, Denlinger C et al.| title=Gastric cancer, version 2.2013: featured updates to the NCCN Guidelines. | journal=J Natl Compr Canc Netw | year= 2013 | volume= 11 | issue= 5 | pages= 531-46 | pmid=23667204 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23667204  }}</ref><ref name="pmid280023202">{{cite journal| author=Luo T, Chen W, Wang L, Zhao H| title=CA125 is a potential biomarker to predict surgically incurable gastric and cardia cancer: A retrospective study. | journal=Medicine (Baltimore) | year= 2016 | volume= 95 | issue= 51 | pages= e5297 | pmid=28002320 | doi=10.1097/MD.0000000000005297 | pmc=5181804 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28002320  }}</ref><ref name="pmid18821070">{{cite journal| author=Ucar E, Semerci E, Ustun H, Yetim T, Huzmeli C, Gullu M| title=Prognostic value of preoperative CEA, CA 19-9, CA 72-4, and AFP levels in gastric cancer. | journal=Adv Ther | year= 2008 | volume= 25 | issue= 10 | pages= 1075-84 | pmid=18821070 | doi=10.1007/s12325-008-0100-4 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18821070  }}</ref><ref name="pmid12435906">{{cite journal| author=Kono K, Amemiya H, Sekikawa T, Iizuka H, Takahashi A, Fujii H et al.| title=Clinicopathologic features of gastric cancers producing alpha-fetoprotein. | journal=Dig Surg | year= 2002 | volume= 19 | issue= 5 | pages= 359-65; discussion 365 | pmid=12435906 | doi=10.1159/000065838 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12435906  }}</ref></small>
+<small><ref name="pmid7054024">{{cite journal |vauthors=Graham DY, Schwartz JT, Cain GD, Gyorkey F |title=Prospective evaluation of biopsy number in the diagnosis of esophageal and gastric carcinoma |journal=Gastroenterology |volume=82 |issue=2 |pages=228–31 |date=February 1982 |pmid=7054024 |doi= |url=}}</ref><ref name="pmid3357941">{{cite journal| author=Sussman SK, Halvorsen RA, Illescas FF, Cohan RH, Saeed M, Silverman PM et al.| title=Gastric adenocarcinoma: CT versus surgical staging. | journal=Radiology | year= 1988 | volume= 167 | issue= 2 | pages= 335-40 | pmid=3357941 | doi=10.1148/radiology.167.2.3357941 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3357941  }}</ref><ref name="pmid19789243">{{cite journal| author=Kim SJ, Kim HH, Kim YH, Hwang SH, Lee HS, Park DJ et al.| title=Peritoneal metastasis: detection with 16- or 64-detector row CT in patients undergoing surgery for gastric cancer. | journal=Radiology | year= 2009 | volume= 253 | issue= 2 | pages= 407-15 | pmid=19789243 | doi=10.1148/radiol.2532082272 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19789243  }}</ref><ref>http://radiopaedia.org/articles/gastric-carcinoma</ref><ref name="pmid11477231">{{cite journal |vauthors=Keogan MT, Edelman RR |title=Technologic advances in abdominal MR imaging |journal=Radiology |volume=220 |issue=2 |pages=310–20 |date=August 2001 |pmid=11477231 |doi=10.1148/radiology.220.2.r01au22310 |url=}}</ref></small>
-* [[Jaundice]]
+<small><ref name="pmid16204706">{{cite journal| author=Yun M, Lim JS, Noh SH, Hyung WJ, Cheong JH, Bong JK et al.| title=Lymph node staging of gastric cancer using (18)F-FDG PET: a comparison study with CT. | journal=J Nucl Med | year= 2005 | volume= 46 | issue= 10 | pages= 1582-8 | pmid=16204706 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16204706  }}</ref><ref name="pmid23722535">{{cite journal |vauthors=Hallinan JT, Venkatesh SK |title=Gastric carcinoma: imaging diagnosis, staging and assessment of treatment response |journal=Cancer Imaging |volume=13 |issue= |pages=212–27 |date=May 2013 |pmid=23722535 |pmc=3667568 |doi=10.1102/1470-7330.2013.0023 |url=}}</ref><ref name="pmid7577468">{{cite journal |vauthors=Yashiro M, Chung YS, Nishimura S, Inoue T, Sowa M |title=Establishment of two new scirrhous gastric cancer cell lines: analysis of factors associated with disseminated metastasis |journal=Br. J. Cancer |volume=72 |issue=5 |pages=1200–10 |date=November 1995 |pmid=7577468 |pmc=2033934 |doi= |url=}}</ref><ref name="pmid22949151">{{cite journal |vauthors=Kunz PL, Gubens M, Fisher GA, Ford JM, Lichtensztajn DY, Clarke CA |title=Long-term survivors of gastric cancer: a California population-based study |journal=J. Clin. Oncol. |volume=30 |issue=28 |pages=3507–15 |date=October 2012 |pmid=22949151 |doi=10.1200/JCO.2011.35.8028 |url=}}</ref></small>
-* [[Anorexia]]
+|[[constipation|↓]]/-
-* [[Weight loss]]
+|<nowiki>+ </nowiki>[[Melena]]
-* [[Nausea and vomiting]]
-* [[Steatorrhea]]
-* [[Dark urine]]
-* [[Back pain]]
-* [[Thrombophlebitis]]
 |<nowiki>+</nowiki>
 |
-* Cancer-associated antigen 19-9 ([[CA 19-9]])<ref name="pmid2930108">{{cite journal |vauthors=Pleskow DK, Berger HJ, Gyves J, Allen E, McLean A, Podolsky DK |title=Evaluation of a serologic marker, CA19-9, in the diagnosis of pancreatic cancer |journal=Ann. Intern. Med. |volume=110 |issue=9 |pages=704–9 |date=May 1989 |pmid=2930108 |doi= |url=}}</ref>
+* [[Weight loss|<small>Weight loss</small>]]
+* [[Early satiety|<small>Early satiety</small>]]
+* [[Dysphagia|<small>Dysphagia</small>]]
+* [[Anorexia|<small>Anorexia</small>]]
+* <small>[[Weakness]] and [[Fatigue (physical)|fatigue]]</small>
+|[[Anemia|↓]]
 |
-* [[Endoscopic retrograde cholangiopancreatography]] (ERCP) is used:<ref name="pmid1557348">{{cite journal |vauthors=Niederau C, Grendell JH |title=Diagnosis of pancreatic carcinoma. Imaging techniques and tumor markers |journal=Pancreas |volume=7 |issue=1 |pages=66–86 |date=1992 |pmid=1557348 |doi= |url=}}</ref>
+* <small>[[Carcinoembryonic antigen]] ([[CEA]])</small>
-** To collect tissue sample
+* [[CA-125|<small>Glycoprotein CA 125</small>]]
-** For imaging of [[biliary tree]] and [[Pancreatic duct|pancreatic ducts]]
+* <small>[[CA19-9|Carbohydrate antigen 19-9]] ([[CA 19-9]])</small>
-** [[Obstruction]] and [[strictures]] of [[common bile duct]] and [[pancreatic duct]] is suggestive of cancer ("double duct" sign)
+* <small>[[Alpha-fetoprotein]] ([[Alpha-fetoprotein|AFP]])</small>
+*
 |
-* Mass within the [[Pancreas|pancreatic]] [[parenchyma]] or [[Pancreatic duct|duct]]<ref name="pmid9925389">{{cite journal |vauthors=Fulcher AS, Turner MA |title=MR pancreatography: a useful tool for evaluating pancreatic disorders |journal=Radiographics |volume=19 |issue=1 |pages=5–24; discussion 41–4; quiz 148–9 |date=1999 |pmid=9925389 |doi=10.1148/radiographics.19.1.g99ja045 |url=}}</ref>
+* <small>On [[endoscopy]] [[gastric cancer]] may appear as:</small>
-* [[Atrophy]] of the [[parenchyma]]<ref name="pmid11222206">{{cite journal |vauthors=Nino-Murcia M, Jeffrey RB, Beaulieu CF, Li KC, Rubin GD |title=Multidetector CT of the pancreas and bile duct system: value of curved planar reformations |journal=AJR Am J Roentgenol |volume=176 |issue=3 |pages=689–93 |date=March 2001 |pmid=11222206 |doi=10.2214/ajr.176.3.1760689 |url=}}</ref>
+** <small>[[Polyp|Polypoid]] [[mass]]</small>
-*
+** <small>[[Ulcerated lesion|Ulcerating]] [[lesion]]</small>
+** <small>Infiltrating [[lesion]]</small>
+** <small>Diffuse thickening</small>
+**
+|
+* <small>[[Computed tomography|CT]] is used to stage the disease extent</small>
+* <small>[[Computed tomography|CT]] can also visulaize</small>
+* <small>primary [[lesion]]:</small>
+** <small>[[Polypoidy|Polypoid]] [[mass]]</small>
+** <small>[[Ulceration|Ulcerating]] [[lesion]]</small>
+** <small>Diffuse thickening (''tunica plastica'')</small>
+** <small>Infiltrating [[mass]]</small>
 |
-* [[Ultrasound|Transabdominal US]]<ref name="pmid10540649">{{cite journal |vauthors=Karlson BM, Ekbom A, Lindgren PG, Källskog V, Rastad J |title=Abdominal US for diagnosis of pancreatic tumor: prospective cohort analysis |journal=Radiology |volume=213 |issue=1 |pages=107–11 |date=October 1999 |pmid=10540649 |doi=10.1148/radiology.213.1.r99oc25107 |url=}}</ref>
+* <small>[[Positron emission tomography|PET scan]]:</small>
-** [[Bile duct|Billiary]] dilatation
+** <small>Useful to confirm [[malignant]] involvement of [[Computed tomography|CT]]-detected [[lymphadenopathy]].</small>
-** Mass in [[pancreas]]
+** <small>Directly visualizes the [[liver]] surface, the [[peritoneum]], and local [[Lymph node|lymph nodes]] for [[metastasis]]</small>
-** Hypoechoic hypovascular mass with irregular borders
+* <small>[[MRI]]:</small>
-* [[Magnetic resonance cholangiopancreatography]](MRCP) :
+** <small>Better T [[Cancer staging|staging]] of [[stomach cancer]] (better soft tissue visualization and of individual layers of [[stomach]] wall)</small>
-** Better than CT to visualize [[Pancreas|pancreatic]] and [[Bile duct|billiary]] anatomy and [[hepatic]] lesions
+* [[Ultrasonography|<small>Ultrasonography</small>]]
-* [[Biopsy]]:
-** [[Percutaneous]] [[FNA|FNA biopsy]]
-** Transduodenal Endo US-guided [[FNA|FNA biopsy]]
 |
-* [[Pancreatic tumor]] can show two type of [[histology]] depending on the location:<ref name="pmid11342768">{{cite journal |vauthors=Hruban RH, Adsay NV, Albores-Saavedra J, Compton C, Garrett ES, Goodman SN, Kern SE, Klimstra DS, Klöppel G, Longnecker DS, Lüttges J, Offerhaus GJ |title=Pancreatic intraepithelial neoplasia: a new nomenclature and classification system for pancreatic duct lesions |journal=Am. J. Surg. Pathol. |volume=25 |issue=5 |pages=579–86 |date=May 2001 |pmid=11342768 |doi= |url=}}</ref><ref name="pmid15252303">{{cite journal |vauthors=Hruban RH, Takaori K, Klimstra DS, Adsay NV, Albores-Saavedra J, Biankin AV, Biankin SA, Compton C, Fukushima N, Furukawa T, Goggins M, Kato Y, Klöppel G, Longnecker DS, Lüttges J, Maitra A, Offerhaus GJ, Shimizu M, Yonezawa S |title=An illustrated consensus on the classification of pancreatic intraepithelial neoplasia and intraductal papillary mucinous neoplasms |journal=Am. J. Surg. Pathol. |volume=28 |issue=8 |pages=977–87 |date=August 2004 |pmid=15252303 |doi= |url=}}</ref>
+* <small>[[Histologically]], there are two major types of [[gastric cancer]]:</small>
+** <small>Intestinal type [[adenocarcinoma]]</small>
+*** <small>Irregular tubular structures</small>
+*** <small>Multiple lumens</small>
+*** <small>Reduced [[stroma]]</small>
+*** <small>[[Intestinal|ntestinal]] [[metaplasia]]</small>
+*** <small>[[cellular]] [[pleomorphism]]</small>
+***
+** <small>Diffuse type [[adenocarcinoma]]</small>
+*** <small>Discohesive</small>
+*** <small>Secrete [[mucus]]</small>
+*** <small>Pools of [[Mucus|mucus/]][[colloid]]</small>
+*** <small>[[Signet ring cell]] appearance</small>
+|<small>[[Biopsy]] and [[Histopathology|histopathological analysis]]</small>
+|}
+===Differentiating small intestine cancer from other causes of abdominal pain and diarrhea===
-* Intraductal [[papillary]] mucinous [[neoplasms]]
+Small intestine cancer must be differentiated from other causes of abdominal pain and diarrhea.
-** [[Papilla|Papillary]] lesions
-** Disseminated or segmental dilation of the [[pancreatic duct]]
+{|
-* Pancreatic ductal adenocarcinoma
+|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
-** Duct-like structures
+! colspan="2" rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
-** Mucin production
+| colspan="9" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Clinical manifestations'''
-** Cell atypia
+|
-** Dense [[stromal]] fibrosis
+|
-|[[Biopsy]] and [[histological]] analysis
+|
+! colspan="10" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Para-clinical findings
+| colspan="1" rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Gold standard'''
+! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Additional findings
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Gastric cancer]]
+| colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Symptoms'''
 |
-* Normal or [[constipation]]
-|<nowiki>+ </nowiki>[[Melena]]
 |
-* [[Abdominal pain]] or [[Abdominal discomfort|discomfort]]
 |
-* [[Weight loss]]<ref name="pmid26742998">{{cite journal| author=Siegel RL, Miller KD, Jemal A| title=Cancer statistics, 2016. | journal=CA Cancer J Clin | year= 2016 | volume= 66 | issue= 1 | pages= 7-30 | pmid=26742998 | doi=10.3322/caac.21332 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26742998  }}</ref><ref name="pmid23667204">{{cite journal| author=Ajani JA, Bentrem DJ, Besh S, D'Amico TA, Das P, Denlinger C et al.| title=Gastric cancer, version 2.2013: featured updates to the NCCN Guidelines. | journal=J Natl Compr Canc Netw | year= 2013 | volume= 11 | issue= 5 | pages= 531-46 | pmid=23667204 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23667204  }}</ref>
+! colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical examination
-* [[Early satiety]]
+!
-* [[Dysphagia]]
+!
-* [[Anorexia]]
+!
-* [[Weakness]] and [[Fatigue (physical)|fatigue]]
+|-
+!
+!
+!
+!
+!
+!
+! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
+! colspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
+!
+!
+! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
+|-
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |[[Abdominal pain]]
+! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |[[Diarrhea]]
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |[[Flushing]]
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |[[Dyspnea]]
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |[[Palpitations]]
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other symptoms
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |[[Wheezing]]
+! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |[[Telangiectasia]]
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |[[Hypotension]]
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |[[Tachycardia]]
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |[[Systolic murmurs|Systolic murmur]] of [[tricuspid regurgitation]]
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other physical findings
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Urinary 5-hydroxyindoleacetic acid (5-HIAA)
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Serum [[Chromogranin]] A (CgA)
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other markers
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |[[Computed tomography|Abdominal computed tomography]] (CT)
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |[[Mri|Abdominal MRI]]
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Somatostatin receptor scintigraphy [SRS], or Octreoscan
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Metaiodobenzylguanidine (MIBG) scintigraphy
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other diagnostic studies
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Transthoracic echocardiography
+|-
+| rowspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |Carcinoid Syndrome<ref name="pmid30133565">{{cite journal |vauthors=Rubin de Celis Ferrari AC, Glasberg J, Riechelmann RP |title=Carcinoid syndrome: update on the pathophysiology and treatment |journal=Clinics (Sao Paulo) |volume=73 |issue=suppl 1 |pages=e490s |date=August 2018 |pmid=30133565 |pmc=6096975 |doi=10.6061/clinics/2018/e490s |url=}}</ref><ref name="pmid14693013">{{cite journal |vauthors=Hegyi J, Schwartz RA, Hegyi V |title=Pellagra: dermatitis, dementia, and diarrhea |journal=Int. J. Dermatol. |volume=43 |issue=1 |pages=1–5 |date=January 2004 |pmid=14693013 |doi= |url=}}</ref><ref name="pmid15100502">{{cite journal |vauthors=Savelli G, Lucignani G, Seregni E, Marchianò A, Serafini G, Aliberti G, Villano C, Maccauro M, Bombardieri E |title=Feasibility of somatostatin receptor scintigraphy in the detection of occult primary gastro-entero-pancreatic (GEP) neuroendocrine tumours |journal=Nucl Med Commun |volume=25 |issue=5 |pages=445–9 |date=May 2004 |pmid=15100502 |doi= |url=}}</ref><ref name="pmid151005022">{{cite journal |vauthors=Savelli G, Lucignani G, Seregni E, Marchianò A, Serafini G, Aliberti G, Villano C, Maccauro M, Bombardieri E |title=Feasibility of somatostatin receptor scintigraphy in the detection of occult primary gastro-entero-pancreatic (GEP) neuroendocrine tumours |journal=Nucl Med Commun |volume=25 |issue=5 |pages=445–9 |date=May 2004 |pmid=15100502 |doi= |url=}}</ref><ref name="BoraVithiavathi2012">{{cite journal|last1=Bora|first1=ManashKumar|last2=Vithiavathi|first2=S|title=Primary bronchial carcinoid: A rare differential diagnosis of pulmonary koch in young adult patient|journal=Lung India|volume=29|issue=1|year=2012|pages=59|issn=0970-2113|doi=10.4103/0970-2113.92366}}</ref><ref name="pmid25207053">{{cite journal |vauthors=Yazıcıoğlu A, Yekeler E, Bıcakcıoğlu P, Ozaydın E, Karaoğlanoğlu N |title=Synchronous bilateral multiple typical pulmonary carcinoid tumors: a unique case with 10 typical carcinoids |journal=Balkan Med J |volume=29 |issue=4 |pages=450–2 |date=December 2012 |pmid=25207053 |pmc=4115868 |doi=10.5152/balkanmedj.2012.081 |url=}}</ref><ref name="pmid14616879">{{cite journal |vauthors=Krausz Y, Keidar Z, Kogan I, Even-Sapir E, Bar-Shalom R, Engel A, Rubinstein R, Sachs J, Bocher M, Agranovicz S, Chisin R, Israel O |title=SPECT/CT hybrid imaging with 111In-pentetreotide in assessment of neuroendocrine tumours |journal=Clin. Endocrinol. (Oxf) |volume=59 |issue=5 |pages=565–73 |date=November 2003 |pmid=14616879 |doi= |url=}}</ref><ref name="van der LelyHerder2005">{{cite journal|last1=van der Lely|first1=Aart J.|last2=Herder|first2=Wouter W. de|title=Carcinoid syndrome: diagnosis and medical management|journal=Arquivos Brasileiros de Endocrinologia & Metabologia|volume=49|issue=5|year=2005|pages=850–860|issn=0004-2730|doi=10.1590/S0004-27302005000500028}}</ref><ref name="pmid28238592">{{cite journal |vauthors=Halperin DM, Shen C, Dasari A, Xu Y, Chu Y, Zhou S, Shih YT, Yao JC |title=Frequency of carcinoid syndrome at neuroendocrine tumour diagnosis: a population-based study |journal=Lancet Oncol. |volume=18 |issue=4 |pages=525–534 |date=April 2017 |pmid=28238592 |pmc=6066284 |doi=10.1016/S1470-2045(17)30110-9 |url=}}</ref>
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Neuroendocrine tumor]] of [[midgut]] <ref name="pmid3227292">{{cite journal |vauthors=Sjöblom SM |title=Clinical presentation and prognosis of gastrointestinal carcinoid tumours |journal=Scand. J. Gastroenterol. |volume=23 |issue=7 |pages=779–87 |date=September 1988 |pmid=3227292 |doi= |url=}}</ref><ref name="pmid24059366">{{cite journal |vauthors=Ganeshan D, Bhosale P, Yang T, Kundra V |title=Imaging features of carcinoid tumors of the gastrointestinal tract |journal=AJR Am J Roentgenol |volume=201 |issue=4 |pages=773–86 |date=October 2013 |pmid=24059366 |doi=10.2214/AJR.12.9758 |url=}}</ref><ref name="symptoms">Signs and symptoms of carcinoid syndrome. National Cancer Institute. http://www.cancer.gov/types/gi-carcinoid-tumors/patient/gi-carcinoid-treatment-pdq</ref><ref name="pmid15887161">{{cite journal |vauthors=Modlin IM, Kidd M, Latich I, Zikusoka MN, Shapiro MD |title=Current status of gastrointestinal carcinoids |journal=Gastroenterology |volume=128 |issue=6 |pages=1717–51 |date=May 2005 |pmid=15887161 |doi= |url=}}</ref>
+| style="background: #F5F5F5; padding: 5px;" | +
+Mild
+| style="background: #F5F5F5; padding: 5px;" | +
+* Intermittent
+* Secretory [[diarrhea]]
+| style="background: #F5F5F5; padding: 5px;" | +
+| style="background: #F5F5F5; padding: 5px;" | +
+| style="background: #F5F5F5; padding: 5px;" | +
+| style="background: #F5F5F5; padding: 5px;" |
+* [[Pellagra]]
+[[Dermatitis]]
+[[Diarrhea]]
+[[Dementia]]
+[[Metastatic]] [[tumors]] in the [[Liver (2)|liver]]: [[Right upper quadrant]] pain, [[Hepatomegaly (new)|hepatomegaly]], and early [[satiety]]
+| 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;" |
+* [[NT-proBNP]]
+** [[Screening]] of [[Carcinoid disease|carcinoid heart disease]]
+** Blood [[Serotonin]] levels
+| style="background: #F5F5F5; padding: 5px;" |
+* [[Neuroendocrine tumor]] of [[midgut]] are difficult to identify on [[CT]] because of their small size.
+* Findings: [[Mass|mass-]]<nowiki/>like process with soft tissue "spokes" radiating into the [[mesenteric]] [[fat]] toward the [[small bowel]] causing retraction.
+* [[Liver]] [[metastases]]
+| style="background: #F5F5F5; padding: 5px;" |
+*[[Sensitivity|Sensitive]] for detection of [[Liver (2)|liver]] [[metastases]]
+| style="background: #F5F5F5; padding: 5px;" | +
+* Localization of [[carcinoid tumor]]
+| style="background: #F5F5F5; padding: 5px;" | +
+| style="background: #F5F5F5; padding: 5px;" |
+* 68-Ga DOTATATE [[PET scan]]
+* [[Positron emission tomography-computed tomography]] ([[PET-CT]]) using 18[[-fluoro-dihydroxyphenylalanine]]
+* Ki-67 labeling index
+* [[Endoscopy]] for [[metastatic]] [[Neuroendocrine tumour]] with an unknown primary site.
+|
+* Valve thickening with retraction and reduction in the mobility of the [[Tricuspid valves|tricuspid valve]]
+*
+| style="background: #F5F5F5; padding: 5px;" |
+* [[Enterochromaffin cells|Enterochromaffin]] [[cells]] stain with [[Potassium chromate|potassium chromate (chromaffin]]).
+*On [[electron microscopy]] ,the [[cells]] in [[tumors]] are found to contain [[membrane]]-bound [[Granules|secretory granules]] with dense-core [[granules]] in the [[cytoplasm]].
+| style="background: #F5F5F5; padding: 5px;" |
+* Somatostatin receptor scintigraphy [SRS], or [[Octreoscan]]
+* [[Biopsy]] and [[histopathology]]
+| style="background: #F5F5F5; padding: 5px;" |
+* [[Mesenteric]] [[fibrosis]]
+Pathognomonic radiological sign of [[midgut]] [[Neuroendocrine tumor|NET]].
+|-
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Neuroendocrine tumor]] of [[lung]]<ref name="pmid18473355">{{cite journal |vauthors=Gustafsson BI, Kidd M, Chan A, Malfertheiner MV, Modlin IM |title=Bronchopulmonary neuroendocrine tumors |journal=Cancer |volume=113 |issue=1 |pages=5–21 |date=July 2008 |pmid=18473355 |doi=10.1002/cncr.23542 |url=}}</ref><ref name="JeungGasser2002">{{cite journal|last1=Jeung|first1=Mi-Young|last2=Gasser|first2=Bernard|last3=Gangi|first3=Afshin|last4=Charneau|first4=Dominique|last5=Ducroq|first5=Xavier|last6=Kessler|first6=Romain|last7=Quoix|first7=Elisabeth|last8=Roy|first8=Catherine|title=Bronchial Carcinoid Tumors of the Thorax: Spectrum of Radiologic Findings|journal=RadioGraphics|volume=22|issue=2|year=2002|pages=351–365|issn=0271-5333|doi=10.1148/radiographics.22.2.g02mr01351}}</ref><ref name="pmid1649924">{{cite journal |vauthors=Nessi R, Basso Ricci P, Basso Ricci S, Bosco M, Blanc M, Uslenghi C |title=Bronchial carcinoid tumors: radiologic observations in 49 cases |journal=J Thorac Imaging |volume=6 |issue=2 |pages=47–53 |date=April 1991 |pmid=1649924 |doi= |url=}}</ref><ref name="pmid5831899">{{cite journal |vauthors=Melmon KL, Sjoerdsma A, Mason DT |title=Distinctive clinical and therapeutic aspects of the syndrome associated with bronchial carcinoid tumors |journal=Am. J. Med. |volume=39 |issue=4 |pages=568–81 |date=October 1965 |pmid=5831899 |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;" |
+* [[Cough]]
+* [[Hemoptysis]]
+* [[Chest pain]]
+* [[Fever]] due to [[Pneumonia|post -obstructuve pneuomnia]]
+*
+| 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;" |
+* [[Immunohistochemical  stains]]:
+* [[Synaptophysin]]
+* [[Neuron-specific enolase]]
+* [[NT-proBNP]]
+* Low [[serotonin]] content as compared to [[midgut]] [[Tumors|tumors.]]
+| style="background: #F5F5F5; padding: 5px;" |
+* Atypical [[neuroendocrine tumors]] have a greater tendency to [[metastasize]] to [[Liver|liver,]][[hypervascular]], and becomies isodense relative to th[[Liver|e liver]] [[parenchyma]] after [[contrast]] administration.
+| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |[[Sensitivity (tests)|Sensitive]] for detection o[[Liver (2)|f liver]] [[metastases]] if present
+| style="background: #F5F5F5; padding: 5px;" | +
+| style="background: #F5F5F5; padding: 5px;" | +
+| style="background: #F5F5F5; padding: 5px;" |
+* [[Chest X ray]]: round or oval [[Opacity|opacities]] from 2-5cm with sharp and notched margins
+* [[Chest]] [[CT]] : [[Hilar]] or Perihilar Masses, Endobronchial [[Nodules]],Related to [[Bronchial|bronchial Obstruction]]:peripheral [[atelectasis]] and postobstructive [[pneumonia]]
+* [[PFTs|Pulmonary funcation test]]
+* [[Bronchoscopy]]
+* [[68-Ga DOTATATE PET scan]]
+* Fluorodeoxyglucose [[PET scan|PET scans]] for atypical [[lung]] [[Neuroendocrine|NETs]] .
+| -
+| style="background: #F5F5F5; padding: 5px;" |Typical low-grade:bland cells containing regular round [[nuclei]] with finely dispersed [[chromatin]] and inconspicuous small [[nucleoli]].Mitotic figures are scarce and [[necrosis]] is absent.
+Intermediate-grade atypical: presence of [[Neuroendocrine]] morphology and either [[necrosis]] or 2 to 10 [[mitoses]] per 10 HPF
+|
+* [[Biopsy]] and [[histopathology]]
+|-
+| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Irritable Bowel Syndrome]]<ref name="pmid18371141">{{cite journal |vauthors=Ford AC, Forman D, Bailey AG, Axon AT, Moayyedi P |title=Irritable bowel syndrome: a 10-yr natural history of symptoms and factors that influence consultation behavior |journal=Am. J. Gastroenterol. |volume=103 |issue=5 |pages=1229–39; quiz 1240 |date=May 2008 |pmid=18371141 |doi=10.1111/j.1572-0241.2007.01740.x |url=}}</ref><ref name="pmid28374308">{{cite journal |vauthors=Simren M, Palsson OS, Whitehead WE |title=Update on Rome IV Criteria for Colorectal Disorders: Implications for Clinical Practice |journal=Curr Gastroenterol Rep |volume=19 |issue=4 |pages=15 |date=April 2017 |pmid=28374308 |pmc=5378729 |doi=10.1007/s11894-017-0554-0 |url=}}</ref><ref name="pmid12454865">{{cite journal |vauthors= |title=American Gastroenterological Association medical position statement: irritable bowel syndrome |journal=Gastroenterology |volume=123 |issue=6 |pages=2105–7 |date=December 2002 |pmid=12454865 |doi=10.1053/gast.2002.37095b |url=}}</ref><ref name="pmid27144627">{{cite journal |vauthors=Mearin F, Lacy BE, Chang L, Chey WD, Lembo AJ, Simren M, Spiller R |title=Bowel Disorders |journal=Gastroenterology |volume= |issue= |pages= |date=February 2016 |pmid=27144627 |doi=10.1053/j.gastro.2016.02.031 |url=}}</ref>
+| style="background: #F5F5F5; padding: 5px;" | +
+Perioidic
+| style="background: #F5F5F5; padding: 5px;" |
+* Intermittent
+* Chronic history of [[Diarrhea|diarhea]] alternating with [[constipation]]
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" |
+*
+* [[Fibromyalgia]]
+* [[Chronic fatigue syndrome]]
+* [[Gastroesophageal reflux disease]],
+* [[Functional dyspepsia]]
+* [[Non-cardiac chest pain]],
+* [[Major depression]]
+* ,[[Anxiety Disorder|Anxiety]]
+| 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;" | -
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" | -
 |
+* [[Bristol stool]] form scale should to record [[stool]] consistency
+* [[Abdominal|Abdomina]]<nowiki/>l [[Radiographic|radiograph]] to assess for [[Stool|stoo]]<nowiki/>l accumulation and determine the severity.
+* Age-appropriate [[colorectal cancer]] [[screening]] in all [[patients]]
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" |[[Rome IV criteria]]
+* Recurrent [[abdominal pain]],  at least 1day/week in the last 3 months, a/s with 2 or more of the following criteria:
+•Related to [[defecation]]
+•Associated with a change in [[stool]] frequency
+•Associated with a change in [[stool]] form (appearance)
+| style="background: #F5F5F5; padding: 5px;" |
+|-
+| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Small intestine cancer|Malignant neoplasms of small intestine]]<ref name="pmid23789703">{{cite journal |vauthors=McLaughlin PD, Maher MM |title=Primary malignant diseases of the small intestine |journal=AJR Am J Roentgenol |volume=201 |issue=1 |pages=W9–14 |date=July 2013 |pmid=23789703 |doi=10.2214/AJR.12.8492 |url=}}</ref><ref name="pmid17372046">{{cite journal |vauthors=Hatzaras I, Palesty JA, Abir F, Sullivan P, Kozol RA, Dudrick SJ, Longo WE |title=Small-bowel tumors: epidemiologic and clinical characteristics of 1260 cases from the connecticut tumor registry |journal=Arch Surg |volume=142 |issue=3 |pages=229–35 |date=March 2007 |pmid=17372046 |doi=10.1001/archsurg.142.3.229 |url=}}</ref><ref name="pmid17026561">{{cite journal |vauthors=Lepage C, Bouvier AM, Manfredi S, Dancourt V, Faivre J |title=Incidence and management of primary malignant small bowel cancers: a well-defined French population study |journal=Am. J. Gastroenterol. |volume=101 |issue=12 |pages=2826–32 |date=December 2006 |pmid=17026561 |doi=10.1111/j.1572-0241.2006.00854.x |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;" |
+* [[Constipation]]
+* [[Fatigue]]
+* Early [[satiety]]
+| 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;" |* [[Abdominal mass]]
+* [[Ascites]]
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" | +
+| style="background: #F5F5F5; padding: 5px;" |[[Abdominal]] [[CT scan]] may be diagnostic of [[Small intestine cancer|small intestine cancer.]] Findings on [[CT scan]] suggestive of [[Small intestine cancer CT|small intestine cancer]] include intrinsic [[mass]] with a short segment of [[Bowel|bowel wall]] thickening
+| style="background: #F5F5F5; padding: 5px;" |[[MRI]] and [[MRI enteroscopy]] are other advance modalities to [[diagnose]] and [[Staging (pathology)|stage]] [[Small intestine cancer|small intestinal cancers]]
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" |[[Endoscopy|Enteroscopy]], [[capsule endoscopy]] and double balloon [[enteroscopy]]
 |
+| style="background: #F5F5F5; padding: 5px;" |
+*[[Adenocarcinoma|Adenocarcinomas]] may be polypoid, infiltrating, or as annular constricting lesions is [[small intestine]].
+*[[Polyps]] and [[adenomas]] of [[small intestine]] are considered precursor lesions of [[adenocarcinoma]].
+*[[Lymphoma|Lymphomas]] of [[small intestine]] present with suspicious growths in [[submucosa]] with normal appearing [[muscosa]].
+*[[Endoscopy|Endoscopic]] evaluation may show multifocal involvement and large [[biopsies]] are required for diagnoses
+|[[Biopsy]] and [[histopathology]]
 |
+|-
+| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Crohn disease]]<ref name="pmid18649092">{{cite journal |vauthors=Hara AK, Swartz PG |title=CT enterography of Crohn's disease |journal=Abdom Imaging |volume=34 |issue=3 |pages=289–95 |date=2009 |pmid=18649092 |doi=10.1007/s00261-008-9443-1 |url=}}</ref><ref name="BaumgartSandborn2012">{{cite journal|last1=Baumgart|first1=Daniel C|last2=Sandborn|first2=William J|title=Crohn's disease|journal=The Lancet|volume=380|issue=9853|year=2012|pages=1590–1605|issn=01406736|doi=10.1016/S0140-6736(12)60026-9}}</ref><ref name="FeuersteinCheifetz2017">{{cite journal|last1=Feuerstein|first1=Joseph D.|last2=Cheifetz|first2=Adam S.|title=Crohn Disease: Epidemiology, Diagnosis, and Management|journal=Mayo Clinic Proceedings|volume=92|issue=7|year=2017|pages=1088–1103|issn=00256196|doi=10.1016/j.mayocp.2017.04.010}}</ref><ref name="García-BoschOrdás2016">{{cite journal|last1=García-Bosch|first1=O.|last2=Ordás|first2=I.|last3=Aceituno|first3=M.|last4=Rodríguez|first4=S.|last5=Ramírez|first5=A. M.|last6=Gallego|first6=M.|last7=Ricart|first7=E.|last8=Rimola|first8=J.|last9=Panes|first9=J.|title=Comparison of Diagnostic Accuracy and Impact of Magnetic Resonance Imaging and Colonoscopy for the Management of Crohn’s Disease|journal=Journal of Crohn's and Colitis|volume=10|issue=6|year=2016|pages=663–669|issn=1873-9946|doi=10.1093/ecco-jcc/jjw015}}</ref>
+| style="background: #F5F5F5; padding: 5px;" |
+* [[Right lower quadrant abdominal pain resident survival guide|Right lower quadrant]] [[pain]]
+| 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;" |
+* Gross [[bloody diarrhea]] +/-
+* [[Weight loss]]
+* [[Fatigue (physical)|Fatigue]]
+| 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;" |
+*
+* [[Weight loss]]
+* [[Pallor]]
+* [[Oral lesions]]
+* [[Odynophagia]]
+* [[Dysphagia]]
+* Perianal skin tags
+* [[Sinus tracts]]
+* [[Gallstones]]
+* Extraintestinal manifestations
+* [[Arthritis]]
+* [[Uveitis]], [[Iritis]], and [[Episcleritis]]
+* [[Erythema nodosum]] and [[Pyoderma gangrenosum]]
+* [[Primary sclerosing cholangitis]]
+* Secondary [[amyloidosis]]
+* [[Thromboembolism]]
+* [[Renal stones]]
+* [[Osteoporosis]]
+* [[Vitamin B12 deficiency]]
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" |
+* [[CRP]]  may be high
+* [[p-ANCA]] and [[Anti saccharomyces cerevisiae antibodies|ASCA]]
+*
+| style="background: #F5F5F5; padding: 5px;" |
+* CT enterography [[:Small bowel]] [[inflammation]] by displaying mural hyperenhancement and thickening; engorged [[vasa recta]]; and [[perienteric]] [[inflammatory]] changes.
 |
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" | -
 |
+* [[CBC]]
+* [[Blood chemistry tests|Blood chemistry]] including [[Electrolyte|electrolytes]]
+* [[Kidney function|Renal function tests]]
+* [[liver enzymes]]
+* [[Blood glucose]]
+* [[ESR]]
+* [[CRP]]
+* [[Serum iron]]
+* [[Vitamin D]] & [[vitamin B12 levels]]
+* [[Stool D/R]] and [[Culture media|culture]] for [[ova]] and [[parasites]],
+* [[Clostridium difficile|''C. difficile'' toxin]]
+|<nowiki>-</nowiki>
+| style="background: #F5F5F5; padding: 5px;" |
+* Focal ulcerations and acute and chronic inflammation
+* [[Granulomas]]
+| style="background: #F5F5F5; padding: 5px;" |
+* [[Colonoscopic|Colonoscop]]<nowiki/>y:focal ulcerations adjacent to areas of normal appearing [[mucosa]] along with polypoid mucosa[[Skip lesion|l,skip lesion]]<nowiki/>s,[[pseudopolyps]],
+| style="background: #F5F5F5; padding: 5px;" |
+|-
+| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Benign cutaneous flushing]]<ref name="IziksonEnglish2006">{{cite journal|last1=Izikson|first1=Leonid|last2=English|first2=Joseph C.|last3=Zirwas|first3=Matthew J.|title=The flushing patient: Differential diagnosis, workup, and treatment|journal=Journal of the American Academy of Dermatology|volume=55|issue=2|year=2006|pages=193–208|issn=01909622|doi=10.1016/j.jaad.2005.07.057}}</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;" | -
+| 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;" | -
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" | -
 |
+|-
+| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Mastocytosis|Systemic mastocytosis]]<ref name="HartmannEscribano2016">{{cite journal|last1=Hartmann|first1=Karin|last2=Escribano|first2=Luis|last3=Grattan|first3=Clive|last4=Brockow|first4=Knut|last5=Carter|first5=Melody C.|last6=Alvarez-Twose|first6=Ivan|last7=Matito|first7=Almudena|last8=Broesby-Olsen|first8=Sigurd|last9=Siebenhaar|first9=Frank|last10=Lange|first10=Magdalena|last11=Niedoszytko|first11=Marek|last12=Castells|first12=Mariana|last13=Oude Elberink|first13=Joanna N.G.|last14=Bonadonna|first14=Patrizia|last15=Zanotti|first15=Roberta|last16=Hornick|first16=Jason L.|last17=Torrelo|first17=Antonio|last18=Grabbe|first18=Jürgen|last19=Rabenhorst|first19=Anja|last20=Nedoszytko|first20=Boguslaw|last21=Butterfield|first21=Joseph H.|last22=Gotlib|first22=Jason|last23=Reiter|first23=Andreas|last24=Radia|first24=Deepti|last25=Hermine|first25=Olivier|last26=Sotlar|first26=Karl|last27=George|first27=Tracy I.|last28=Kristensen|first28=Thomas K.|last29=Kluin-Nelemans|first29=Hanneke C.|last30=Yavuz|first30=Selim|last31=Hägglund|first31=Hans|last32=Sperr|first32=Wolfgang R.|last33=Schwartz|first33=Lawrence B.|last34=Triggiani|first34=Massimo|last35=Maurer|first35=Marcus|last36=Nilsson|first36=Gunnar|last37=Horny|first37=Hans-Peter|last38=Arock|first38=Michel|last39=Orfao|first39=Alberto|last40=Metcalfe|first40=Dean D.|last41=Akin|first41=Cem|last42=Valent|first42=Peter|title=Cutaneous manifestations in patients with mastocytosis: Consensus report of the European Competence Network on Mastocytosis; the American Academy of Allergy, Asthma & Immunology; and the European Academy of Allergology and Clinical Immunology|journal=Journal of Allergy and Clinical Immunology|volume=137|issue=1|year=2016|pages=35–45|issn=00916749|doi=10.1016/j.jaci.2015.08.034}}</ref><ref name="LeeWhittaker2008">{{cite journal|last1=Lee|first1=Jason K|last2=Whittaker|first2=Scott J|last3=Enns|first3=Robert A|last4=Zetler|first4=Peter|title=Gastrointestinal manifestations of systemic mastocytosis|journal=World Journal of Gastroenterology|volume=14|issue=45|year=2008|pages=7005|issn=1007-9327|doi=10.3748/wjg.14.7005}}</ref><ref name="pmid2002264">{{cite journal |vauthors=Horan RF, Austen KF |title=Systemic mastocytosis: retrospective review of a decade's clinical experience at the Brigham and Women's Hospital |journal=J. Invest. Dermatol. |volume=96 |issue=3 |pages=5S–13S; discussion 13S–14S |date=March 1991 |pmid=2002264 |doi= |url=}}</ref><ref name="SokolGeorgin-Lavialle2010">{{cite journal|last1=Sokol|first1=Harry|last2=Georgin-Lavialle|first2=Sophie|last3=Grandpeix-Guyodo|first3=Catherine|last4=Canioni|first4=Danielle|last5=Barete|first5=Stéphane|last6=Dubreuil|first6=Patrice|last7=Lortholary|first7=Olivier|last8=Beaugerie|first8=Laurent|last9=Hermine|first9=Olivier|title=Gastrointestinal involvement and manifestations in systemic mastocytosis|journal=Inflammatory Bowel Diseases|volume=16|issue=7|year=2010|pages=1247–1253|issn=1078-0998|doi=10.1002/ibd.21218}}</ref><ref name="pmid17063092">{{cite journal |vauthors=Bedeir A, Jukic DM, Wang L, Mullady DK, Regueiro M, Krasinskas AM |title=Systemic mastocytosis mimicking inflammatory bowel disease: A case report and discussion of gastrointestinal pathology in systemic mastocytosis |journal=Am. J. Surg. Pathol. |volume=30 |issue=11 |pages=1478–82 |date=November 2006 |pmid=17063092 |doi=10.1097/01.pas.0000213310.51553.d7 |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;" |
+* [[Maculopapular rash]]
+* [[Pruritus]]
+| 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;" |
+* Diffuse [[musculoskeletal pain]]
+* [[Neuropsychiatric symptoms]]
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" |
+* Activating [[mutations]] of ''[[KIT]]''
+* Serum [[Tryptase]] levels
+| 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;" |
+|-
+| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Asthma]] exacerbation<ref name="pmid22386508">{{cite journal |vauthors=Fuhlbrigge A, Peden D, Apter AJ, Boushey HA, Camargo CA, Gern J, Heymann PW, Martinez FD, Mauger D, Teague WG, Blaisdell C |title=Asthma outcomes: exacerbations |journal=J. Allergy Clin. Immunol. |volume=129 |issue=3 Suppl |pages=S34–48 |date=March 2012 |pmid=22386508 |pmc=3595577 |doi=10.1016/j.jaci.2011.12.983 |url=}}</ref><ref name="pmid16337448">{{cite journal |vauthors=Limb SL, Brown KC, Wood RA, Wise RA, Eggleston PA, Tonascia J, Adkinson NF |title=Irreversible lung function deficits in young adults with a history of childhood asthma |journal=J. Allergy Clin. Immunol. |volume=116 |issue=6 |pages=1213–9 |date=December 2005 |pmid=16337448 |doi=10.1016/j.jaci.2005.09.024 |url=}}</ref><ref name="pmid17468458">{{cite journal |vauthors=Aldington S, Beasley R |title=Asthma exacerbations. 5: assessment and management of severe asthma in adults in hospital |journal=Thorax |volume=62 |issue=5 |pages=447–58 |date=May 2007 |pmid=17468458 |pmc=2117186 |doi=10.1136/thx.2005.045203 |url=}}</ref><ref name="pmid19187331">{{cite journal |vauthors=Dougherty RH, Fahy JV |title=Acute exacerbations of asthma: epidemiology, biology and the exacerbation-prone phenotype |journal=Clin. Exp. Allergy |volume=39 |issue=2 |pages=193–202 |date=February 2009 |pmid=19187331 |pmc=2730743 |doi=10.1111/j.1365-2222.2008.03157.x |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;" | +
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" |
+* Tachypnea
+* Prolonged expiratory phase of respiration (decreased I:E ratio)
+* Seated position with use of extended arms to support the upper chest (tripod position)
+* +/- Pulsus paradoxus
+| 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;" | -
+|[[Chest X ray]]
+| -
+| style="background: #F5F5F5; padding: 5px;" |
+* Loss of the normal pseudostratified structure of airway epithelium
+* Increase in the proportion of goblet cells
+* Fibrotic thickening of the sub-epithelial reticular basement membrane
+* Increased numbers of myofibroblasts
+* Increased vascularity
+* Increased airway smooth muscle mass
+* Increased extracellular matrix
+| style="background: #F5F5F5; padding: 5px;" |
+| style="background: #F5F5F5; padding: 5px;" |
+|-
+| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Anaphylaxis]]<ref name="pmid18596587">{{cite journal |vauthors=Peavy RD, Metcalfe DD |title=Understanding the mechanisms of anaphylaxis |journal=Curr Opin Allergy Clin Immunol |volume=8 |issue=4 |pages=310–5 |date=August 2008 |pmid=18596587 |pmc=2683407 |doi=10.1097/ACI.0b013e3283036a90 |url=}}</ref><ref name="pmid20944042">{{cite journal |vauthors=Tupper J, Visser S |title=Anaphylaxis: A review and update |journal=Can Fam Physician |volume=56 |issue=10 |pages=1009–11 |date=October 2010 |pmid=20944042 |pmc=2954079 |doi= |url=}}</ref><ref name="pmid12209078">{{cite journal |vauthors=Kemp SF, Lockey RF |title=Anaphylaxis: a review of causes and mechanisms |journal=J. Allergy Clin. Immunol. |volume=110 |issue=3 |pages=341–8 |date=September 2002 |pmid=12209078 |doi= |url=}}</ref><ref name="pmid21293765">{{cite journal |vauthors=Bjornsson HM, Graffeo CS |title=Improving diagnostic accuracy of anaphylaxis in the acute care setting |journal=West J Emerg Med |volume=11 |issue=5 |pages=456–61 |date=December 2010 |pmid=21293765 |pmc=3027438 |doi= |url=}}</ref><ref name="urlUsefulness and Limitations of Sequential Serum Tryptase for the Diagnosis of Anaphylaxis in 102 Patients - FullText - International Archives of Allergy and Immunology 2013, Vol. 160, No. 2 - Karger Publishers">{{cite web |url=https://www.karger.com/Article/Fulltext/339749 |title=Usefulness and Limitations of Sequential Serum Tryptase for the Diagnosis of Anaphylaxis in 102 Patients - FullText - International Archives of Allergy and Immunology 2013, Vol. 160, No. 2 - Karger Publishers |format= |work= |accessdate=}}</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;" |
+* [[Vomiting]]
+* [[Hives|Generalized hives]],
+* [[Pruritus]]
+* [[Itching]]
+| 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;" |
+* Swollen [[lips]]-[[tongue]]-[[uvula]]
+* [[Periorbital edema]],
+* [[Conjunctival|Conjunctival swelling]]
+| 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;" |
+* plasma [[tryptase]]
+* Plasm[[Histamine|a histamine]] levels
+* Take proper clinical history and medication history specially [[beta blockers]],[[Angiotensin Converting Enzyme Inhibitor|ACE-inhibitors,]][[opioids]]
+* [[Skin testing]] with [[Allergens|allergen extracts]]
+* [[Enzyme linked immunosorbent assay (ELISA)|enzyme-linked immunosorbent assays (ELISAs)]] for quantification of allergen-specific [[IgE]] levels
+*
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" |
+|History of exposure to [[Insect allergy|insect]] stings,food alllergy,rubber latex,food [[Additives|additives,]],allergy to medications,physical factors such s excercise and cold
+|-
+| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |Histaminergic [[Angioedema]]<ref name="pmid28687103">{{cite journal |vauthors=Busse PJ, Smith T |title=Histaminergic Angioedema |journal=Immunol Allergy Clin North Am |volume=37 |issue=3 |pages=467–481 |date=August 2017 |pmid=28687103 |doi=10.1016/j.iac.2017.03.001 |url=}}</ref><ref name="pmid28818177">{{cite journal |vauthors=Hahn J, Hoffmann TK, Bock B, Nordmann-Kleiner M, Trainotti S, Greve J |title=Angioedema |journal=Dtsch Arztebl Int |volume=114 |issue=29-30 |pages=489–496 |date=July 2017 |pmid=28818177 |pmc=5569554 |doi=10.3238/arztebl.2017.0489 |url=}}</ref><ref name="pmid28405953">{{cite journal |vauthors=Bernstein JA, Cremonesi P, Hoffmann TK, Hollingsworth J |title=Angioedema in the emergency department: a practical guide to differential diagnosis and management |journal=Int J Emerg Med |volume=10 |issue=1 |pages=15 |date=December 2017 |pmid=28405953 |pmc=5389952 |doi=10.1186/s12245-017-0141-z |url=}}</ref><ref name="pmid23131076">{{cite journal |vauthors=Bernstein JA, Moellman J |title=Emerging concepts in the diagnosis and treatment of patients with undifferentiated angioedema |journal=Int J Emerg Med |volume=5 |issue=1 |pages=39 |date=November 2012 |pmid=23131076 |pmc=3518251 |doi=10.1186/1865-1380-5-39 |url=}}</ref><ref name="pmid23282406">{{cite journal |vauthors=Kaplan AP |title=Angioedema |journal=World Allergy Organ J |volume=1 |issue=6 |pages=103–13 |date=June 2008 |pmid=23282406 |pmc=3651192 |doi=10.1097/WOX.0b013e31817aecbe |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;" |
+* Generalized [[pruritus]]
+* [[Throat]] tightness
+* [[Hoarse voice]]
+* [[Difficulty swallowing]]
+| 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;" |
+* [[Urticaria]]
+* Localized [[swelling]] of [[skin]]
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" |
+* [[Bowel|Bowel wall]] edema
+* Circumferential thickening of the [[Small bowel|small bowel wall]] with [[ascites]] or incomplete [[obstruction]]
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" |
+* [[CBC|CBC with differential,]]
+* [[Electrolyte|Electrolytes]]
+* [[Liver function tests]]
+* [[C-reactive protein (CRP)|C-reactive protein]]
+* [[ESR|Erythrocyte sedimentation rate]]
+* Levels of the [[Complement System|complement protein C4]]
+* Serum tota[[Tryptase|l tryptase]]
+* Allergen-specific [[IgE immunoassay|IgE immunoassays]]
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" |
+* Take proper clinical history of previous similar episodes
+* Medication history
+* Any allergy to insects stings , foods or any ingestion within previous 24 hours
+|-
+| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Medullary carcinoma of thyroid|Medullary Thyroid Carcinoma]]<ref name="pmid20627492">{{cite journal |vauthors=Pacini F, Castagna MG, Cipri C, Schlumberger M |title=Medullary thyroid carcinoma |journal=Clin Oncol (R Coll Radiol) |volume=22 |issue=6 |pages=475–85 |date=August 2010 |pmid=20627492 |doi=10.1016/j.clon.2010.05.002 |url=}}</ref><ref name="pmid24037980">{{cite journal |vauthors=Roy M, Chen H, Sippel RS |title=Current understanding and management of medullary thyroid cancer |journal=Oncologist |volume=18 |issue=10 |pages=1093–100 |date=2013 |pmid=24037980 |pmc=3805151 |doi=10.1634/theoncologist.2013-0053 |url=}}</ref><ref name="pmid24552221">{{cite journal |vauthors=Mian C, Perrino M, Colombo C, Cavedon E, Pennelli G, Ferrero S, De Leo S, Sarais C, Cacciatore C, Manfredi GI, Verga U, Iacobone M, De Pasquale L, Pelizzo MR, Vicentini L, Persani L, Fugazzola L |title=Refining calcium test for the diagnosis of medullary thyroid cancer: cutoffs, procedures, and safety |journal=J. Clin. Endocrinol. Metab. |volume=99 |issue=5 |pages=1656–64 |date=May 2014 |pmid=24552221 |doi=10.1210/jc.2013-4088 |url=}}</ref><ref name="pmid26494386">{{cite journal |vauthors=Bae YJ, Schaab M, Kratzsch J |title=Calcitonin as Biomarker for the Medullary Thyroid Carcinoma |journal=Recent Results Cancer Res. |volume=204 |issue= |pages=117–37 |date=2015 |pmid=26494386 |doi=10.1007/978-3-319-22542-5_5 |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;" |
+* [[Neck pain]]
+* [[Hoarseness]]
+* [[Cough]]
+* [[Difficulty swallowing]]
+* [[Difficulty breathing]]
+* [[Lethargy]]
+* [[Bone pain]] from [[metastasis]]
+| 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;" |
+* [[Solitary thyroid nodule]]
+* [[Cervical lymph nodes|Cervical lymph node involvement]]
+* [[Weight loss]]
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" |
+* Basal serum [[calcitonin]] concentrations
+* [[Carcinoembryonic antigen peptide-1|Carcinoembryonic antigen (CEA) concentration]]
+* [[Thyroid function tests]]: normal
+* [[Germline]] ''[[RET gene|RET]]'' testing
+* [[Calcium|Serum calcium]]
+* Plasma fractionated [[Metanephrine|metanephrines]]
+| 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;" |
+* [[Ultrasonography]] of the [[neck]]
+Fo[[Metastasis|r metastasis]]
+* [[Chest]] [[computed tomography]]
+* [[Neck]] [[CT]]
+* Three-phase contrast-enhanced [[Liver (2)|liver]] [[CT-scans|CT]]
+* Axial [[MRI]]
+* Bone [[scintigraphy]].
+| style="background: #F5F5F5; padding: 5px;" | -
+| style="background: #F5F5F5; padding: 5px;" |
+* [[Immunohistochemical staining]] for [[calcitonin]]
+* [[Spindle cells|Spindle]]-shaped and frequently [[Pleomorphic|pleomorphic cells]] without follicle development
+| style="background: #F5F5F5; padding: 5px;" |
+* [[Fine-needle aspiration|Fine-needle aspiration (FNA) biopsy]]
+* [[TNM staging system|TNM staging]]
+* American Thyroid Association (ATA) Guidelines for Management and evaluation of [[Medullary carcinoma of the thyroid|Medullary Thyroid Cancer]]
 |
 |}
 ==References==