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| Line 19: |
Line 19: |
| *[[Gastric cancer]] | | *[[Gastric cancer]] |
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| ==Table for Differential Diagnosis of Small Intestine Cancer==
| |
| '''<small>ABBREVIATIONS''':
| |
|
| |
|
| '''N/A''': Not available, '''NL''': Normal,</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="6" 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'''
| |
| |-
| |
| | colspan="4" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Symptoms'''
| |
| |-
| |
| ! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
| |
| ! colspan="3" 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;" |Bowel
| |
| Frequency
| |
| ! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Blood in stool
| |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Abd pain
| |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other symptoms
| |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hb
| |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Tumor marker
| |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Endoscopy
| |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |CT scan
| |
| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other diagnostic study
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Adenocarcinoma|<small>Adenocarcinoma</small>]]
| |
| <small>of</small>
| |
|
| |
| <small>small</small>
| |
|
| |
| <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;" | +
| |
| | style="background: #F5F5F5; padding: 5px;" | +/-
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| *[[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;" |
| |
| *<small>[[Polyp|Polyps]] (villous, tubular, tubulo-villous)</small>
| |
| *[[Ulcer|<small>Ulcerating polyps</small>]]
| |
| *<small>[[cancerous]] [[lesions]]</small>
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| *<small>Luminal narrowing and [[bowel obstruction]]</small>
| |
| *<small>Circumferential thickening of the bowel wall</small>
| |
| *[[Enlarged lymph nodes|<small>Enlarged lymph nodes</small>]]
| |
| *<small>Pulmonary [[metastases]]</small>
| |
| *<small>Peritoneal metastases</small>
| |
| *[[Metastases|<small>Hepatic metastases</small>]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| *<small>[[PET scan|PET scans]]: Detailed images and metastasis</small>
| |
| *<small>[[Barium enema]]: Cancer or a precancerous polyp</small>
| |
| *<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
| |
| ** Sheets or cords of malignant cells,
| |
| **Cellular atypia, pleomorphism
| |
| **High mitotic rate
| |
| * Necrotic debris in glandular lumina
| |
| * Desmoplastic reaction (sign of invasion)
| |
| | style="background: #F5F5F5; padding: 5px;" |[[Biopsy]] and [[histopathological]] analysis
| |
| |-
| |
| | 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;" | +/-
| |
| | style="background: #F5F5F5; padding: 5px;" | +
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| *[[Flushing (physiology)|<small>Flushing</small>]]
| |
| *[[Wheezing|<small>Wheezing</small>]]
| |
| *[[Shortness of breath|<small>Shortness of breath</small>]]
| |
| *[[Palpitations|<small>Palpitations</small>]]
| |
| *[[Weight gain|<small>Weight gain</small>]]
| |
| *[[Hirsutism|<small>Hirsutism</small>]]
| |
| *[[Weakness|<small>Weakness</small>]]
| |
| *[[Leg edema|<small>Leg edema</small>]]
| |
| | style="background: #F5F5F5; padding: 5px;" | [[Anemia of chronic disease|↓]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * <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;" |
| |
| * <small>Well-defined single or multiple lesions</small>
| |
| * <small>Round or ovoid in shape</small>
| |
| * <small>Variable in size ranges between 2-5 cm</small>
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * <small>[[PET scan]] 11C-5-hydroxytryptophan (11C-5-HTP): Deetects metastasis</small>
| |
| * <small>[[MRI]]:</small>
| |
| ** <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>
| |
| ** <small>Mesenteric metastases presents as nodular masses with [[mesenteric]] stranding</small>
| |
| ** <small>[[Liver]] metastases may show hypointense precontrast T1- and hyperintense T2-weighted images</small>
| |
| ** <small>[[Liver]] metastases are commonly hypervascular</small>
| |
| * <small>Ki-67 index</small>
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Solid or spongy nests of cells accentuated by neatly outlined luminal spaces
| |
|
| |
| * Peripheral nuclear palisading
| |
| * Granular eosinophilic cytoplasm.
| |
| | style="background: #F5F5F5; padding: 5px;" |[[Biopsy]] and [[Histopathology|histopathological analysis]]
| |
| |-
| |
| | 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;" | +/-
| |
| | style="background: #F5F5F5; padding: 5px;" | +
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * <small>Weight loss</small>
| |
| | style="background: #F5F5F5; padding: 5px;" | [[Anemia of chronic disease|↓]]
| |
| | style="background: #F5F5F5; padding: 5px;" |<small>Non-Hodgkin’s lymphomas: CD-20</small>
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * <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;" |
| |
| * <small>CT scan: polypoid mass, circumferential-cavitary lesions, focal mucosal nodularity, diffuse ulcerative or nodular lesions, regional lymph node involvement</small>
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * <small>Biopsy:</small>
| |
| ** [[Diffuse large B cell lymphoma|<small>Diffuse large B-cell lymphoma</small>]]
| |
| ** [[MALT lymphoma|<small>Extranodal marginal zone lymphoma (MALT)</small>]]
| |
| ** [[Mantle cell lymphoma|<small>Mantle cell lymphoma</small>]]
| |
| ** [[Burkitt's lymphoma|<small>Burkitt’s lymphoma</small>]]
| |
| ** [[Follicular lymphoma|<small>Follicular lymphoma</small>]]
| |
| * <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]]:
| |
| * [[MALT lymphoma|Extranodal marginal zone lymphoma (MALT)]]
| |
| * [[Mantle cell lymphoma]]
| |
| * [[Burkitt's lymphoma|Burkitt’s lymphoma]]
| |
| * [[Follicular lymphoma]]
| |
| *
| |
| | style="background: #F5F5F5; padding: 5px;" |[[Biopsy]] and [[histopathological]] analysis
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Gastrointestinal stromal tumor|<small>Gastrointestinal</small>]]
| |
|
| |
| [[Gastrointestinal stromal tumor|<small>Stromal</small>]]
| |
|
| |
| [[Gastrointestinal stromal tumor|<small>Tumors (GIST)</small>]]
| |
|
| |
| <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>
| |
|
| |
| <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>
| |
| | style="background: #F5F5F5; padding: 5px;" | ↑↓
| |
| | style="background: #F5F5F5; padding: 5px;" | +/-
| |
| | style="background: #F5F5F5; padding: 5px;" | -
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * <small>Mostly [[asymptomatic]]</small>
| |
| * <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;" |
| |
| * <small>KIT protein</small>
| |
| * [[CD117|<small>CD 117 antigen</small>]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * <small>Subepithelial round masses</small>
| |
| * <small>Smooth margins</small>
| |
| * <small>Normal overlying [[mucosa]] may be intact or [[Ulcerated lesion|ulcerated]]</small>
| |
| * <small>Bulging into [[Gastrointestinal tract|gastrointestinal]] [[lumen]]</small>
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * <small>Small GIST (< 5 cms) are [[homogeneous]] with clear boundaries and have an [[intraluminal]] pattern of growth.</small>
| |
| * <small>Intermediate GIST (size of 5-10 cms) are [[heterogeneous]] with irregular borders and [[Intraluminal|intra]] or extra-luminal pattern of [[growth]].</small>
| |
| * <small>Large GISTs (>10 cms) are [[heterogeneous]] with irregular borders and have local or distant spread</small>
| |
| * <small>Malignant GIST with metastasis:</small>
| |
| ** <small>Size greater than 10 cm</small>
| |
| ** [[Calcification|<small>Calcifications</small>]]
| |
| ** <small>Irregular margins</small>
| |
| ** <small>[[Heterogeneous]] and lobulated</small>
| |
| ** [[Lymphadenopathy|<small>Lymphadenopathy</small>]]
| |
| ** [[Ulceration|<small>Ulceration</small>]]
| |
| ** <small>Extraluminal and [[mesenteric]] fat infiltration</small>
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * <small>[[MRI]]: [[Hemorrhage]], [[necrosis]], surrounding structures and [[metastasis]].</small>
| |
| * <small>[[Endoscopic ultrasound|Endoscopic]] [[ultrasonography]]:</small>
| |
| ** <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;" |
| |
| *[[Spindle cells|Spindle cell]] type are [[eosinophilic]] cells arranged in the form of whorls or fascicles.
| |
| *[[Epithelioid]] [[GIST|GISTs]] are rounded cells with oval nuclei and vesicular chromatin and appears nested
| |
| *On [[immunohistochemical staining]] they are positive for [[Molecular marker|molecular markers]] [[CD117]] antigen and KIT protein.
| |
| | style="background: #F5F5F5; padding: 5px;" |Endoscopic ultrasound with[[Biopsy]] and [[Histopathological|histopathological analysis]]
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Peutz-Jeghers syndrome|<small>Peutz-Jeghers</small>]]
| |
|
| |
| <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>
| |
|
| |
| <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;" | +
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * <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|<small>Multiple polyps</small>]]
| |
| *[[Intussusception|<small>Intussusception</small>]]
| |
| *[[Bowel obstruction|<small>Bowel obstruction</small>]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * <small>[[Barium enema]]: Multiple [[Polyp|polyps]].</small>
| |
| * <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
| |
| ** Smaller [[Polyp|polyps]] may lack the prominent arborizing smooth muscle
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Genetic testing]] for [[STK11]]
| |
|
| |
| * [[Colonoscopy]]
| |
| |-
| |
| | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Juvenile polyposis syndrome|<small>Juvenile</small>]]
| |
|
| |
| [[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;" | +
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * <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;" |
| |
| * <small>M[[Polyps|ultiple polyps]] in [[gastrointestinal tract]]</small>
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * <small>[[Barium]] study: Multiple polyps in GI tract</small>
| |
| * <small>[[Stool]] [[DNA test]]: ''SMAD4'' or ''BMPR1A''</small>
| |
| * <small>Diagnose if any of the following positive:</small>
| |
| ** <small>More than five [[Polyps|juvenile polyps]] of the [[Colon|colorectum]]</small>
| |
| ** <small>Multiple juvenile [[Polyp|polyps]] throughout the [[GI tract]]</small>
| |
| ** <small>Any number of juvenile [[polyps]] and a family history of [[Juvenile polyposis syndrome|juvenile polyposis]]</small>
| |
| ** <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
| |
| * 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
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * 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''
| |
| |-
| |
| | 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;" |[[Diarrhea|↑]]
| |
| | style="background: #F5F5F5; padding: 5px;" | +
| |
| | style="background: #F5F5F5; padding: 5px;" | +
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Melena|<small>Melena</small>]]
| |
|
| |
| * [[Hematochezia|<small>Hematochezia</small>]]
| |
| * [[Abdominal pain|<small>Abdominal pain</small>]]
| |
| * [[Nausea and vomiting|<small>N/V</small>]]
| |
| | style="background: #F5F5F5; padding: 5px;" | [[Anemia|↓]]
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[CD34|<small>CD34</small>]]
| |
| * [[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;" |
| |
| * <small>[[Electrophoresis]]: [[antibodies]] against [[Kaposi sarcoma]] [[Herpes virus|herpes virus (HHV-8)]]</small>
| |
| * <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>
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Vascular]] proliferation
| |
| * Red blood cell and [[hemosiderin]] extravasation
| |
| * [[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
| |
| |-
| |
| | 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;" | +
| |
| | style="background: #F5F5F5; padding: 5px;" | -
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * <small>N/A</small>
| |
| | style="background: #F5F5F5; padding: 5px;" | [[Anemia|↓]]
| |
| | style="background: #F5F5F5; padding: 5px;" |<small>N/A</small>
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * <small>Bright red, flat lesions</small>
| |
| * <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;" |
| |
| * Aberrant vessels with thickened, hypertrophic walls in the mucosa and the submucosa.
| |
| * Arteries directly connected to veins without capillary beds
| |
| | style="background: #F5F5F5; padding: 5px;" |Accidental fining
| |
| |-
| |
| | 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;" |[[Diarrhea|↑]]
| |
| | style="background: #F5F5F5; padding: 5px;" | +
| |
| | style="background: #F5F5F5; padding: 5px;" | +
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * <small>[[Fever]], [[Rigor|chills]]</small>
| |
| * [[Nausea and vomiting|<small>N/V</small>]]
| |
| * [[Bloating|<small>Bloating</small>]]
| |
| | style="background: #F5F5F5; padding: 5px;" | -
| |
| | style="background: #F5F5F5; padding: 5px;" |<small>N/A</small>
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * <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;" |
| |
| * <small>[[Stool culture|Stool cultures]] in adequate [[culture media]]</small>
| |
| * <small>[[Stool test|Stool analysis]]: [[Leukocytosis]]</small>
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * N/A
| |
| | style="background: #F5F5F5; padding: 5px;" |Stool culture
| |
| |-
| |
| |-
| |
| | 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;" |[[Diarrhea|↑]]
| |
| | style="background: #F5F5F5; padding: 5px;" | +
| |
| | style="background: #F5F5F5; padding: 5px;" | +
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Tenesmus|<small>Tenesmus</small>]]
| |
| | style="background: #F5F5F5; padding: 5px;" | -
| |
| | style="background: #F5F5F5; padding: 5px;" |<small>S100 (mucosal Schwann cell hamartoma (MSCH)</small>
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * <small>Large polypoid mass</small>
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * <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;" |
| |
| * <small>[[Biopsy]]: Proliferation of bland [[spindle cells]] in the [[lamina]] propria ([[mucosa]]<nowiki/>l [[schwann cell]] [[hamartoma]] (MSCH))</small>
| |
| | 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|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;" |[[Diarrhea|↑]]
| |
| | style="background: #F5F5F5; padding: 5px;" |<big>+</big>
| |
| | style="background: #F5F5F5; padding: 5px;" | +
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * <small>[[Diarrhea]] mixed with blood and [[mucus]]</small>
| |
| * <small>W[[Weight loss|eight loss]]</small>
| |
| * <small>Urgency</small>
| |
| * [[Tenesmus|<small>Tenesmus</small>]]
| |
| | style="background: #F5F5F5; padding: 5px;" | [[Anemia|↓]]
| |
| | style="background: #F5F5F5; padding: 5px;" |<small>N/A</small>
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * <small>Continuous lesions</small>
| |
| * <small>[[Erythema]] (or redness of the [[mucosa]]) and friability of the [[mucosa]]</small>
| |
| * <small>Crypts, formation of residual mucosal tissue</small>
| |
| * [[Polyp (medicine)|<small>Pseudopolyps</small>]]
| |
| | style="background: #F5F5F5; padding: 5px;" |<small>N/A</small>
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * N/A
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * Mucosal and submucosal inflammation
| |
| * Hemorrhage or inflammatory polymorphonuclear cells aggregate in the lamina propria
| |
| * Distorted crypts
| |
| * Crypt abscess
| |
| | style="background: #F5F5F5; padding: 5px;" |Endoscopy and a mucosal biopsy
| |
| |-
| |
| | 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;" |[[Diarrhea|↑]]
| |
| | style="background: #F5F5F5; padding: 5px;" | +
| |
| | style="background: #F5F5F5; padding: 5px;" | +
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * [[Tenesmus|<small>Tenesmus</small>]]
| |
| * [[Nausea and vomiting|<small>N/V</small>]]
| |
| * [[Bowel obstruction|<small>Bowel obstruction</small>]]
| |
| * [[Fever|<small>Fever</small>]]
| |
| *
| |
| | style="background: #F5F5F5; padding: 5px;" | [[Anemia|↓]]
| |
| | style="background: #F5F5F5; padding: 5px;" |<small>N/A</small>
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * <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;" |
| |
| * 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;" |<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;" | +
| |
| | style="background: #F5F5F5; padding: 5px;" | +
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * <small>Straining during [[defecation]]</small>
| |
| * [[Urgency|<small>Urgency</small>]]
| |
| * <small>Sensation of incomplete evacuation</small>
| |
| * <small>[[Mucus]] passage</small>
| |
| * [[Bloating|<small>Bloating</small>]]
| |
| * <small>Weight loss</small>
| |
| | style="background: #F5F5F5; padding: 5px;" | -
| |
| | style="background: #F5F5F5; padding: 5px;" |<small>N/A</small>
| |
| | style="background: #F5F5F5; padding: 5px;" |<small>Not recommended</small>
| |
| | style="background: #F5F5F5; padding: 5px;" |<small>N/A</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;" |<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;" |[[Constipation|↓]][[Diarrhea|↑]]
| |
| | style="background: #F5F5F5; padding: 5px;" | +
| |
| | style="background: #F5F5F5; padding: 5px;" | +
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * <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;" |
| |
| * 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
| |
| | style="background: #F5F5F5; padding: 5px;" |
| |
| * N/A
| |
| | style="background: #F5F5F5; padding: 5px;" |Transvaginal ultrasonography
| |
| |-
| |
| | 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>
| |
|
| |
| <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>
| |
| |
| |
| * <small>Fever</small>
| |
| * <small>Fatigue,</small>
| |
| * <small>Weight loss</small>
| |
| * <small>Anorexia</small>
| |
| * <small>Night sweats</small>
| |
| * <small>Bowel obstruction</small>
| |
|
| |
| * <small>Abdominal distension</small>
| |
| * <small>Lymph node enlargement</small>
| |
| |[[Anemia|↓]]
| |
| |<small>N/A</small>
| |
| |
| |
| * <small>To get sample for histolopathology and culture</small>
| |
|
| |
| * <small>Forms on endoscopy:</small>
| |
| ** <small>Hypertrophic</small>
| |
| ** <small>Ulcerative</small>
| |
|
| |
| * <small>[[Endoscopy|Endoscopic]] findings:</small>
| |
| ** <small>[[Ulcers]] in [[mucosa]]</small>
| |
| ** [[Nodules|<small>Nodules in mucosa</small>]]
| |
| ** <small>[[Strictures]] in [[intestinal wall]]</small>
| |
| ** <small>[[Pseudopolyps]] formation</small>
| |
| ** [[Adhesions|<small>Adhesions</small>]]
| |
| ** [[Fistulas|<small>Fistulas</small>]]
| |
| ** <small>Deformed [[ileocecal valve]]</small>
| |
| |
| |
| * <small>Concentric thickening at the site of lesion with proximal intestinal dilatation</small>
| |
| * <small>asymmetric thickening of the intestinal wall</small>
| |
| * <small>Lymphadenopathy</small>
| |
| * <small>Thickening of the peritoneum</small>
| |
| * <small>Ascites</small>
| |
| |
| |
| *[[Small bowel follow-through]] or [[barium enema]]:
| |
| ** [[Mucosal]] [[ulcerations]]
| |
| **Strictures in the [[intestinal wall]]
| |
| **[[Cecum|Cecal]] deformations
| |
| **Incompetency of [[ileocecal valve]]
| |
| *[[Ultrasound]]:
| |
| ** [[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]]
| |
| |[[Endoscopy|Endoscopic]] [[biopsy]] and [[Histopathology|histopathology analysis]]
| |
| |-
| |
| | 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>
| |
|
| |
| <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|<small>Heartburn</small>]]
| |
| * <small>Asymptomatic</small>
| |
|
| |
| * [[Chest discomfort|<small>Chest discomfort</small>]]
| |
|
| |
| * <small>Early [[satiety]]</small>
| |
| * [[Nausea and vomiting|<small>Nausea and vomiting</small>]]
| |
| * [[Anorexia|<small>Anorexia</small>]]
| |
| * [[Bloating|<small>Bloating</small>]]
| |
| * [[Perforation|<small>Perforation</small>]]
| |
| |[[Anemia|↓]]
| |
| |<small>N/A</small>
| |
| |
| |
| * <small>Smooth [[ulcers]] in [[mucosa]] of [[intestine]]</small>
| |
| * <small>[[Ulcers]] with round edges</small>
| |
| * <small>Flat [[ulcer]] base filled with exudate</small>
| |
| |
| |
| * <small>Shows [[ulcers]] ([[Perforated ulcer|perforated]] or non-perforated) when done for the investigation of [[abdominal]] pain</small>
| |
| |
| |
| * .[[Barium swallow]] (infrequent)
| |
| * ''[[Helicobacter pylori|H. Pylori]]'' testing
| |
| * [[Hydrogen Breath Test|Hydrogen breath test]]
| |
| |
| |
| * Endoscopic biopsy sample may show positive [[Helicobacter pylori|H. Pylori]] by [[H&E stain]]
| |
| |Endoscopic visualization of ulcer
| |
| |-
| |
| | 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>
| |
| |
| |
| * <small>[[Asthenia]] and [[depression]]</small>
| |
|
| |
| * [[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>
| |
| |
| |
| * <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)</small>
| |
| |
| |
| * <small>Mass within the [[Pancreas|pancreatic]] [[parenchyma]] or [[Pancreatic duct|duct]]</small>
| |
| * <small>[[Atrophy]] of the [[parenchyma]]</small>
| |
| *
| |
| |
| |
| * [[Ultrasound|Transabdominal US]]
| |
| ** [[Bile duct|Billiary]] dilatation
| |
| ** Mass in [[pancreas]]
| |
| ** Hypoechoic hypovascular mass with irregular borders
| |
| * [[Magnetic resonance cholangiopancreatography]](MRCP) :
| |
| ** Better than CT to visualize [[Pancreas|pancreatic]] and [[Bile duct|billiary]] anatomy and [[hepatic]] lesions
| |
| * [[Biopsy]]:
| |
| ** [[Percutaneous]] [[FNA|FNA biopsy]]
| |
| ** Transduodenal Endo US-guided [[FNA|FNA biopsy]]
| |
| |
| |
| * [[Pancreatic tumor]] can show two type of [[histology]] depending on the location:
| |
|
| |
| * Intraductal [[papillary]] mucinous [[neoplasms]]
| |
| ** [[Papilla|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
| |
| |-
| |
| | 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>
| |
|
| |
| <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>
| |
| |[[constipation|↓]]/-
| |
| |<nowiki>+ </nowiki>[[Melena]]
| |
| |<nowiki>+</nowiki>
| |
| |
| |
| * [[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|↓]]
| |
| |
| |
| * <small>[[Carcinoembryonic antigen]] ([[CEA]])</small>
| |
| * [[CA-125|<small>Glycoprotein CA 125</small>]]
| |
| * <small>[[CA19-9|Carbohydrate antigen 19-9]] ([[CA 19-9]])</small>
| |
| * <small>[[Alpha-fetoprotein]] ([[Alpha-fetoprotein|AFP]])</small>
| |
| *
| |
| |
| |
| * <small>On [[endoscopy]] [[gastric cancer]] may appear as:</small>
| |
| ** <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>Ulcerating lesion</small>
| |
| ** <small>Diffuse thickening (''tunica plastica'')</small>
| |
| ** <small>Infiltrating mass</small>
| |
| |
| |
| * [[Positron emission tomography|PET scan]]:
| |
| ** Useful to confirm [[malignant]] involvement of [[Computed tomography|CT]]-detected [[lymphadenopathy]].
| |
| ** Directly visualizes the [[liver]] surface, the [[peritoneum]], and local [[Lymph node|lymph nodes]] for metastasis
| |
| * [[MRI]]:
| |
| ** Better T [[Cancer staging|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]]
| |
| *** [[Intestinal|ntestinal]] [[metaplasia]]
| |
| *** [[cellular]] [[pleomorphism]]
| |
| ***
| |
| ** Diffuse type [[adenocarcinoma]]
| |
| *** Discohesive
| |
| *** Secrete [[mucus]]
| |
| *** Pools of [[Mucus|mucus/]][[colloid]]
| |
| *** [[Signet ring cell]] appearance
| |
| |[[Biopsy]] and [[Histopathology|histopathological analysis]]
| |
| |}
| |
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| ==References== | | ==References== |