Sandbox: DDx pancrease: Difference between revisions

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{| style="border: 0px; font-size: 90%; margin: 3px; width: 1000px"
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! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|'''Differential Diagnosis'''}}
! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|'''Clinical Presentation'''}}
! style="background: #4479BA; width: 450px;" | {{fontcolor|#FFF|'''Laboratory Findings'''}}
! style="background: #4479BA; width: 450px;" | {{fontcolor|#FFF|'''Imaging'''}}
! style="background: #4479BA; width: 450px;" | {{fontcolor|#FFF|'''Histopathology'''}}


|-
, Adenosquamous carcinoma , Metastases to pancreas
 


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'''Age'''
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:::::Patients older than 3 years of age
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:::::Patients younger than 3 years of age
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:::::Patients older than 3 years of age
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:::::Patients younger than 3 years of age


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*Done:


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**Zollinger-Ellison syndrome, Adenocarcinoma of pancreas, Solid-pseudopapillary tumour of pancreas, Insulinoma, Gastrinoma, Glucagonoma, VIPoma, Somatostatinoma
'''Extent of previous surgical resection'''
, , Intraductal papillary mucinous neoplasm, Mucinous cystic neoplasm, Pancreatic intraepithelial neoplasia, Pancreatoblastoma, Serous cystadenoma, carcinoma,Intraductal papillary mucinous neoplasm (IPMN), Serous cystadenoma, Mucinous cystic neoplasm, ,  ,,  Pancreatic ductal adenocarcinoma Solid-pseudopapillary neoplasm
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::::<1.5 cm² residual tumor after resection
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::Subtotal resection '''or''' >1.5 cm² residual tumor after resection
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::::<1.5 cm² residual tumor after resection
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::Subtotal resection '''or''' >1.5 cm² residual tumor after resection


|-
*Rare
# Colloid carcinoma
# Hepatoid carcinoma
# Signet ring cell
# Pancreatic teratoma
# Pancreatic lymphoma
# Pancreatic Sarcoma
# Undifferentiated carcinoma/Undifferentiated carcinoma with osteoclast-like giant cell
# Neurofibroma


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* Elderly
'''Tumor stage'''
* Positive history of other cancer
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* Present with abdominal pain, malabsorption symptoms, gastric outlet obstruction symptoms, and gastrointestinal bleeding symptoms
:::M0 stage confirmed by [[MRI]] and [[CSF]] sampling
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:::M1-M3 stage '''or''' presence of [[leptomeningeal]] seeding


| style="padding: 5px 5px; background: #F5F5F5;" |
:::M0 stage confirmed by [[MRI]] and [[CSF]] sampling
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:::M1-M3 stage '''or''' presence of [[leptomeningeal]] seeding
|}




ic
Zollinger-Ellison syndrome, Adenocarcinoma of pancreas, Acinar cell carcinoma of pancreas, Adenosquamous carcinoma, Colloid carcinoma, Hepatoid carcinoma, Intraductal papillary mucinous neoplasm, Mucinous cystic neoplasm, Pancreatic intraepithelial neoplasia, Pancreatoblastoma, Serous cystadenoma, Signet ring cell carcinoma, Solid-pseudopapillary neoplasm, Undifferentiated carcinoma, Undifferentiated carcinoma with osteoclast-like giant cell, Neuroendocrine tumors, Pancreatic ductal adenocarcinoma, Intraductal papillary mucinous neoplasm (IPMN), Serous cystadenoma, mucinous cystic neoplasm, solid-pseudopapillary tumour of pancreas, insulinoma, gastrinoma, glucagonoma, VIPoma, somatostatinoma, pancreatic lymphangioma, pancreatic teratoma, pancreatic lymphoma, schwannoma, neurofibroma, sarcoma, intraductal tubular neoplasm (ITN), metastases to pancreas, Von Hippel-Landau (VHL)-associated serous cystic neoplasm


Pancreatic atrophy, pancreatic lipoma, Lymphoepithelial cyst
{| style="border: 0px; font-size: 90%; margin: 3px; width: 1200px"
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! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|'''Characteristics'''}}
! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|'''Insulinoma'''}}
! style="background: #4479BA; width: 450px;" | {{fontcolor|#FFF|'''Vipoma'''}}
! style="background: #4479BA; width: 450px;" | {{fontcolor|#FFF|'''Gastrinoma'''}}
|-
! style="background: #8f8990; width: 150px;" | {{fontcolor|#FFF|'''Symptoms'''}}
|-
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'''Diaphoresis'''
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Present
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Absent
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Absent
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
'''Watery diarrhea'''
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Absent
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Present
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Absent
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
'''Heartburn'''
| style="padding: 5px 5px; background: #F5F5F5;" align=center|
Absent
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Absent
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Present
|-
! style="background: #8f8990; width: 150px;" | {{fontcolor|#FFF|'''Lab values'''}}
|-
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'''Hypoglycemia'''
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Present
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Absent
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Absent
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
'''Hypokalemia'''
| style="padding: 5px 5px; background: #F5F5F5;" align=center|
Absent
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Present
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Absent
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
'''Hypergastrinemia'''
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Absent
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Absent
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Present
|-
| style="padding: 5px 5px; background: #8f8990; font-weight: bold" align=center  |{{fontcolor|#FFF|
'''CT scan'''}}
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Calcification and hyperattenuation of the mass
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Hypervascularity with diffuse multiple metastatic nodulation
| style="padding: 5px 5px; background: #F5F5F5;" align=left|
Small hypoattenuating nodule ± calcification
|-
| style="padding: 5px 5px; background: #8f8990; font-weight: bold" align=center |{{fontcolor|#FFF|
'''Histopathology'''}}
| style="padding: 5px 5px; background: #F5F5F5;" align=left|
Solid or gyriform cellular patterns with amyloid deposition, absence of glands, and nesidioblastosis
| style="padding: 5px 5px; background: #F5F5F5;" align=left|
Solid sheets with uniform cuboidal cells, centrally located nuclei, and granular cytoplasm
| style="padding: 5px 5px; background: #F5F5F5;" align=left|
Lobular-trabecular pattern of gastrin positive tumor cells with infiltration of Brunner glands
|}

Latest revision as of 03:23, 25 October 2015

, Adenosquamous carcinoma , Metastases to pancreas


  • Done:
    • Zollinger-Ellison syndrome, Adenocarcinoma of pancreas, Solid-pseudopapillary tumour of pancreas, Insulinoma, Gastrinoma, Glucagonoma, VIPoma, Somatostatinoma

, , Intraductal papillary mucinous neoplasm, Mucinous cystic neoplasm, Pancreatic intraepithelial neoplasia, Pancreatoblastoma, Serous cystadenoma, carcinoma,Intraductal papillary mucinous neoplasm (IPMN), Serous cystadenoma, Mucinous cystic neoplasm, , ,, Pancreatic ductal adenocarcinoma Solid-pseudopapillary neoplasm

  • Rare
  1. Colloid carcinoma
  2. Hepatoid carcinoma
  3. Signet ring cell
  4. Pancreatic teratoma
  5. Pancreatic lymphoma
  6. Pancreatic Sarcoma
  7. Undifferentiated carcinoma/Undifferentiated carcinoma with osteoclast-like giant cell
  8. Neurofibroma
  • Elderly
  • Positive history of other cancer
  • Present with abdominal pain, malabsorption symptoms, gastric outlet obstruction symptoms, and gastrointestinal bleeding symptoms
Characteristics Insulinoma Vipoma Gastrinoma
Symptoms

Diaphoresis

Present

Absent

Absent

Watery diarrhea

Absent

Present

Absent

Heartburn

Absent

Absent

Present

Lab values

Hypoglycemia

Present

Absent

Absent

Hypokalemia

Absent

Present

Absent

Hypergastrinemia

Absent

Absent

Present

CT scan

Calcification and hyperattenuation of the mass

Hypervascularity with diffuse multiple metastatic nodulation

Small hypoattenuating nodule ± calcification

Histopathology

Solid or gyriform cellular patterns with amyloid deposition, absence of glands, and nesidioblastosis

Solid sheets with uniform cuboidal cells, centrally located nuclei, and granular cytoplasm

Lobular-trabecular pattern of gastrin positive tumor cells with infiltration of Brunner glands

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