Bladder cancer differential diagnosis: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Bladder_cancer]] | |||
{{CMG}}; {{AE}} {{SC}} | {{CMG}}; {{AE}} {{SC}} | ||
==Overview== | ==Overview== | ||
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
The most common presentation of bladder cancer is hematuria | The most common presentation of bladder cancer is hematuria; however in the advanced cases, the presentation can be bladder mass. | ||
Bladder cancer must be differentiated from other causes of hematuria as in the below table: | |||
'''Bladder cancer must be differentiated from other causes of hematuria as in the below table:''' | |||
{| | {| | ||
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| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | '''Biopsy:''' | | style="background: #F5F5F5; padding: 5px;" | '''Biopsy:''' | ||
IgA deposited in a diffuse granular | [[IgA]] deposited in a diffuse [[Granular cell|granular]] pattern in the [[mesangium]] | ||
| style="background: #F5F5F5; padding: 5px;" |Biopsy | | style="background: #F5F5F5; padding: 5px;" |Biopsy | ||
* | * | ||
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* Cylindrical [[casts]] | * Cylindrical [[casts]] | ||
| style="background: #F5F5F5; padding: 5px;" |'''Biopsy:''' | | style="background: #F5F5F5; padding: 5px;" |'''Biopsy:''' | ||
* Monoclonal antibodies directed against alpha-3 (IV), alpha-4 (IV), and alpha-5 (IV) chains of typ-e IV | * [[Monoclonal antibodies]] directed against alpha-3 (IV), alpha-4 (IV), and alpha-5 (IV) chains of [[Type-IV collagen|typ-e IV collage]]<nowiki/>n | ||
| style="background: #F5F5F5; padding: 5px;" |Genetic analysis | | style="background: #F5F5F5; padding: 5px;" |[[Genetics|Genetic]] analysis | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Post-streptococcal glomerulonephritis]]<ref name="pmid15213266">{{cite journal |vauthors=Yoshizawa N, Yamakami K, Fujino M, Oda T, Tamura K, Matsumoto K, Sugisaki T, Boyle MD |title=Nephritis-associated plasmin receptor and acute poststreptococcal glomerulonephritis: characterization of the antigen and associated immune response |journal=J. Am. Soc. Nephrol. |volume=15 |issue=7 |pages=1785–93 |date=July 2004 |pmid=15213266 |doi= |url=}}</ref><ref name="pmid20708459">{{cite journal |vauthors=Oda T, Yoshizawa N, Yamakami K, Tamura K, Kuroki A, Sugisaki T, Sawanobori E, Higashida K, Ohtomo Y, Hotta O, Kumagai H, Miura S |title=Localization of nephritis-associated plasmin receptor in acute poststreptococcal glomerulonephritis |journal=Hum. Pathol. |volume=41 |issue=9 |pages=1276–85 |date=September 2010 |pmid=20708459 |doi=10.1016/j.humpath.2010.02.006 |url=}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Post-streptococcal glomerulonephritis]]<ref name="pmid15213266">{{cite journal |vauthors=Yoshizawa N, Yamakami K, Fujino M, Oda T, Tamura K, Matsumoto K, Sugisaki T, Boyle MD |title=Nephritis-associated plasmin receptor and acute poststreptococcal glomerulonephritis: characterization of the antigen and associated immune response |journal=J. Am. Soc. Nephrol. |volume=15 |issue=7 |pages=1785–93 |date=July 2004 |pmid=15213266 |doi= |url=}}</ref><ref name="pmid20708459">{{cite journal |vauthors=Oda T, Yoshizawa N, Yamakami K, Tamura K, Kuroki A, Sugisaki T, Sawanobori E, Higashida K, Ohtomo Y, Hotta O, Kumagai H, Miura S |title=Localization of nephritis-associated plasmin receptor in acute poststreptococcal glomerulonephritis |journal=Hum. Pathol. |volume=41 |issue=9 |pages=1276–85 |date=September 2010 |pmid=20708459 |doi=10.1016/j.humpath.2010.02.006 |url=}}</ref> | ||
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| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Edema | * [[Edema]] | ||
* Anemia | * [[Anemia]] | ||
* Increased Blood Pressure | * Increased [[Blood pressure|Blood Pressure]] | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Urine samples for protein and blood | * Urine samples for [[protein]] and [[blood]] | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
'''Biopsy''' | '''Biopsy''' | ||
* Irregularly thin and | * Irregularly thin and attenuated [[GBM]] | ||
* Splitting | * Splitting of [[GBM]] | ||
* Scarring | * Scarring | ||
* Immunoglobulin G and C3 in a diffuse granular pattern | * [[Immunoglobulin G]] and [[C3 disease|C3]] in a diffuse [[Granule cell|granular]] pattern | ||
* | * Starry sky pattern | ||
| style="background: #F5F5F5; padding: 5px;" |Biopsy | | style="background: #F5F5F5; padding: 5px;" |Biopsy | ||
|- | |- | ||
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| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Nephrotic syndrome | * [[Nephrotic syndrome]] | ||
* ESRD | * [[ESRD]] | ||
* Pleural effusion | * [[Pleural effusion]] | ||
* Ascites | * [[Ascites]] | ||
* Abdominal pain | * [[Abdominal pain]] | ||
** | ** | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Urinalysis reveals large amounts of protein, along with hyaline and broad waxy casts | * [[Urinalysis]] reveals large amounts of protein, along with [[hyaline]] and broad waxy casts | ||
* Hepatitis B or C infection | * [[Hepatitis B]] or [[Hepatitis C|C]] infection | ||
* | * [[Anti-neutrophil cytoplasmic antibody]] titers, [[serum protein electrophoresis]] | ||
| style="background: #F5F5F5; padding: 5px;" |'''Biopsy''' | | style="background: #F5F5F5; padding: 5px;" |'''Biopsy''' | ||
* Segmental solidification in the perihilar region and peripheral areas, | * Segmental solidification in the perihilar region and peripheral areas, especially the [[tubular]] pole | ||
* Coarsely granular deposits -of IgM and C3 | * Coarsely [[Granule cell|granular]] deposits -of [[Immunoglobulin M|IgM]] and [[C3 glomerular disease|C3]] | ||
| style="background: #F5F5F5; padding: 5px;" |Biopsy | | style="background: #F5F5F5; padding: 5px;" |Biopsy | ||
|- | |- | ||
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* Abdominal pain | * Abdominal pain | ||
* Painful cutaneous nodules | * Painful cutaneous nodules | ||
* Migratory | * Migratory poly arthropathy | ||
* Sinusitis | * [[Rhinosinusitis|Sinusitis]] | ||
* Cough | * [[Cough]] | ||
* Hemoptysis. | * [[Hemoptysis]]. | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Low iron | * Low [[iron]] | ||
* Eosinophilia | * [[Eosinophilia]] | ||
* Increased serum creatinine level | * Increased serum [[creatinine]] level | ||
* Eleated LDH and CPK | * Eleated [[Lactate dehydrogenase|LDH]] and [[Creatine kinase|CPK]] | ||
* Proteinuria | * [[Proteinuria]] | ||
| style="background: #F5F5F5; padding: 5px;" | Biopsy: | | style="background: #F5F5F5; padding: 5px;" | Biopsy: | ||
* Diffuse, proliferative, necrotizing glomerulonephritis with | * Diffuse, proliferative, necrotizing [[Glomerular disease|glomerulonephritis]] with [[Glomerular disease|crescent]] formation | ||
| style="background: #F5F5F5; padding: 5px;" |Biopsy | | style="background: #F5F5F5; padding: 5px;" |Biopsy | ||
|- | |- | ||
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* [[Proteinuria]] | * [[Proteinuria]] | ||
* Cellular casts | * Cellular casts | ||
* Low iron | * Low [[iron]] | ||
| style="background: #F5F5F5; padding: 5px;" | Biopsy, | | style="background: #F5F5F5; padding: 5px;" | Biopsy, | ||
* Different pathologies, [[Lupus nephritis|CLICK HERE]] for more | * Different pathologies, [[Lupus nephritis|CLICK HERE]] for more information. | ||
| style="background: #F5F5F5; padding: 5px;" |Biopsy | | style="background: #F5F5F5; padding: 5px;" |Biopsy | ||
|- | |- | ||
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| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Hematuria | * [[Hematuria]] | ||
* Proteinuria | * [[Proteinuria]] | ||
| style="background: #F5F5F5; padding: 5px;" | Biopsy | | style="background: #F5F5F5; padding: 5px;" | Biopsy | ||
| style="background: #F5F5F5; padding: 5px;" | Biopsy | | style="background: #F5F5F5; padding: 5px;" | Biopsy | ||
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* [[Isosthenuria]] | * [[Isosthenuria]] | ||
| style="background: #F5F5F5; padding: 5px;" |Biopsy: | | style="background: #F5F5F5; padding: 5px;" |Biopsy: | ||
* [[Edema]] and infiltration by mononuclear cells, (principally lymphocytes) | * [[Edema]] and infiltration by [[Monocyte|mononuclear cells]], (principally lymphocytes) | ||
* [[Eosinophils]] are present, often in large numbers. | * [[Eosinophils]] are present, often in large numbers. | ||
| style="background: #F5F5F5; padding: 5px;" |Renal biopsy | | style="background: #F5F5F5; padding: 5px;" |Renal biopsy | ||
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* [[Hyperuricosuria]] | * [[Hyperuricosuria]] | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Hydronephrosis +/- | * Ultrasound: [[Hydronephrosis]] +/- | ||
* Abdominal CT scan without contrast | * [[Computed tomography|Abdominal CT scan]] without contrast | ||
| style="background: #F5F5F5; padding: 5px;" |Abdominal CT scan without contrast | | style="background: #F5F5F5; padding: 5px;" |Abdominal [[Computed tomography|CT scan]] without contrast | ||
|- | |- | ||
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Reflux nephropathy|Reflux nephropathy (hydronephrosis)]] | | colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Reflux nephropathy|Reflux nephropathy (hydronephrosis)]] | ||
| Line 258: | Line 259: | ||
* Elevated [[WBC]] count | * Elevated [[WBC]] count | ||
* Elevated [[BUN]] | * Elevated [[BUN]] | ||
* Hyperkalemia | * [[Hyperkalemia]] | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Ultrasound: Hydronephrosis +/- | * Ultrasound: [[Hydronephrosis]] +/- | ||
* Biopsy: Kidney scar | * Biopsy: [[Kidney]] scar | ||
| style="background: #F5F5F5; padding: 5px;" |– | | style="background: #F5F5F5; padding: 5px;" |– | ||
|- | |- | ||
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| style="background: #F5F5F5; padding: 5px;" |± | | style="background: #F5F5F5; padding: 5px;" |± | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Flank mass | * [[Flanks|Flank]] mass | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Anemia | * [[Anemia]] | ||
* Hematuria | * [[Hematuria]] | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Both [[CT]] and [[MRI]] may be used to detect [[neoplastic]] masses that may define renal cell carcinoma or metastasis of the primary cancer. [[CT]] scan and use of intravenous (IV) contrast is generally used for work-up and follow-up of patients with [[Renal cell carcinoma|renal cell carcinom]]<nowiki/>a. | * Both [[CT]] and [[MRI]] may be used to detect [[neoplastic]] masses that may define renal cell carcinoma or metastasis of the primary cancer. [[CT]] scan and use of intravenous (IV) contrast is generally used for work-up and follow-up of patients with [[Renal cell carcinoma|renal cell carcinom]]<nowiki/>a. | ||
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| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Abdominal pain | * [[Abdominal pain]] | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* [[Anemia]] | * [[Anemia]] | ||
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| style="background: #F5F5F5; padding: 5px;" |Biopsy | | style="background: #F5F5F5; padding: 5px;" |Biopsy | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Bladder cancer]]<ref name="pmid21360040">{{cite journal| author=Pons F, Orsola A, Morote J, Bellmunt J| title=Variant forms of bladder cancer: basic considerations on treatment approaches. | journal=Curr Oncol Rep | year= 2011 | volume= 13 | issue= 3 | pages= 216-21 | pmid=21360040 | doi=10.1007/s11912-011-0161-4 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21360040 }}</ref><ref name="pmid10918764">{{cite journal |vauthors=Metts MC, Metts JC, Milito SJ, Thomas CR |title=Bladder cancer: a review of diagnosis and management |journal=J Natl Med Assoc |volume=92 |issue=6 |pages=285–94 |date=June 2000 |pmid=10918764 |pmc=2640522 |doi= |url=}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Bladder cancer]]<ref name="pmid21360040">{{cite journal| author=Pons F, Orsola A, Morote J, Bellmunt J| title=Variant forms of bladder cancer: basic considerations on treatment approaches. | journal=Curr Oncol Rep | year= 2011 | volume= 13 | issue= 3 | pages= 216-21 | pmid=21360040 | doi=10.1007/s11912-011-0161-4 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21360040 }}</ref><ref name="pmid10918764">{{cite journal |vauthors=Metts MC, Metts JC, Milito SJ, Thomas CR |title=Bladder cancer: a review of diagnosis and management |journal=J Natl Med Assoc |volume=92 |issue=6 |pages=285–94 |date=June 2000 |pmid=10918764 |pmc=2640522 |doi= |url=}}</ref><ref name="pmid182316182">{{cite journal |vauthors=Rom M, Kuehhas FE, Djavan B |title=New findings in bladder and prostate cancer: highlights of the 22nd annual congress of the European association of urology, march 21-24, 2007, berlin, Germany |journal=Rev Urol |volume=9 |issue=4 |pages=214–9 |date=2007 |pmid=18231618 |pmc=2199502 |doi= |url=}}</ref> | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| Line 329: | Line 330: | ||
* [[Anemia]] | * [[Anemia]] | ||
* [[Hematuria]] | * [[Hematuria]] | ||
| style="background: #F5F5F5; padding: 5px;" |Ultrasound, CT scan, Biopsy | | style="background: #F5F5F5; padding: 5px;" |[[Ultrasound]], [[Computed tomography|CT scan]], Biopsy | ||
| style="background: #F5F5F5; padding: 5px;" |Biopsy | | style="background: #F5F5F5; padding: 5px;" |Biopsy | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Prostate cancer]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Prostate cancer]]<ref name="pmid23451265">{{cite journal |vauthors=Chung SD, Liu SP, Lin HC |title=Association between prostate cancer and urinary calculi: a population-based study |journal=PLoS ONE |volume=8 |issue=2 |pages=e57743 |date=2013 |pmid=23451265 |pmc=3581486 |doi=10.1371/journal.pone.0057743 |url=}}</ref><ref name="pmid18231618">{{cite journal |vauthors=Rom M, Kuehhas FE, Djavan B |title=New findings in bladder and prostate cancer: highlights of the 22nd annual congress of the European association of urology, march 21-24, 2007, berlin, Germany |journal=Rev Urol |volume=9 |issue=4 |pages=214–9 |date=2007 |pmid=18231618 |pmc=2199502 |doi= |url=}}</ref> | ||
| style="background: #F5F5F5; padding: 5px;" |± | | style="background: #F5F5F5; padding: 5px;" |± | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| Line 345: | Line 346: | ||
* [[Anemia]] | * [[Anemia]] | ||
* [[Hematuria]] | * [[Hematuria]] | ||
| style="background: #F5F5F5; padding: 5px;" |Ultrasound, CT scan, Biopsy | | style="background: #F5F5F5; padding: 5px;" |[[Ultrasound]], [[Computed tomography|CT scan]], Biopsy | ||
| style="background: #F5F5F5; padding: 5px;" |Biopsy | | style="background: #F5F5F5; padding: 5px;" |Biopsy | ||
|- | |- | ||
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|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Familial|Familial diseases]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Familial|Familial diseases]] | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Polycystic kidney disease]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Polycystic kidney disease]]'''<ref name="pmid8321262">{{cite journal |vauthors=Gabow PA |title=Autosomal dominant polycystic kidney disease |journal=N. Engl. J. Med. |volume=329 |issue=5 |pages=332–42 |date=July 1993 |pmid=8321262 |doi=10.1056/NEJM199307293290508 |url=}}</ref><ref name="pmid16523049">{{cite journal |vauthors=Adeva M, El-Youssef M, Rossetti S, Kamath PS, Kubly V, Consugar MB, Milliner DM, King BF, Torres VE, Harris PC |title=Clinical and molecular characterization defines a broadened spectrum of autosomal recessive polycystic kidney disease (ARPKD) |journal=Medicine (Baltimore) |volume=85 |issue=1 |pages=1–21 |date=January 2006 |pmid=16523049 |doi=10.1097/01.md.0000200165.90373.9a |url=}}</ref>''' | ||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| Line 386: | Line 387: | ||
| style="background: #F5F5F5; padding: 5px;" |Ultrasound: | | style="background: #F5F5F5; padding: 5px;" |Ultrasound: | ||
* Unilateral or bilateral [[cysts]] | * Unilateral or bilateral [[cysts]] | ||
CT: | [[CT-scans|CT]]: | ||
* Hyperdense appearance, | * Hyperdense appearance, | ||
* Septations | * Septations | ||
| Line 399: | Line 400: | ||
* Tubular atrophy | * Tubular atrophy | ||
* Thickening and lamellation of tubular basement membranes | * Thickening and lamellation of tubular basement membranes | ||
| style="background: #F5F5F5; padding: 5px;" |[[Ultrasound]] | |||
| style="background: #F5F5F5; padding: 5px;" |Ultrasound | |||
|- | |- | ||
| rowspan="3" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Vascular anomaly|Vascular diseases]] | | rowspan="3" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Vascular anomaly|Vascular diseases]] | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Renal vein thrombosis]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Renal vein thrombosis]]<ref>{{Cite journal | ||
| author = [[U. Kuhlmann]], [[J. Steurer]], [[A. Bollinger]], [[G. Pouliadis]], [[J. Briner]] & [[W. Siegenthaler]] | |||
| title = [Incidence and clinical significance of thromboses and thrombo-embolic complications in nephrotic syndrome patients] | |||
| journal = [[Schweizerische medizinische Wochenschrift]] | |||
| volume = 111 | |||
| issue = 27-28 | |||
| pages = 1034–1040 | |||
| year = 1981 | |||
| month = July | |||
| pmid = 7268357 | |||
}}</ref><ref>{{Cite journal | |||
| author = [[F. Llach]], [[S. Papper]] & [[S. G. Massry]] | |||
| title = The clinical spectrum of renal vein thrombosis: acute and chronic | |||
| journal = [[The American journal of medicine]] | |||
| volume = 69 | |||
| issue = 6 | |||
| pages = 819–827 | |||
| year = 1980 | |||
| month = December | |||
| pmid = 7446547 | |||
}}</ref> | |||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
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| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Asymptomatic | * Asymptomatic | ||
* Abdominal pain | * [[Abdominal pain]] | ||
* Acute in onset | * Acute in onset | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Elevation in serum lactate dehydrogenase | * Elevation in serum [[lactate dehydrogenase]] | ||
* Cholesterol levels for | * [[Cholesterol]] levels for hyper-cholesterolemia | ||
* Albumin levels for hypoalbuminemia | * [[Albumin]] levels for hypoalbuminemia | ||
* Serum complement levels | * Serum [[complement]] levels | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Ultrasound | * [[Ultrasound]] | ||
* Venography | * [[Venography]] | ||
| style="background: #F5F5F5; padding: 5px;" |'''Renal venography:''' Gold standard | | style="background: #F5F5F5; padding: 5px;" |'''Renal venography:''' Gold standard | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Granulomatosis with polyangiitis|Wegner's granulomatosis polyangiitis]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Granulomatosis with polyangiitis|Wegner's granulomatosis polyangiitis]]<ref name="pmid27733943">{{cite journal| author=Pagnoux C| title=Updates in ANCA-associated vasculitis. | journal=Eur J Rheumatol | year= 2016 | volume= 3 | issue= 3 | pages= 122-133 | pmid=27733943 | doi=10.5152/eurjrheum.2015.0043 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27733943 }}</ref><ref name="pmid12541109">{{cite journal |vauthors=Lee KS, Kim TS, Fujimoto K, Moriya H, Watanabe H, Tateishi U, Ashizawa K, Johkoh T, Kim EA, Kwon OJ |title=Thoracic manifestation of Wegener's granulomatosis: CT findings in 30 patients |journal=Eur Radiol |volume=13 |issue=1 |pages=43–51 |year=2003 |pmid=12541109 |doi=10.1007/s00330-002-1422-2 |url=}}</ref><ref name="pmid17133251">{{cite journal| author=Kallenberg CG, Heeringa P, Stegeman CA| title=Mechanisms of Disease: pathogenesis and treatment of ANCA-associated vasculitides. | journal=Nat Clin Pract Rheumatol | year= 2006 | volume= 2 | issue= 12 | pages= 661-70 | pmid=17133251 | doi=10.1038/ncprheum0355 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17133251 }}</ref><ref name="pmid93665842">{{cite journal |vauthors=Jennette JC, Falk RJ |title=Small-vessel vasculitis |journal=N. Engl. J. Med. |volume=337 |issue=21 |pages=1512–23 |date=November 1997 |pmid=9366584 |doi=10.1056/NEJM199711203372106 |url=}}</ref> | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| Line 436: | Line 476: | ||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* URTI | * [[Upper respiratory tract infection|URTI]] | ||
* CNS involvement | * [[CNS]] involvement | ||
* Ophthalmic involvement | * [[Ophthalmic]] involvement | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* | * [[Proteinuria]] | ||
* Microscopic hematuria | * Microscopic [[hematuria]] | ||
* RBC casts | * [[RBC casts]] | ||
| style="background: #F5F5F5; padding: 5px;" | CT chest: | | style="background: #F5F5F5; padding: 5px;" | [[Computed tomography|CT]] chest: | ||
* Multiple [[Pulmonary nodule|lung nodules]] | * Multiple [[Pulmonary nodule|lung nodules]] | ||
* [[Consolidation (medicine)|Consolidation]] | * [[Consolidation (medicine)|Consolidation]] | ||
| Line 455: | Line 495: | ||
| style="background: #F5F5F5; padding: 5px;" |Biopsy | | style="background: #F5F5F5; padding: 5px;" |Biopsy | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Henoch-Schönlein purpura]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Henoch-Schönlein purpura]]<ref name="pmid9366584">{{cite journal |vauthors=Jennette JC, Falk RJ |title=Small-vessel vasculitis |journal=N. Engl. J. Med. |volume=337 |issue=21 |pages=1512–23 |date=November 1997 |pmid=9366584 |doi=10.1056/NEJM199711203372106 |url=}}</ref><ref name="pmid25557596">{{cite journal |vauthors=Chen JY, Mao JH |title=Henoch-Schönlein purpura nephritis in children: incidence, pathogenesis and management |journal=World J Pediatr |volume=11 |issue=1 |pages=29–34 |date=February 2015 |pmid=25557596 |doi=10.1007/s12519-014-0534-5 |url=}}</ref> | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| Line 465: | Line 505: | ||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Abdominal pain | * [[Abdominal pain]] | ||
* Rash | * [[Rash]] | ||
* Hematuria | * [[Hematuria]] | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* | * [[Proteinuria]] | ||
* Microscopic hematuria | * Microscopic [[hematuria]] | ||
* RBC casts | * [[Urinary casts|RBC casts]] | ||
| style="background: #F5F5F5; padding: 5px;" |Biopsy: | | style="background: #F5F5F5; padding: 5px;" |Biopsy: | ||
IgA deposited in a diffuse granular pattern in the mesangium | [[Immunoglobulin A|IgA]] deposited in a diffuse [[Granule cell|granular]] pattern in the [[mesangium]] | ||
| style="background: #F5F5F5; padding: 5px;" |Renal biopsy, and clinical syndrome | | style="background: #F5F5F5; padding: 5px;" |Renal biopsy, and clinical syndrome | ||
|- | |- | ||
| Line 503: | Line 543: | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Nocturia | * [[Nocturia]] | ||
* Other voiding symptoms | * Other voiding symptoms | ||
** Slow urinary stream | ** Slow urinary stream | ||
** Splitting or spraying of the urinary stream | ** Splitting or spraying of the [[Urinary system|urinary]] stream | ||
** Intermittent urinary stream | ** Intermittent urinary stream | ||
** Hesitancy | ** Hesitancy | ||
| Line 512: | Line 552: | ||
** Terminal dribbling | ** Terminal dribbling | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Urinalysis to rule out UTI | * Urinalysis to rule out [[Urinary tract infection|UTI]] | ||
* Elevated BUN/Cr | * Elevated [[Blood urea nitrogen|BUN]]/[[Creatinine|Cr]] | ||
* High PSA values | * High [[Prostate specific antigen|PSA]] values | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Urine cytology to screen for bladder cancer | * Urine cytology to screen for bladder cancer | ||
| Line 520: | Line 560: | ||
| style="background: #F5F5F5; padding: 5px;" |Biopsy | | style="background: #F5F5F5; padding: 5px;" |Biopsy | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Urolithiasis]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Urolithiasis]]<ref name="pmid126499872">{{cite journal |vauthors=Hochreiter W, Knoll T, Hess B |title=[Pathophysiology, diagnosis and conservative therapy of non-calcium kidney calculi] |language=German |journal=Ther Umsch |volume=60 |issue=2 |pages=89–97 |date=February 2003 |pmid=12649987 |doi=10.1024/0040-5930.60.2.89 |url=}}</ref><ref name="pmid24818849">{{cite journal |vauthors=Flannigan R, Choy WH, Chew B, Lange D |title=Renal struvite stones--pathogenesis, microbiology, and management strategies |journal=Nat Rev Urol |volume=11 |issue=6 |pages=333–41 |date=June 2014 |pmid=24818849 |doi=10.1038/nrurol.2014.99 |url=}}</ref><ref name="pmid25685869">{{cite journal |vauthors=Pereira DJ, Schoolwerth AC, Pais VM |title=Cystinuria: current concepts and future directions |journal=Clin. Nephrol. |volume=83 |issue=3 |pages=138–46 |date=March 2015 |pmid=25685869 |doi= |url=}}</ref> | ||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" | +/- | | style="background: #F5F5F5; padding: 5px;" | +/- | ||
| Line 529: | Line 569: | ||
| 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;" | | ||
* Urine analysis | * [[Flanks|Flank]] | ||
* [[Groin]] pain | |||
| style="background: #F5F5F5; padding: 5px;" | | |||
* [[Urine|Urine analysis]] | |||
* High Cr | * High [[Creatinine|Cr]] | ||
| style="background: #F5F5F5; padding: 5px;" |Abdominppelvic CT scan without contrast | | style="background: #F5F5F5; padding: 5px;" |Abdominppelvic [[Computed tomography|CT scan]] without contrast | ||
| style="background: #F5F5F5; padding: 5px;" |Abdominppelvic CT scan without contrast | | style="background: #F5F5F5; padding: 5px;" |Abdominppelvic [[Computed tomography|CT scan]] without contrast | ||
|- | |- | ||
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Disease | ! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Disease | ||
| Line 553: | Line 595: | ||
|- | |- | ||
| rowspan="4" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Infectious disease|Infectious diseases]] | | rowspan="4" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Infectious disease|Infectious diseases]] | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pyelonephritis]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pyelonephritis]]<ref name="pmid256858692">{{cite journal |vauthors=Pereira DJ, Schoolwerth AC, Pais VM |title=Cystinuria: current concepts and future directions |journal=Clin. Nephrol. |volume=83 |issue=3 |pages=138–46 |date=March 2015 |pmid=25685869 |doi= |url=}}</ref><ref name="pmid18092884">{{cite journal| author=Rosen DA, Hooton TM, Stamm WE, Humphrey PA, Hultgren SJ| title=Detection of intracellular bacterial communities in human urinary tract infection. | journal=PLoS Med | year= 2007 | volume= 4 | issue= 12 | pages= e329 | pmid=18092884 | doi=10.1371/journal.pmed.0040329 | pmc=2140087 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18092884 }}</ref> | ||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
| Line 568: | Line 610: | ||
* Positive [[leukocyte esterase]] test and [[nitrite test]]. | * Positive [[leukocyte esterase]] test and [[nitrite test]]. | ||
* Blood/urine cultures | * Blood/urine cultures | ||
| style="background: #F5F5F5; padding: 5px;" |CT and ultrasound: | | style="background: #F5F5F5; padding: 5px;" |[[Computed tomography|CT]] and [[ultrasound]]: | ||
* Enlarged kidneys | * Enlarged [[Kidney|kidneys]] | ||
* Round swollen [[Kidney|kidneys]] | * Round swollen [[Kidney|kidneys]] | ||
* Hypodense appearance | * Hypodense appearance | ||
| Line 575: | Line 617: | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Cystitis]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Cystitis]]<ref name="pmid16298166">{{cite journal| author=Franco AV| title=Recurrent urinary tract infections. | journal=Best Pract Res Clin Obstet Gynaecol | year= 2005 | volume= 19 | issue= 6 | pages= 861-73 | pmid=16298166 | doi=10.1016/j.bpobgyn.2005.08.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16298166 }}</ref><ref name="pmid162981662">{{cite journal| author=Franco AV| title=Recurrent urinary tract infections. | journal=Best Pract Res Clin Obstet Gynaecol | year= 2005 | volume= 19 | issue= 6 | pages= 861-73 | pmid=16298166 | doi=10.1016/j.bpobgyn.2005.08.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16298166 }}</ref> | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| Line 588: | Line 630: | ||
* Supra pubic tenderness | * Supra pubic tenderness | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* [[Pyuria]]: > 5-10 WBC/hpf or 27 [[WBC]]/microliter | * [[Pyuria]]: > 5-10 [[White blood cells|WBC]]/hpf or 27 [[WBC]]/microliter | ||
* Positive [[leukocyte esterase]] test and [[nitrite test]]. | * Positive [[leukocyte esterase]] test and [[nitrite test]]. | ||
* Positive urine/blood cultures | * Positive urine/blood cultures | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |[[Ultrasound|Ultrasound:]] | ||
* Presence of gas in the bladder wall. | |||
* Presence of | |||
* Also help to detect the presence of a [[tumor]] or a [[Stone massage|stone]]. | * Also, help to detect the presence of a [[tumor]] or a [[Stone massage|stone]]. | ||
| style="background: #F5F5F5; padding: 5px;" |Urine culture | | style="background: #F5F5F5; padding: 5px;" |Urine culture | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Prostatitis]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Prostatitis]]<ref>{{Cite journal | ||
| author = [[John N. Krieger]], [[Ulrich Dobrindt]], [[Donald E. Riley]] & [[Eric Oswald]] | |||
| title = Acute Escherichia coli prostatitis in previously health young men: bacterial virulence factors, antimicrobial resistance, and clinical outcomes | |||
| journal = [[Urology]] | |||
| volume = 77 | |||
| issue = 6 | |||
| pages = 1420–1425 | |||
| year = 2011 | |||
| month = June | |||
| doi = 10.1016/j.urology.2010.12.059 | |||
| pmid = 21459419 | |||
}}</ref><ref name="pmid20704171">{{cite journal| author=Sharp VJ, Takacs EB, Powell CR| title=Prostatitis: diagnosis and treatment. | journal=Am Fam Physician | year= 2010 | volume= 82 | issue= 4 | pages= 397-406 | pmid=20704171 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20704171 }}</ref> | |||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
| Line 610: | Line 662: | ||
* Body aches | * Body aches | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Increased [[leukocytes]] (>10 per high power field) on CBC | * Increased [[leukocytes]] (>10 per high power field) on [[Complete blood count|CBC]] | ||
* Bacteria seen on [[urine culture]] | * Bacteria seen on [[urine culture]] | ||
* Elevated [[C-reactive protein]] | * Elevated [[C-reactive protein]] | ||
* Transiently elevated [[PSA]] (prostate specific antigen) levels | * Transiently elevated [[PSA]] ([[prostate specific antigen]]) levels | ||
| style="background: #F5F5F5; padding: 5px;" |Ultrasound: | | style="background: #F5F5F5; padding: 5px;" |[[Ultrasound|Ultrasound:]] | ||
* Focal hypoechoic region located in the peripheral part of the [[prostate]] | * Focal hypoechoic region located in the peripheral part of the [[prostate]] | ||
CT scan: | [[Computed tomography|CT scan:]] | ||
* Edema of the [[prostate gland]] with diffuse enlargement,. | * Edema of the [[prostate gland]] with diffuse enlargement,. | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Urethritis]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Urethritis]]<ref name="pmid1538163">{{cite journal |vauthors=McNagny SE, Parker RM, Zenilman JM, Lewis JS |title=Urinary leukocyte esterase test: a screening method for the detection of asymptomatic chlamydial and gonococcal infections in men |journal=J. Infect. Dis. |volume=165 |issue=3 |pages=573–6 |year=1992 |pmid=1538163 |doi= |url=}}</ref><ref name="pmid20353145">{{cite journal |vauthors=Brill JR |title=Diagnosis and treatment of urethritis in men |journal=Am Fam Physician |volume=81 |issue=7 |pages=873–8 |year=2010 |pmid=20353145 |doi= |url=}}</ref> | ||
| style="background: #F5F5F5; padding: 5px;" | -/- | | style="background: #F5F5F5; padding: 5px;" | -/- | ||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
| Line 630: | Line 682: | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Urethral discharge | * [[Urethral]] discharge | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Mucoid, [[mucopurulent]], or [[purulent]] [[discharge]] | * Mucoid, [[mucopurulent]], or [[purulent]] [[discharge]] | ||
| Line 636: | Line 688: | ||
* Positive leukocyte esterase test. | * Positive leukocyte esterase test. | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
CT scan: | [[Computed tomography|CT scan]]: | ||
* Diffuse, circumferential urothelial wall thickening and contrast-enhancement | * Diffuse, circumferential urothelial wall thickening and [[contrast]]-enhancement | ||
* Periureteric or perinephric fat stranding. | * Periureteric or perinephric fat stranding. | ||
| style="background: #F5F5F5; padding: 5px;" |Urine culture | | style="background: #F5F5F5; padding: 5px;" |[[Urine culture]] | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Urogenital|Urogenital trauma]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Urogenital|Urogenital trauma]] | ||
| Line 652: | Line 704: | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* History of | * History of [[Physical trauma|trauma]] | ||
| style="background: #F5F5F5; padding: 5px;" |Hematuria | | style="background: #F5F5F5; padding: 5px;" | | ||
| style="background: #F5F5F5; padding: 5px;" |Retrograde | * [[Hematuria]] | ||
| style="background: #F5F5F5; padding: 5px;" |Retrograde | | style="background: #F5F5F5; padding: 5px;" | | ||
* Retrograde urethrogram (RUG) | |||
| style="background: #F5F5F5; padding: 5px;" | | |||
* Retrograde urethrogram (RUG) | |||
|} | |} | ||
Latest revision as of 21:26, 14 February 2019
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shanshan Cen, M.D. [2]
Overview
Bladder cancer must be differentiated from renal cancer, renal stones, prostate cancer, and cystitis.
Differential Diagnosis
The most common presentation of bladder cancer is hematuria; however in the advanced cases, the presentation can be bladder mass.
Bladder cancer must be differentiated from other causes of hematuria as in the below table:
| Diseases | Clinical manifestations | Para-clinical findings | Gold standard | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Symptoms | Physical examina | ||||||||||||
| Lab Findings | Diagnosi | ||||||||||||
| Low back pain | Fever | Nausea/
Vomiting |
Urinary symptoms | Hypertension | Pitting edema | Other | |||||||
| Dysuria | Frequency | Oliguria | |||||||||||
| Glomerular diseases | IgA nephropathy[1][2] (Berger nephropathy) | + | - | - | - | + | + | + | - | - | Biopsy:
IgA deposited in a diffuse granular pattern in the mesangium |
Biopsy
| |
| Hereditary nephritis[3][4] (Alport syndrome) | - | - | - | - | - | - | + | - |
|
Biopsy:
|
Genetic analysis | ||
| Post-streptococcal glomerulonephritis[5][6] | +/- | + | - | - | + | + | + | + |
|
Biopsy
|
Biopsy | ||
| Focal segmental glomerular sclerosis[7][8][9] | - | - | - | - | - | - | + | + |
|
Biopsy | Biopsy | ||
| Rapidly progressive glomerulonephritis[10][11][12] | + | + | + | - | - | - | + | - |
|
|
Biopsy:
|
Biopsy | |
| Lupus nephritis[13][14] | - | + | - | - | - | - | + | + |
|
|
Biopsy,
|
Biopsy | |
| Fabry disease | - | - | - | - | - | - | + | + | - | Biopsy | Biopsy | ||
| Disease | Low back pain | Fever | Nausea/
Vomiting |
Dysuria | Frequency | Oliguria | Hypertension | Pitting edema | Other | Lab Findings | Diagnosis method | Gold standard | |
| Tubulointerstitial diseases[15][16][17] | + | + | + | – | – | – | – | – | Rash | Biopsy:
|
Renal biopsy | ||
| Nephrolithiasis[18][19] | + | ± | + | ± | ± | ± | – | – |
|
|
Abdominal CT scan without contrast | ||
| Reflux nephropathy (hydronephrosis) | + | + | - | - | - | - | - | + |
|
|
– | ||
| Malignancy | Renal cell carcinoma (RCC)[20][21] | - | - | - | - | - | - | ± | ± |
|
|
– | |
| Nephroblastoma (Wilms tumor)[22][23] | - | - | - | - | - | - | - | - |
Biopsy:
|
Biopsy | |||
| Bladder cancer[27][28][29] | - | - | - | - | ± | ± | - | - | Suprapubic pain | Ultrasound, CT scan, Biopsy | Biopsy | ||
| Prostate cancer[30][31] | ± | - | - | - | ± | ± | - | - | - | Ultrasound, CT scan, Biopsy | Biopsy | ||
| Disease | Low back pain | Fever | Nausea/
Vomiting |
Dysuria | Frequency | Oliguria | Hypertension | Pitting edema | Other | Lab Findings | Diagnosis method | Gold standard | |
| Familial diseases | Polycystic kidney disease[32][33] | + | - | - | - | - | - | + | + |
|
Ultrasound:
CT:
Genetic testing demonstrates: Biopsy:
|
Ultrasound | |
| Vascular diseases | Renal vein thrombosis[34][35] | + | + | + | - | - | - | - | - |
|
|
Renal venography: Gold standard | |
| Wegner's granulomatosis polyangiitis[36][37][38][39] | - | - | - | - | - | +/- | + | + |
|
|
CT chest:
Biopsy:
|
Biopsy | |
| Henoch-Schönlein purpura[40][41] | - | - | - | - | - | +/- | +/- | + |
|
Biopsy:
IgA deposited in a diffuse granular pattern in the mesangium |
Renal biopsy, and clinical syndrome | ||
| Disease | Low back pain | Fever | Nausea/
Vomiting |
Dysuria | Frequency | Oliguria | Hypertension | Pitting edema | Other | Lab Findings | Diagnosis method | Gold standard | |
| Lower urinary tract diseases | Benign prostatic hyperplasia | +/- | - | - | + | + | - | - | - |
|
Biopsy | ||
| Urolithiasis[42][43][44] | + | +/- | + | + | + | + | - | - |
|
Abdominppelvic CT scan without contrast | Abdominppelvic CT scan without contrast | ||
| Disease | Low back pain | Fever | Nausea/
Vomiting |
Dysuria | Frequency | Oliguria | Hypertension | Pitting edema | Other | Lab Findings | Diagnosis method | Gold standard | |
| Infectious diseases | Pyelonephritis[45][46] | + | + | + | + | + | + | - | - |
|
CT and ultrasound: | - | |
| Cystitis[47][48] | - | - | - | + | + | + | - | - |
|
|
Ultrasound:
|
Urine culture | |
| Prostatitis[49][50] | - | + | - | + | + | + | - | - |
|
|
Ultrasound:
|
- | |
| Urethritis[51][52] | -/- | + | - | + | + | + | - | - |
|
|
|
Urine culture | |
| Urogenital trauma | Inserted bladder or ureteral catheters | - | - | - | + | + | + | - | - |
|
|
| |
Lower abdominal mass can be classified to the gynecological and non-gynecological causes. Bladder cancer in the advanced cases can present as a bladder mass. Below table discusses lower abdominal mass causes:
References
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|month=ignored (help) - ↑ F. Llach, S. Papper & S. G. Massry (1980). "The clinical spectrum of renal vein thrombosis: acute and chronic". The American journal of medicine. 69 (6): 819–827. PMID 7446547. Unknown parameter
|month=ignored (help) - ↑ Pagnoux C (2016). "Updates in ANCA-associated vasculitis". Eur J Rheumatol. 3 (3): 122–133. doi:10.5152/eurjrheum.2015.0043. PMID 27733943.
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- ↑ Chen JY, Mao JH (February 2015). "Henoch-Schönlein purpura nephritis in children: incidence, pathogenesis and management". World J Pediatr. 11 (1): 29–34. doi:10.1007/s12519-014-0534-5. PMID 25557596.
- ↑ Hochreiter W, Knoll T, Hess B (February 2003). "[Pathophysiology, diagnosis and conservative therapy of non-calcium kidney calculi]". Ther Umsch (in German). 60 (2): 89–97. doi:10.1024/0040-5930.60.2.89. PMID 12649987.
- ↑ Flannigan R, Choy WH, Chew B, Lange D (June 2014). "Renal struvite stones--pathogenesis, microbiology, and management strategies". Nat Rev Urol. 11 (6): 333–41. doi:10.1038/nrurol.2014.99. PMID 24818849.
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|month=ignored (help) - ↑ Sharp VJ, Takacs EB, Powell CR (2010). "Prostatitis: diagnosis and treatment". Am Fam Physician. 82 (4): 397–406. PMID 20704171.
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