Lymphomatoid granulomatosis differential diagnosis: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
No edit summary
 
(44 intermediate revisions by 2 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Lymphomatoid granulomatosis}}
[[Image:Home_logo1.png|right|250px|link=http://www.wikidoc.org/index.php/Lymphomatoid_granulomatosis]]
{{CMG}}; {{AE}}  
{{CMG}}; {{AE}} {{kakbar}}


==Overview==
==Overview==
Lymphamtoid granulomatosis must be differentiated from Bronchocentric granulomatosis and Churg-Strauss, Necrotizing sarcoid granulomatosis, Wegeners granulomatosis, Hodgkins disease, Non-hodgkin lymphoma, and Nasal angiocentric lymphoma
Lymphamtoid granulomatosis must be differentiated from [[bronchocentric granulomatosis]] and [[Eosinophilic granulomatosis with polyangiitis|Churg-Strauss]], [[Sarcoidosis|necrotizing sarcoid granulomatosis]], [[Wegeners granulomatosis differential diagnosis|Wegeners granulomatosis]], [[Hodgkin's lymphoma|Hodgkins disease]], [[Non-Hodgkin lymphoma|non-Hodgkin lymphoma]], and [[Nasal lymphoma|Nasal angiocentric lymphoma]]


==Differentiating Lymphamatoid granulomatosis from other Diseases==
==Differentiating Lymphamatoid granulomatosis from other Diseases==


As Lymphamatoid granulomatosis  manifests in a variety of clinical forms, differentiation must be established in accordance with the particular subtypes pulmonary being the most common. The sub types are the following:<ref name="pmid23006954">{{cite journal| author=Roschewski M, Wilson WH| title=Lymphomatoid granulomatosis. | journal=Cancer J | year= 2012 | volume= 18 | issue= 5 | pages= 469-74 | pmid=23006954 | doi=10.1097/PPO.0b013e31826c5e19 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23006954  }} </ref><ref name="pmid24678394">{{cite journal| author=Fernandez-Alvarez R, Gonzalez M, Fernandez A, Gonzalez-Rodriguez A, Sancho J, Dominguez F et al.| title=Lymphomatoid granulomatosis of central nervous system and lung driven by epstein barr virus proliferation: successful treatment with rituximab-containing chemotherapy. | journal=Mediterr J Hematol Infect Dis | year= 2014 | volume= 6 | issue= 1 | pages= e2014017 | pmid=24678394 | doi=10.4084/MJHID.2014.017 | pmc=3965717 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24678394  }} </ref><ref name="pmid27051739">{{cite journal| author=Shaigany S, Weitz NA, Husain S, Geskin L, Grossman ME| title=A case of lymphomatoid granulomatosis presenting with cutaneous lesions. | journal=JAAD Case Rep | year= 2015 | volume= 1 | issue= 4 | pages= 234-7 | pmid=27051739 | doi=10.1016/j.jdcr.2015.05.008 | pmc=4808726 | url=
As Lymphamatoid granulomatosis  manifests in a variety of clinical forms, differentiation must be established in accordance with the particular subtypes pulmonary being the most common. The sub types are the following:<ref name="pmid23006954">{{cite journal| author=Roschewski M, Wilson WH| title=Lymphomatoid granulomatosis. | journal=Cancer J | year= 2012 | volume= 18 | issue= 5 | pages= 469-74 | pmid=23006954 | doi=10.1097/PPO.0b013e31826c5e19 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23006954  }} </ref><ref name="pmid24678394">{{cite journal| author=Fernandez-Alvarez R, Gonzalez M, Fernandez A, Gonzalez-Rodriguez A, Sancho J, Dominguez F et al.| title=Lymphomatoid granulomatosis of central nervous system and lung driven by epstein barr virus proliferation: successful treatment with rituximab-containing chemotherapy. | journal=Mediterr J Hematol Infect Dis | year= 2014 | volume= 6 | issue= 1 | pages= e2014017 | pmid=24678394 | doi=10.4084/MJHID.2014.017 | pmc=3965717 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24678394  }} </ref><ref name="pmid27051739"><nowiki>{{cite journal| author=Shaigany S, Weitz NA, Husain S, Geskin L, Grossman ME| title=A case of lymphomatoid granulomatosis presenting with cutaneous lesions. | journal=JAAD Case Rep | year= 2015 | volume= 1 | issue= 4 | pages= 234-7 | pmid=27051739 | doi=10.1016/j.jdcr.2015.05.008 | pmc=4808726 | url=</nowiki>
*Pulmonary
*Pulmonary
*CNS
*CNS
*Dermatologic
*Cutaneous


Pulmonary Lymphamatoid granulomatosis must be differentiated from other diseases that cause:<ref name="pmid26078192">{{cite journal| author=Santalla-Martínez M, García-Quiroga H, Navarro-Menéndez I| title=Pulmonary lymphomatoid granulomatosis. A rare entity in the differential diagnosis of pulmonary nodules. | journal=Arch Bronconeumol | year= 2015 | volume= 51 | issue= 11 | pages= 606-7 | pmid=26078192 | doi=10.1016/j.arbres.2015.05.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26078192  }} </ref><ref name="pmid25399945">{{cite journal| author=Miloslavsky EM, Stone JH, Unizony SH| title=Challenging mimickers of primary systemic vasculitis. | journal=Rheum Dis Clin North Am | year= 2015 | volume= 41 | issue= 1 | pages= 141-60, ix | pmid=25399945 | doi=10.1016/j.rdc.2014.09.011 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25399945  }} </ref><ref name="pmid24466760">{{cite journal| author=Tagliavini E, Rossi G, Valli R, Zanelli M, Cadioli A, Mengoli MC et al.| title=Lymphomatoid granulomatosis: a practical review for pathologists dealing with this rare pulmonary lymphoproliferative process. | journal=Pathologica | year= 2013 | volume= 105 | issue= 4 | pages= 111-6 | pmid=24466760 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24466760  }} </ref><ref name="pmid7053488">{{cite journal| author=Fauci AS, Haynes BF, Costa J, Katz P, Wolff SM| title=Lymphomatoid Granulomatosis. Prospective clinical and therapeutic experience over 10 years. | journal=N Engl J Med | year= 1982 | volume= 306 | issue= 2 | pages= 68-74 | pmid=7053488 | doi=10.1056/NEJM198201143060203 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7053488  }} </ref>
Pulmonary Lymphamatoid granulomatosis must be differentiated from other diseases that cause:<nowiki><ref name="pmid26078192"></nowiki>{{cite journal| author=Santalla-Martínez M, García-Quiroga H, Navarro-Menéndez I| title=Pulmonary lymphomatoid granulomatosis. A rare entity in the differential diagnosis of pulmonary nodules. | journal=Arch Bronconeumol | year= 2015 | volume= 51 | issue= 11 | pages= 606-7 | pmid=26078192 | doi=10.1016/j.arbres.2015.05.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26078192  }} </ref><ref name="pmid25399945">{{cite journal| author=Miloslavsky EM, Stone JH, Unizony SH| title=Challenging mimickers of primary systemic vasculitis. | journal=Rheum Dis Clin North Am | year= 2015 | volume= 41 | issue= 1 | pages= 141-60, ix | pmid=25399945 | doi=10.1016/j.rdc.2014.09.011 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25399945  }} </ref><ref name="pmid24466760">{{cite journal| author=Tagliavini E, Rossi G, Valli R, Zanelli M, Cadioli A, Mengoli MC et al.| title=Lymphomatoid granulomatosis: a practical review for pathologists dealing with this rare pulmonary lymphoproliferative process. | journal=Pathologica | year= 2013 | volume= 105 | issue= 4 | pages= 111-6 | pmid=24466760 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24466760  }} </ref><ref name="pmid7053488">{{cite journal| author=Fauci AS, Haynes BF, Costa J, Katz P, Wolff SM| title=Lymphomatoid Granulomatosis. Prospective clinical and therapeutic experience over 10 years. | journal=N Engl J Med | year= 1982 | volume= 306 | issue= 2 | pages= 68-74 | pmid=7053488 | doi=10.1056/NEJM198201143060203 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7053488  }} </ref>
*Cough(non-productive, rarely hemoptysis can occur)<ref name="pmid26631890">{{cite journal| author=Xu B, Liu H, Wang B, Zhang H, Wu H, Jin R et al.| title=Fever, Dry Cough and Exertional Dyspnea: Pulmonary Lymphomatoid Granulomatosis Masquerading as Pneumonia, Granulomatosis with Polyangiitis and Infectious Mononucleosis. | journal=Intern Med | year= 2015 | volume= 54 | issue= 23 | pages= 3045-9 | pmid=26631890 | doi=10.2169/internalmedicine.54.4822 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26631890  }} </ref><ref name="pmid25163591">{{cite journal| author=Ameli F, Ghafourian F, Masir N| title=Systematic Epstein-Barr virus-positive T-cell lymphoproliferative disease presenting as a persistent fever and cough: a case report. | journal=J Med Case Rep | year= 2014 | volume= 8 | issue=  | pages= 288 | pmid=25163591 | doi=10.1186/1752-1947-8-288 | pmc=4150421 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25163591  }} </ref>
*[[Cough]](non-productive, rarely hemoptysis can occur)<ref name="pmid26631890">{{cite journal| author=Xu B, Liu H, Wang B, Zhang H, Wu H, Jin R et al.| title=Fever, Dry Cough and Exertional Dyspnea: Pulmonary Lymphomatoid Granulomatosis Masquerading as Pneumonia, Granulomatosis with Polyangiitis and Infectious Mononucleosis. | journal=Intern Med | year= 2015 | volume= 54 | issue= 23 | pages= 3045-9 | pmid=26631890 | doi=10.2169/internalmedicine.54.4822 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26631890  }} </ref><ref name="pmid25163591">{{cite journal| author=Ameli F, Ghafourian F, Masir N| title=Systematic Epstein-Barr virus-positive T-cell lymphoproliferative disease presenting as a persistent fever and cough: a case report. | journal=J Med Case Rep | year= 2014 | volume= 8 | issue=  | pages= 288 | pmid=25163591 | doi=10.1186/1752-1947-8-288 | pmc=4150421 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25163591  }} </ref>
*Dyspnea<ref name="pmid21968985">{{cite journal| author=Olusina D, Ezemba N, Nzegwu MA| title=Pulmonary Lymphomatoid Granulomatosis: Report of A Case and Review of Literature. | journal=Niger Med J | year= 2011 | volume= 52 | issue= 1 | pages= 60-63 | pmid=21968985 | doi= | pmc=3180752 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21968985  }} </ref>
*[[Dyspnea]]<ref name="pmid21968985">{{cite journal| author=Olusina D, Ezemba N, Nzegwu MA| title=Pulmonary Lymphomatoid Granulomatosis: Report of A Case and Review of Literature. | journal=Niger Med J | year= 2011 | volume= 52 | issue= 1 | pages= 60-63 | pmid=21968985 | doi= | pmc=3180752 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21968985  }} </ref>
*Chest tightness<ref name="pmid26966605">{{cite journal| author=O'Brien S, Schmidt P| title=Lymphomatoid Granulomatosis with Paraneoplastic Polymyositis: A Rare Malignancy with Rare Complication. | journal=Case Rep Rheumatol | year= 2016 | volume= 2016 | issue=  | pages= 8242597 | pmid=26966605 | doi=10.1155/2016/8242597 | pmc=4757691 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26966605  }} </ref>
*[[Chest tightness]]<ref name="pmid26966605">{{cite journal| author=O'Brien S, Schmidt P| title=Lymphomatoid Granulomatosis with Paraneoplastic Polymyositis: A Rare Malignancy with Rare Complication. | journal=Case Rep Rheumatol | year= 2016 | volume= 2016 | issue=  | pages= 8242597 | pmid=26966605 | doi=10.1155/2016/8242597 | pmc=4757691 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26966605  }} </ref>
Other Symptoms that are asscociated with the pulmonary symptoms are:<ref name="pmid26966605">{{cite journal| author=O'Brien S, Schmidt P| title=Lymphomatoid Granulomatosis with Paraneoplastic Polymyositis: A Rare Malignancy with Rare Complication. | journal=Case Rep Rheumatol | year= 2016 | volume= 2016 | issue=  | pages= 8242597 | pmid=26966605 | doi=10.1155/2016/8242597 | pmc=4757691 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26966605  }} </ref><ref name="pmid22711054">{{cite journal| author=Alinari L, Pant S, McNamara K, Kalmar JR, Marsh W, Allen CM et al.| title=Lymphomatoid granulomatosis presenting with gingival involvement in an immune competent elderly male. | journal=Head Neck Pathol | year= 2012 | volume= 6 | issue= 4 | pages= 496-501 | pmid=22711054 | doi=10.1007/s12105-012-0378-z | pmc=3500898 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22711054  }} </ref> <ref name="pmid30288554">{{cite journal| author=Alexandra G, Claudia G| title=Lymphomatoid granulomatosis mimicking cancer and sarcoidosis. | journal=Ann Hematol | year= 2018 | volume=  | issue=  | pages=  | pmid=30288554 | doi=10.1007/s00277-018-3505-4 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30288554  }} </ref>
Other Symptoms that are asscociated with the pulmonary symptoms are:<ref name="pmid26966605">{{cite journal| author=O'Brien S, Schmidt P| title=Lymphomatoid Granulomatosis with Paraneoplastic Polymyositis: A Rare Malignancy with Rare Complication. | journal=Case Rep Rheumatol | year= 2016 | volume= 2016 | issue=  | pages= 8242597 | pmid=26966605 | doi=10.1155/2016/8242597 | pmc=4757691 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26966605  }} </ref><ref name="pmid22711054">{{cite journal| author=Alinari L, Pant S, McNamara K, Kalmar JR, Marsh W, Allen CM et al.| title=Lymphomatoid granulomatosis presenting with gingival involvement in an immune competent elderly male. | journal=Head Neck Pathol | year= 2012 | volume= 6 | issue= 4 | pages= 496-501 | pmid=22711054 | doi=10.1007/s12105-012-0378-z | pmc=3500898 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22711054  }} </ref><ref name="pmid30288554">{{cite journal| author=Alexandra G, Claudia G| title=Lymphomatoid granulomatosis mimicking cancer and sarcoidosis. | journal=Ann Hematol | year= 2018 | volume=  | issue=  | pages=  | pmid=30288554 | doi=10.1007/s00277-018-3505-4 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30288554  }} </ref>
*Malaise
*[[Malaise]]<ref name="pmid26966605">{{cite journal| author=O'Brien S, Schmidt P| title=Lymphomatoid Granulomatosis with Paraneoplastic Polymyositis: A Rare Malignancy with Rare Complication. | journal=Case Rep Rheumatol | year= 2016 | volume= 2016 | issue=  | pages= 8242597 | pmid=26966605 | doi=10.1155/2016/8242597 | pmc=4757691 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26966605  }} </ref>
*Weight loss
*[[Weight loss]]<ref name="pmid25535225">{{cite journal| author=Olmes DG, Agaimy A, Kloska S, Linker RA| title=Fatal lymphomatoid granulomatosis with primary CNS-involvement in an immunocompetent 80-year-old woman. | journal=BMJ Case Rep | year= 2014 | volume= 2014 | issue=  | pages=  | pmid=25535225 | doi=10.1136/bcr-2014-206825 | pmc=4275695 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25535225  }} </ref>
*Fatigue
*[[Fatigue]]<ref name="CostiniukKaramchandani2018">{{cite journal|last1=Costiniuk|first1=Cecilia T.|last2=Karamchandani|first2=Jason|last3=Bessissow|first3=Ali|last4=Routy|first4=Jean-Pierre|last5=Szabo|first5=Jason|last6=Frenette|first6=Charles|title=Angiocentric lymph proliferative disorder (lymphomatoid granulomatosis) in a person with newly-diagnosed HIV infection: a case report|journal=BMC Infectious Diseases|volume=18|issue=1|year=2018|issn=1471-2334|doi=10.1186/s12879-018-3128-3}}</ref>


From the symptoms listed above; Lymphamatoid granulomatosis is usually differtiated from the following diseases Bronchocentric granulomatosis and Churg-Strauss, Necrotizing sarcoid granulomatosis, Wegeners granulomatosis, Hodgkins disease, Non-hodgkin lymphoma, and Nasal angiocentric lymphoma.<ref name="pmid10544614">{{cite journal| author=Bohle M, Rasche K, Müller KM, Schultze-Werninghaus G, Fisseler-Eckhoff A| title=[Lymphomatoid granulomatosis: differential diagnosis and therapy]. | journal=Med Klin (Munich) | year= 1999 | volume= 94 | issue= 9 | pages= 513-9 | pmid=10544614 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10544614  }} </ref><ref name="pmiddoi.org/10.1053/stcs.2002.34450">{{cite journal| author=Schmoldt A, Benthe HF, Haberland G| title=Digitoxin metabolism by rat liver microsomes. | journal=Biochem Pharmacol | year= 1975 | volume= 24 | issue= 17 | pages= 1639-41 | pmid=doi.org/10.1053/stcs.2002.34450 | doi= | pmc=5922622 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10  }} </ref>
From the symptoms listed above; Lymphamatoid granulomatosis is usually differtiated from the following diseases bronchocentric granulomatosis and Churg-Strauss, necrotizing sarcoid granulomatosis, Wegeners granulomatosis, Hodgkins disease, non-Hodgkin lymphoma, and nasal angiocentric lymphoma.<ref name="pmid10544614">{{cite journal| author=Bohle M, Rasche K, Müller KM, Schultze-Werninghaus G, Fisseler-Eckhoff A| title=[Lymphomatoid granulomatosis: differential diagnosis and therapy]. | journal=Med Klin (Munich) | year= 1999 | volume= 94 | issue= 9 | pages= 513-9 | pmid=10544614 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10544614  }} </ref><ref name="pmiddoi.org/10.1053/stcs.2002.34450">{{cite journal| author=Schmoldt A, Benthe HF, Haberland G| title=Digitoxin metabolism by rat liver microsomes. | journal=Biochem Pharmacol | year= 1975 | volume= 24 | issue= 17 | pages= 1639-41 | pmid=doi.org/10.1053/stcs.2002.34450 | doi= | pmc=5922622 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10  }} </ref><ref name="pmidhttps://doi.org/10.1007/s00247-014-3233-4">{{cite journal| author=Schmoldt A, Benthe HF, Haberland G| title=Digitoxin metabolism by rat liver microsomes. | journal=Biochem Pharmacol | year= 1975 | volume= 24 | issue= 17 | pages= 1639-41 | pmid=https://doi.org/10.1007/s00247-014-3233-4 | doi= | pmc=5922622 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10  }} </ref>


In contrast, CNS lymphamatoid granulomatosis must be differentiated from other diseases that cause:<ref name="pmid29635846">{{cite journal| author=Kim JY, Jung KC, Park SH, Choe JY, Kim JE| title=Primary lymphomatoid granulomatosis in the central nervous system: A report of three cases. | journal=Neuropathology | year= 2018 | volume=  | issue=  | pages=  | pmid=29635846 | doi=10.1111/neup.12467 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29635846  }} </ref><ref name="pmid28824078">{{cite journal| author=Kano Y, Kodaira M, Ushiki A, Kosaka M, Yamada M, Shingu K et al.| title=The Complete Remission of Acquired Immunodeficiency Syndrome-associated Isolated Central Nervous System Lymphomatoid Granulomatosis: A Case Report and Review of the Literature. | journal=Intern Med | year= 2017 | volume= 56 | issue= 18 | pages= 2497-2501 | pmid=28824078 | doi=10.2169/internalmedicine.8776-16 | pmc=5643181 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28824078  }} </ref><ref name="pmid27656321">{{cite journal| author=Quinones E, Potes LI, Silva N, Lobato-Polo J| title=Lymphomatoid granulomatosis of the brain: A case report. | journal=Surg Neurol Int | year= 2016 | volume= 7 | issue= Suppl 23 | pages= S612-6 | pmid=27656321 | doi=10.4103/2152-7806.189732 | pmc=5025951 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27656321  }} </ref><ref name="pmid20672711">{{cite journal| author=Halvani A, Owlia MB, Sami R| title=Lymphomatoid granulomatosis with splenomegaly and pancytopenia. | journal=Zhongguo Fei Ai Za Zhi | year= 2010 | volume= 13 | issue= 1 | pages= 84-6 | pmid=20672711 | doi=10.3779/j.issn.1009-3419.2010.01.17 | pmc=6000673 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20672711  }} </ref>  
In contrast, CNS lymphamatoid granulomatosis must be differentiated from other diseases that cause:<ref name="pmid29635846">{{cite journal| author=Kim JY, Jung KC, Park SH, Choe JY, Kim JE| title=Primary lymphomatoid granulomatosis in the central nervous system: A report of three cases. | journal=Neuropathology | year= 2018 | volume=  | issue=  | pages=  | pmid=29635846 | doi=10.1111/neup.12467 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29635846  }} </ref><ref name="pmid28824078">{{cite journal| author=Kano Y, Kodaira M, Ushiki A, Kosaka M, Yamada M, Shingu K et al.| title=The Complete Remission of Acquired Immunodeficiency Syndrome-associated Isolated Central Nervous System Lymphomatoid Granulomatosis: A Case Report and Review of the Literature. | journal=Intern Med | year= 2017 | volume= 56 | issue= 18 | pages= 2497-2501 | pmid=28824078 | doi=10.2169/internalmedicine.8776-16 | pmc=5643181 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28824078  }} </ref><ref name="pmid27656321">{{cite journal| author=Quinones E, Potes LI, Silva N, Lobato-Polo J| title=Lymphomatoid granulomatosis of the brain: A case report. | journal=Surg Neurol Int | year= 2016 | volume= 7 | issue= Suppl 23 | pages= S612-6 | pmid=27656321 | doi=10.4103/2152-7806.189732 | pmc=5025951 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27656321  }} </ref><ref name="pmid20672711">{{cite journal| author=Halvani A, Owlia MB, Sami R| title=Lymphomatoid granulomatosis with splenomegaly and pancytopenia. | journal=Zhongguo Fei Ai Za Zhi | year= 2010 | volume= 13 | issue= 1 | pages= 84-6 | pmid=20672711 | doi=10.3779/j.issn.1009-3419.2010.01.17 | pmc=6000673 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20672711  }} </ref>  
*Headaches  
*[[Headache|Headaches]]<ref name="pmid21559262">{{cite journal| author=Castrale C, El Haggan W, Chapon F, Reman O, Lobbedez T, Ryckelynck JP et al.| title=Lymphomatoid granulomatosis treated successfully with rituximab in a renal transplant patient. | journal=J Transplant | year= 2011 | volume= 2011 | issue=  | pages= 865957 | pmid=21559262 | doi=10.1155/2011/865957 | pmc=3087939 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21559262  }} </ref>
*Seizures  
*[[Seizure|Seizures]]<ref name="LiuChen2014">{{cite journal|last1=Liu|first1=Hongli|last2=Chen|first2=Jing|last3=Yu|first3=Dandan|last4=Hu|first4=Jianli|title=Lymphomatoid granulomatosis involving the central nervous system: A case report and review of the literature|journal=Oncology Letters|volume=7|issue=6|year=2014|pages=1843–1846|issn=1792-1074|doi=10.3892/ol.2014.2002}}</ref>
*Hemiparesis
*[[Hemiparesis]]<ref name="PatsalidesAtac2005">{{cite journal|last1=Patsalides|first1=Athos D.|last2=Atac|first2=Gokce|last3=Hedge|first3=Upendra|last4=Janik|first4=John|last5=Grant|first5=Nicole|last6=Jaffe|first6=Elaine S.|last7=Dwyer|first7=Andrew|last8=Patronas|first8=Nicholas J.|last9=Wilson|first9=Wyndham H.|title=Lymphomatoid Granulomatosis: Abnormalities of the Brain at MR Imaging|journal=Radiology|volume=237|issue=1|year=2005|pages=265–273|issn=0033-8419|doi=10.1148/radiol.2371041087}}</ref>
*Ataxia
*[[Ataxia]]<ref name="CarginiCivica2014">{{cite journal|last1=Cargini|first1=Pasqualino|last2=Civica|first2=Maria|last3=Sollima|first3=Laura|last4=Di Cola|first4=Emanuela|last5=Pontecorvi|first5=Emanuele|last6=Cutilli|first6=Tommaso|title=Oral lymphomatoid granulomatosis, the first sign of a ‘rare disease’: a case report|journal=Journal of Medical Case Reports|volume=8|issue=1|year=2014|issn=1752-1947|doi=10.1186/1752-1947-8-152}}</ref>
The differentials are the following CVA, Brain tumors or CNS lymphoma and Parkinsonism.<ref name="pmid19513302">{{cite journal| author=Sohn EH, Song CJ, Lee HJ, Kim S, Kim JM, Lee AY| title=Central nervous system lymphomatoid granulomatosis presenting with parkinsonism. | journal=J Clin Neurol | year= 2007 | volume= 3 | issue= 2 | pages= 108-11 | pmid=19513302 | doi=10.3988/jcn.2007.3.2.108 | pmc=2686859 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19513302  }} </ref>
The differentials are the following [[Stroke|CVA]], [[Brain tumor|Brain tumors]] or [[Lymphoma|CNS lymphoma]] and [[Parkinsonism]].<ref name="pmid19513302">{{cite journal| author=Sohn EH, Song CJ, Lee HJ, Kim S, Kim JM, Lee AY| title=Central nervous system lymphomatoid granulomatosis presenting with parkinsonism. | journal=J Clin Neurol | year= 2007 | volume= 3 | issue= 2 | pages= 108-11 | pmid=19513302 | doi=10.3988/jcn.2007.3.2.108 | pmc=2686859 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19513302  }} </ref>


Finally Cutaneous Lymphamatoid granulomatosis must also be differtiated from other diseases that cause:<ref name="pmid20672711">{{cite journal| author=Halvani A, Owlia MB, Sami R| title=Lymphomatoid granulomatosis with splenomegaly and pancytopenia. | journal=Zhongguo Fei Ai Za Zhi | year= 2010 | volume= 13 | issue= 1 | pages= 84-6 | pmid=20672711 | doi=10.3779/j.issn.1009-3419.2010.01.17 | pmc=6000673 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20672711  }} </ref><ref name="pmid25355540">{{cite journal| author=Rysgaard CD, Stone MS| title=Lymphomatoid granulomatosis presenting with cutaneous involvement: a case report and review of the literature. | journal=J Cutan Pathol | year= 2015 | volume= 42 | issue= 3 | pages= 188-93 | pmid=25355540 | doi=10.1111/cup.12402 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25355540  }} </ref><ref name="pmid26143428">{{cite journal| author=Gangar P, Venkatarajan S| title=Granulomatous Lymphoproliferative Disorders: Granulomatous Slack Skin and Lymphomatoid Granulomatosis. | journal=Dermatol Clin | year= 2015 | volume= 33 | issue= 3 | pages= 489-96 | pmid=26143428 | doi=10.1016/j.det.2015.03.013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26143428  }} </ref>
Finally Cutaneous Lymphamatoid granulomatosis must also be differtiated from other diseases that cause:<ref name="pmid20672711">{{cite journal| author=Halvani A, Owlia MB, Sami R| title=Lymphomatoid granulomatosis with splenomegaly and pancytopenia. | journal=Zhongguo Fei Ai Za Zhi | year= 2010 | volume= 13 | issue= 1 | pages= 84-6 | pmid=20672711 | doi=10.3779/j.issn.1009-3419.2010.01.17 | pmc=6000673 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20672711  }} </ref><ref name="pmid25355540">{{cite journal| author=Rysgaard CD, Stone MS| title=Lymphomatoid granulomatosis presenting with cutaneous involvement: a case report and review of the literature. | journal=J Cutan Pathol | year= 2015 | volume= 42 | issue= 3 | pages= 188-93 | pmid=25355540 | doi=10.1111/cup.12402 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25355540  }} </ref><ref name="pmid26143428">{{cite journal| author=Gangar P, Venkatarajan S| title=Granulomatous Lymphoproliferative Disorders: Granulomatous Slack Skin and Lymphomatoid Granulomatosis. | journal=Dermatol Clin | year= 2015 | volume= 33 | issue= 3 | pages= 489-96 | pmid=26143428 | doi=10.1016/j.det.2015.03.013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26143428  }} </ref>
*Erythematous rash
*[[Rash|Erythematous rash]]<ref name="pmid27051739">{{cite journal| author=Shaigany S, Weitz NA, Husain S, Geskin L, Grossman ME| title=A case of lymphomatoid granulomatosis presenting with cutaneous lesions. | journal=JAAD Case Rep | year= 2015 | volume= 1 | issue= 4 | pages= 234-7 | pmid=27051739 | doi=10.1016/j.jdcr.2015.05.008 | pmc=4808726 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27051739  }} </ref>
*Macules  
*[[Macule|Macules]] <ref name="Carlson1991">{{cite journal|last1=Carlson|first1=Keith C.|title=Cutaneous Signs of Lymphomatoid Granulomatosis|journal=Archives of Dermatology|volume=127|issue=11|year=1991|pages=1693|issn=0003-987X|doi=10.1001/archderm.1991.01680100093011}}</ref>
*Papules   
*[[Papule|Papules]]<ref name="pmid27051739">{{cite journal| author=Shaigany S, Weitz NA, Husain S, Geskin L, Grossman ME| title=A case of lymphomatoid granulomatosis presenting with cutaneous lesions. | journal=JAAD Case Rep | year= 2015 | volume= 1 | issue= 4 | pages= 234-7 | pmid=27051739 | doi=10.1016/j.jdcr.2015.05.008 | pmc=4808726 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27051739 }} </ref><ref name="Minars1975">{{cite journal|last1=Minars|first1=Norman|title=Lymphomatoid Granulomatosis of the Skin|journal=Archives of Dermatology|volume=111|issue=4|year=1975|pages=493|issn=0003-987X|doi=10.1001/archderm.1975.01630160083009}}</ref>
*Plaques  
*[[Plaque|Plaques]] <ref name="RysgaardStone2015">{{cite journal|last1=Rysgaard|first1=Carolyn D.|last2=Stone|first2=Mary Seabury|title=Lymphomatoid granulomatosis presenting with cutaneous involvement: a case report and review of the literature|journal=Journal of Cutaneous Pathology|volume=42|issue=3|year=2015|pages=188–193|issn=03036987|doi=10.1111/cup.12402}}</ref>
*Subcutaneous nodules   
*[[Nodule (medicine)|Subcutaneous nodules]]<ref name="pmid27051739">{{cite journal| author=Shaigany S, Weitz NA, Husain S, Geskin L, Grossman ME| title=A case of lymphomatoid granulomatosis presenting with cutaneous lesions. | journal=JAAD Case Rep | year= 2015 | volume= 1 | issue= 4 | pages= 234-7 | pmid=27051739 | doi=10.1016/j.jdcr.2015.05.008 | pmc=4808726 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27051739 }} </ref><ref name="Prieto Herman ReinehrCorrêa Martins2017">{{cite journal|last1=Prieto Herman Reinehr|first1=Clarissa|last2=Corrêa Martins|first2=Carla|last3=Trein Cunha|first3=Vivian|last4=Elen Lira|first4=Franci|last5=Sprinz|first5=Eduardo|last6=Cartell|first6=André|last7=Bakos|first7=Renato Marchiori|title=Cutaneous human immunodeficiency virus (HIV)-associated lymphomatoid granulomatosis: complete regression following antiretroviral therapy|journal=International Journal of Dermatology|volume=56|issue=5|year=2017|pages=e100–e102|issn=00119059|doi=10.1111/ijd.13551}}</ref>
*Larger ulcerated nodules
*[[Nodules|Larger ulcerated nodules]]<ref name="pmid27051739">{{cite journal| author=Shaigany S, Weitz NA, Husain S, Geskin L, Grossman ME| title=A case of lymphomatoid granulomatosis presenting with cutaneous lesions. | journal=JAAD Case Rep | year= 2015 | volume= 1 | issue= 4 | pages= 234-7 | pmid=27051739 | doi=10.1016/j.jdcr.2015.05.008 | pmc=4808726 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27051739  }} </ref><ref name="LeeNamuduri2018">{{cite journal|last1=Lee|first1=Lynette Y.|last2=Namuduri|first2=Rama|last3=Chan|first3=Michelle M. F.|last4=Quek|first4=Jeffrey K. S.|last5=Koh|first5=Mark J.-A.|title=Epstein-Barr virus positive diffuse large B-cell lymphoma presenting with vaginal sloughing and ulcerated skin nodule|journal=Journal of Cutaneous Pathology|volume=45|issue=2|year=2018|pages=162–166|issn=03036987|doi=10.1111/cup.13074}}</ref>
The differentials are the following Dermatomyositis, and Psoriasis  
The differentials are the following [[Polymyositis and dermatomyositis|Dermatomyositis]], and [[Psoriasis]]<ref name="BertiFelicetti2018">{{cite journal|last1=Berti|first1=Alvise|last2=Felicetti|first2=Mara|last3=Peccatori|first3=Susanna|last4=Bortolotti|first4=Roberto|last5=Guella|first5=Anna|last6=Vivaldi|first6=Paolo|last7=Morelli|first7=Luca|last8=Barabareschi|first8=Mattia|last9=Paolazzi|first9=Giuseppe|title=EBV-induced lymphoproliferative disorders in rheumatic patients: A systematic review of the literature|journal=Joint Bone Spine|volume=85|issue=1|year=2018|pages=35–40|issn=1297319X|doi=10.1016/j.jbspin.2017.01.006}}</ref><ref name="pmid26966605">{{cite journal| author=O'Brien S, Schmidt P| title=Lymphomatoid Granulomatosis with Paraneoplastic Polymyositis: A Rare Malignancy with Rare Complication. | journal=Case Rep Rheumatol | year= 2016 | volume= 2016 | issue=  | pages= 8242597 | pmid=26966605 | doi=10.1155/2016/8242597 | pmc=4757691 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26966605  }} </ref>
 
===Differentiating Lymphamatoid Granulomatosis ===
===Differentiating Lymphamatoid Granulomatosis ===


On the basis of Cough, Dyspnea, and Chest tightness, Lymphamatoid granulomatosis must be differentiated from Bronchocentric granulomatosis and Churg-Strauss, Necrotizing sarcoid granulomatosis, Wegeners granulomatosis, Hodgkins disease, Non-hodgkin lymphoma, and Nasal angiocentric lymphoma.
On the basis of Cough, Dyspnea, and Chest tightness, Lymphamatoid granulomatosis must be differentiated from Bronchocentric granulomatosis and Churg-Strauss, Necrotizing sarcoid granulomatosis, Wegeners granulomatosis, Hodgkins disease, Non-hodgkin lymphoma, and Nasal angiocentric lymphoma.<ref name="pmid10544614">{{cite journal| author=Bohle M, Rasche K, Müller KM, Schultze-Werninghaus G, Fisseler-Eckhoff A| title=[Lymphomatoid granulomatosis: differential diagnosis and therapy]. | journal=Med Klin (Munich) | year= 1999 | volume= 94 | issue= 9 | pages= 513-9 | pmid=10544614 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10544614  }} </ref><ref name="pmiddoi.org/10.1053/stcs.2002.34450">{{cite journal| author=Schmoldt A, Benthe HF, Haberland G| title=Digitoxin metabolism by rat liver microsomes. | journal=Biochem Pharmacol | year= 1975 | volume= 24 | issue= 17 | pages= 1639-41 | pmid=doi.org/10.1053/stcs.2002.34450 | doi= | pmc=5922622 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10  }} </ref><ref name="pmidhttps://doi.org/10.1007/s00247-014-3233-4">{{cite journal| author=Schmoldt A, Benthe HF, Haberland G| title=Digitoxin metabolism by rat liver microsomes. | journal=Biochem Pharmacol | year= 1975 | volume= 24 | issue= 17 | pages= 1639-41 | pmid=https://doi.org/10.1007/s00247-014-3233-4 | doi= | pmc=5922622 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10  }} </ref>


{|
{|
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
|-  
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
| colspan="6" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Clinical manifestations'''
| colspan="4" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Clinical manifestations'''
! colspan="7" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Para-clinical findings
! colspan="4" 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="1" rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Gold standard'''
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Additional findings
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Additional findings
|-
|-
| colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Symptoms'''
| colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Symptoms'''
! colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical examination
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical examination
|-
|-
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
|-  
|-  
Line 63: Line 62:
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Chest tightness
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Chest tightness
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Auscultation
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Auscultation
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab findings
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab 2
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab 3
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |X-ray
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |X-ray
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |CT scan
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |CT scan
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging 3
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Lymphmatoid  granulomatosis
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Lymphmatoid  granulomatosis]]<ref name="pmid23006954">{{cite journal| author=Roschewski M, Wilson WH| title=Lymphomatoid granulomatosis. | journal=Cancer J | year= 2012 | volume= 18 | issue= 5 | pages= 469-74 | pmid=23006954 | doi=10.1097/PPO.0b013e31826c5e19 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23006954  }} </ref>
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |Wheezing
Rales
Rhonchi
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |EBV infused B-cells on blood scan
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Wheeze|Wheezing]]
* [[Rales]]
* [[Rhonchi]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Mononucleosis|EBV i]]<nowiki/>nfused [[B cell|B-cells]] on blood scan
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Dense, large, mass like infiltrate and bilateral nodular disease.
* Dense, large, mass like infiltrate and bilateral [[Nodular lesions|nodular]] disease.
| style="background: #F5F5F5; padding: 5px;" |Poorly defined nodular peribronchovascular infiltrates with air-bronchograms.
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Poorly defined nodular peribronchovascular infiltrates with air-bronchograms.
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
** Nodular and diffuse lymphoid infiltrates along lymphatics and bronchovascular bundles
* Nodular and diffuse [[Lymphocyte|lymphoid]] infiltrates  
** Centers of nodules have large vessels with lymphatic infiltration
* Centers of [[Nodule (medicine)|nodules]] have large vessels  
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
** Predisposing factor is primary or secondary immunodeficiency states
* Predisposing factor immunodeficient states
** Patients may have fever of unknown origin, hemoptysis, history of multiple skin or other biopsies without diagnosis
* Patients may have [[fever of unknown origin]], [[hemoptysis]], history of multiple skin or other [[Biopsy|biopsies]] without diagnosis
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Churg-Strauss syndrome
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Eosinophilic granulomatosis with polyangiitis|Churg-Strauss syndrome]]<ref name="Della Rossa2002">{{cite journal|last1=Della Rossa|first1=A.|title=Churg-Strauss syndrome: clinical and serological features of 19 patients from a single Italian centre|journal=Rheumatology|volume=41|issue=11|year=2002|pages=1286–1294|issn=14602172|doi=10.1093/rheumatology/41.11.1286}}</ref>
| style="background: #F5F5F5; padding: 5px;" | +   
| style="background: #F5F5F5; padding: 5px;" | +   
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |Wheezing
Rales
Rhonchi
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Wheeze|Wheezing]]
* [[Rales]]
* [[Rhonchi]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Greater than 50% have positive ANCA, often antimyeloperoxidase
* Greater than 50% have positive [[Anti-neutrophil cytoplasmic antibody|ANCA]], often antimyeloperoxidase
* Eosinophilia
* [[Eosinophilia]]
* Elevated [[Erythrocyte sedimentation rate|ESR]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Pulmonary infiltrates:Typically, these are transient patchy alveolar infiltrates.
| style="background: #F5F5F5; padding: 5px;" |Pulmonary infiltrates:
Typically, these are transient patchy alveolar infiltrates.
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Subpleural airspace consolidation
* Subpleural airspace consolidation
* Enlarged hilar or mediastinal lymph nodes  
* Enlarged [[Hilar lymphadenopathy|hilar]] or mediastinal lymph nodes  
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Lung and extrapulmonary sites with [[eosinophilic]] infiltrate,
* [[Granuloma|Granulomatous]] reaction
* May have edema, lymphocytes, sarcoid-like granulomas.
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Lung and extrapulmonary sites with eosinophilic infiltrate,
* + [[Anti-neutrophil cytoplasmic antibody|P-ANCA]] in cells on lung biposy
* Granulomatous reaction near small arteries, eosinophilic vasculitis
* May have edema, lymphocytes, sarcoid-like granulomas.
| style="background: #F5F5F5; padding: 5px;" | + P-ANCA
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Very rare
* Very rare
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Necrotizing sarcoid granulomatosis
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Sarcoidosis|Necrotizing sarcoid granulomatosis]]<ref name="Quaden2005">{{cite journal|last1=Quaden|first1=C.|title=Necrotising sarcoid granulomatosis: clinical, functional, endoscopical and radiographical evaluations|journal=European Respiratory Journal|volume=26|issue=5|year=2005|pages=778–785|issn=0903-1936|doi=10.1183/09031936.05.00024205}}</ref>
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |Wheezing
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |Increased levels of ACE in the blood
* [[Wheeze|Wheezing]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Increased levels of [[Angiotensin-converting enzyme|ACE]] in the blood
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |Hilar adenopathy
* [[Hilar lymphadenopathy|Hilar]] adenopathy
| style="background: #F5F5F5; padding: 5px;" |bihilar lymphadenopathy and reticulonodular infiltrates
 
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[bihilar lymphadenopathy]] and [[reticulonodular]] infiltrates
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Inflammatory and granulomatous reactions
* Inflammatory and [[granulomatous]] reactions
* Resembling lymphoma  and atypia
* Resembling [[lymphoma]] and [[atypia]]
* Dense, noncaseating granulomatous infiltrate
* Dense, noncaseating [[Granuloma|granulomas]]
* Also Schaumann bodies  
* Also [[Schaumann bodies]]
| style="background: #F5F5F5; padding: 5px;" |High levels of ACE in blood
| style="background: #F5F5F5; padding: 5px;" |High levels of [[Angiotensin-converting enzyme|ACE]] in blood
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Affects skin, lymph nodes and organs
* Affects skin, lymph nodes and organs
* Diagnosis of exclusion
* Diagnosis of exclusion
* Patients often have anergy to delayed hypersensitivity tests
* Patients often have anergy to delayed [[hypersensitivity]] tests
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
!Diseases
!Diseases
Line 158: Line 141:
!Chest thightness
!Chest thightness
!Auscultation
!Auscultation
! colspan="1" rowspan="1" |
!
!Lab findings
!Lab findings
!Lab 2
!Lab 3
!X-ray
!X-ray
!CT scan
!CT scan
!Imaging 3
!Histopathology
!Histopathology
|'''Gold standard'''
|'''Gold standard'''
!Additional findings
!Additional findings
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Wegeners granulomatosis
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Wegeners granulomatosis history and symptoms|Wegeners granulomatosis]]<ref name="de GrootGross2016">{{cite journal|last1=de Groot|first1=K|last2=Gross|first2=W L|title=Wegener's granulomatosis: disease course, assessment of activity and                extent and treatment|journal=Lupus|volume=7|issue=4|year=2016|pages=285–291|issn=0961-2033|doi=10.1191/096120398678920118}}</ref>
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |Wheezing
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |C- ANCA
Urinalysis:
Hematuria
Red cell casts
Biopsy: Granulomatous inflmmation within the arterial wall ''or'' in the perivascular area
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Wheeze|Wheezing]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Anti-neutrophil cytoplasmic antibody|C- ANCA]]
* [[Urinalysis]]:
* [[Hematuria]]:[[Red cell casts]]
* Biopsy: [[Granulomatous]] inflmmation within the arterial wall ''or'' in the perivascular area
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Nodules,
* [[Nodule (medicine)|Nodules]],
* Infiltrates ''or''
* [[Infiltrates]] ''or''
* Cavities
* [[Cavity|Cavities]]
| style="background: #F5F5F5; padding: 5px;" |Pulmonary nodules with or without cavitation and airspace consolidation
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Pulmonary [[Nodule (medicine)|nodules]] with or without cavitation
* Airspace consolidation
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
** Liquefactive or coagulative necrosis in lungs with huge number of eosinophils, and granulomas; surrounded by histiocytes and giant cells with central necrosis
* [[Liquefactive necrosis|Liquefactive]] or [[coagulative necrosis]] in lungs  
** Destructive leukocytic angiitis of arteries and veins  
* Destructive leukocytic [[angiitis]] of arteries and veins  
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Biopsy]] of the lung
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* p-ANCA: perinuclear staining, directed against myeloperoxidase, is usually negative, but positive in microscopic polyarteritis, inflammatory bowel disease, crescentic glomerulonephritis
* [[p-ANCA]]: perinuclear staining, directed against [[myeloperoxidase]], which is usually negative,
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Hodgkin disease
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hodgkin's lymphoma|Hodgkin disease]]<ref name="TownsendLinch2012">{{cite journal|last1=Townsend|first1=William|last2=Linch|first2=David|title=Hodgkin's lymphoma in adults|journal=The Lancet|volume=380|issue=9844|year=2012|pages=836–847|issn=01406736|doi=10.1016/S0140-6736(12)60035-X}}</ref>
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
Line 207: Line 180:
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Contains a small number of the characteristic [[neoplastic]] cells ('''Hodgkin and [[Reed-Sternberg cell|Reed-Sternberg cells]]''' or '''[[lymphocyte]] predominant cells''') within a background rich in inflammatory cells
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Parenchyma|Parenchymal]] lung involvement occurs in 1/3 of patients with Hodgkin
* Almost all have associated hilar or mediastinal adenopathy
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Contains a small number of the characteristic neoplastic cells ('''Hodgkin and Reed-Sternberg cells''' or '''lymphocyte predominant cells''') within a background rich in inflammatory cells
* Massive [[mediastinal]] soft tissue masses consistent with [[lymphoma]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Parenchymal lung involvement occurs in 1/3 of patients with Hodgkin
* [[Neoplastic]] cells are [[Hodgkin's lymphoma|Hodgkin]] and [[Reed-Sternberg cell|Reed-Sternberg]] (HRS) cells
* Almost all have associated hilar or mediastinal adenopathy
* Effaced [[lymph node]] with variable number of [[Reed-Sternberg cell|HRS]] cells
| style="background: #F5F5F5; padding: 5px;" |Massive mediastinal soft tissue masses consistent with lymphoma
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Reed-Sternberg cell|Reed-sternberg cells]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Neoplastic cells are Hodgkin and Reed-Sternberg (HRS) cells
* Development of [[Hodgkin's lymphoma|Hodgkin's disease]] may in some patients be preceded by enhanced activation of [[Epstein Barr virus|Epstein–Barr virus]]
* Effaced lymph node with variable number of HRS cells in a background of inflammatory cells
| style="background: #F5F5F5; padding: 5px;" |Reed Sternberg cells
| style="background: #F5F5F5; padding: 5px;" |Development of Hodgkin's disease may in some patients be preceded by enhanced activation of Epstein–Barr virus
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Non-hodgkin lymphoma
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Non-Hodgkin lymphoma|Non-hodgkin lymphoma]]<ref name="ZelenetzAbramson2011">{{cite journal|last1=Zelenetz|first1=Andrew D.|last2=Abramson|first2=Jeremy S.|last3=Advani|first3=Ranjana H.|last4=Andreadis|first4=C. Babis|last5=Bartlett|first5=Nancy|last6=Bellam|first6=Naresh|last7=Byrd|first7=John C.|last8=Czuczman|first8=Myron S.|last9=Fayad|first9=Luis E.|last10=Glenn|first10=Martha J.|last11=Gockerman|first11=Jon P.|last12=Gordon|first12=Leo I.|last13=Harris|first13=Nancy Lee|last14=Hoppe|first14=Richard T.|last15=Horwitz|first15=Steven M.|last16=Kelsey|first16=Christopher R.|last17=Kim|first17=Youn H.|last18=LaCasce|first18=Ann S.|last19=Nademanee|first19=Auayporn|last20=Porcu|first20=Pierluigi|last21=Press|first21=Oliver|last22=Pro|first22=Barbara|last23=Reddy|first23=Nashitha|last24=Sokol|first24=Lubomir|last25=Swinnen|first25=Lode J.|last26=Tsien|first26=Christina|last27=Vose|first27=Julie M.|last28=Wierda|first28=William G.|last29=Yahalom|first29=Joachim|last30=Zafar|first30=Nadeem|title=Non-Hodgkin's Lymphomas|journal=Journal of the National Comprehensive Cancer Network|volume=9|issue=5|year=2011|pages=484–560|issn=1540-1405|doi=10.6004/jnccn.2011.0046}}</ref>
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
Line 229: Line 200:
| 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;" |
*<nowiki/>Can be caused by;
| style="background: #F5F5F5; padding: 5px;" |Can be caused by;
**[[Epstein Barr virus|EBV]]
EBV  
** [[Human Immunodeficiency Virus (HIV)|HIV]]
**[[Hepatitis B|Hep B]]<nowiki/>and[[Hepatitis C|C]]
** [[Human T-lymphotropic virus|HTLV]]


HIV
* Lymphomatous appearing [[B cell|B]] and [[T cell|T cells]]( condition arises from B and T cells)


Hep C
* Abnormal [[Liver function tests|LFT]]'s


HTLV
* CBC count: Can be normal in early-stage disease; in more advanced stages, can show:
 
** [[anemia]]
Lymphomatous appearing B and T cells( condition arises from B and T cells)
**[[thrombocytopenia]]
**[[leukopenia]]
** [[pancytopenia]]
** [[lymphocytosis]]
**[[thrombocytosis]]
| style="background: #F5F5F5; padding: 5px;" |
* [[Widened mediastinum|Mediastinal widening]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Mediastinum]] can show enlarged [[tracheobronchial]] and subcarinal nodes.
* Small bilateral [[pleural effusion]] can be seen
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |Mediastinal widening due to grossly enlarged right paratracheal and left paratracheal nodes.
* Sensitivity and specificity of diagnosis with fine [[Needle aspiration biopsy|needle aspiration]] increases with use of flow cytometry
| style="background: #F5F5F5; padding: 5px;" |Mediastinum can show enlarged tracheobronchial and subcarinal nodes. small bilateral pleural effusion can be seen
* Occasionally associated with [[monoclonal gammopathy]];
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Pop corn cells in [[Nodular lymphocyte predominant Hodgkin lymphoma|NLPHL]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Sensitivity and specificity of diagnosis with fine needle aspiration increases with use of flow cytometry
* Symptoms include:
| style="background: #F5F5F5; padding: 5px;" |Pop corn cells in NLPHL
* [[enlarged lymph nodes]]
| style="background: #F5F5F5; padding: 5px;" |Symptoms include enlarged lymph nodes, fever, night sweats, weight loss, and tiredness
* [[fever]]
* [[Sleep hyperhidrosis|Night sweats]],  
* [[weight loss]]
* [[Fatigue|Tiredness]]
|}
|}


Latest revision as of 20:49, 28 February 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kamal Akbar, M.D.[2]

Overview

Lymphamtoid granulomatosis must be differentiated from bronchocentric granulomatosis and Churg-Strauss, necrotizing sarcoid granulomatosis, Wegeners granulomatosis, Hodgkins disease, non-Hodgkin lymphoma, and Nasal angiocentric lymphoma

Differentiating Lymphamatoid granulomatosis from other Diseases

As Lymphamatoid granulomatosis manifests in a variety of clinical forms, differentiation must be established in accordance with the particular subtypes pulmonary being the most common. The sub types are the following:[1][2][3][4][5][6]

Other Symptoms that are asscociated with the pulmonary symptoms are:[10][11][12]

From the symptoms listed above; Lymphamatoid granulomatosis is usually differtiated from the following diseases bronchocentric granulomatosis and Churg-Strauss, necrotizing sarcoid granulomatosis, Wegeners granulomatosis, Hodgkins disease, non-Hodgkin lymphoma, and nasal angiocentric lymphoma.[15][16][17]

In contrast, CNS lymphamatoid granulomatosis must be differentiated from other diseases that cause:[18][19][20][21]

The differentials are the following CVA, Brain tumors or CNS lymphoma and Parkinsonism.[26]

Finally Cutaneous Lymphamatoid granulomatosis must also be differtiated from other diseases that cause:[21][27][28]

The differentials are the following Dermatomyositis, and Psoriasis[34][10]

Differentiating Lymphamatoid Granulomatosis

On the basis of Cough, Dyspnea, and Chest tightness, Lymphamatoid granulomatosis must be differentiated from Bronchocentric granulomatosis and Churg-Strauss, Necrotizing sarcoid granulomatosis, Wegeners granulomatosis, Hodgkins disease, Non-hodgkin lymphoma, and Nasal angiocentric lymphoma.[15][16][17]

Diseases Clinical manifestations Para-clinical findings Gold standard Additional findings
Symptoms Physical examination
Lab Findings Imaging Histopathology
Cough Dyspnea Chest tightness Auscultation X-ray CT scan
Lymphmatoid granulomatosis[1] + + +
  • Dense, large, mass like infiltrate and bilateral nodular disease.
  • Poorly defined nodular peribronchovascular infiltrates with air-bronchograms.
  • Nodular and diffuse lymphoid infiltrates
  • Centers of nodules have large vessels
Churg-Strauss syndrome[35] + + +
  • Pulmonary infiltrates:Typically, these are transient patchy alveolar infiltrates.
  • Subpleural airspace consolidation
  • Enlarged hilar or mediastinal lymph nodes
  • Lung and extrapulmonary sites with eosinophilic infiltrate,
  • Granulomatous reaction
  • May have edema, lymphocytes, sarcoid-like granulomas.
  • + P-ANCA in cells on lung biposy
  • Very rare
Necrotizing sarcoid granulomatosis[36] + + -
  • Increased levels of ACE in the blood
 High levels of ACE in blood
  • Affects skin, lymph nodes and organs
  • Diagnosis of exclusion
  • Patients often have anergy to delayed hypersensitivity tests
Diseases Cough Dyspnea Chest thightness Auscultation Lab findings X-ray CT scan Histopathology Gold standard Additional findings
Wegeners granulomatosis[37] + + -
  • Pulmonary nodules with or without cavitation
  • Airspace consolidation
Hodgkin disease[38] - - -
  • Parenchymal lung involvement occurs in 1/3 of patients with Hodgkin
  • Almost all have associated hilar or mediastinal adenopathy
Non-hodgkin lymphoma[39] - - -
  • Lymphomatous appearing B and T cells( condition arises from B and T cells)

References

  1. ↑ 1.0 1.1 Roschewski M, Wilson WH (2012). "Lymphomatoid granulomatosis". Cancer J. 18 (5): 469–74. doi:10.1097/PPO.0b013e31826c5e19. PMID 23006954.
  2. ↑ Fernandez-Alvarez R, Gonzalez M, Fernandez A, Gonzalez-Rodriguez A, Sancho J, Dominguez F; et al. (2014). "Lymphomatoid granulomatosis of central nervous system and lung driven by epstein barr virus proliferation: successful treatment with rituximab-containing chemotherapy". Mediterr J Hematol Infect Dis. 6 (1): e2014017. doi:10.4084/MJHID.2014.017. PMC 3965717. PMID 24678394.
  3. ↑ 3.0 3.1 3.2 3.3 3.4 {{cite journal| author=Shaigany S, Weitz NA, Husain S, Geskin L, Grossman ME| title=A case of lymphomatoid granulomatosis presenting with cutaneous lesions. | journal=JAAD Case Rep | year= 2015 | volume= 1 | issue= 4 | pages= 234-7 | pmid=27051739 | doi=10.1016/j.jdcr.2015.05.008 | pmc=4808726 | url=
    • Pulmonary
    • CNS
    • Cutaneous
    Pulmonary Lymphamatoid granulomatosis must be differentiated from other diseases that cause:<ref name="pmid26078192">Santalla-Martínez M, García-Quiroga H, Navarro-Menéndez I (2015). "Pulmonary lymphomatoid granulomatosis. A rare entity in the differential diagnosis of pulmonary nodules". Arch Bronconeumol. 51 (11): 606–7. doi:10.1016/j.arbres.2015.05.003. PMID 26078192.
  4. ↑ Miloslavsky EM, Stone JH, Unizony SH (2015). "Challenging mimickers of primary systemic vasculitis". Rheum Dis Clin North Am. 41 (1): 141–60, ix. doi:10.1016/j.rdc.2014.09.011. PMID 25399945.
  5. ↑ Tagliavini E, Rossi G, Valli R, Zanelli M, Cadioli A, Mengoli MC; et al. (2013). "Lymphomatoid granulomatosis: a practical review for pathologists dealing with this rare pulmonary lymphoproliferative process". Pathologica. 105 (4): 111–6. PMID 24466760.
  6. ↑ Fauci AS, Haynes BF, Costa J, Katz P, Wolff SM (1982). "Lymphomatoid Granulomatosis. Prospective clinical and therapeutic experience over 10 years". N Engl J Med. 306 (2): 68–74. doi:10.1056/NEJM198201143060203. PMID 7053488.
  7. ↑ Xu B, Liu H, Wang B, Zhang H, Wu H, Jin R; et al. (2015). "Fever, Dry Cough and Exertional Dyspnea: Pulmonary Lymphomatoid Granulomatosis Masquerading as Pneumonia, Granulomatosis with Polyangiitis and Infectious Mononucleosis". Intern Med. 54 (23): 3045–9. doi:10.2169/internalmedicine.54.4822. PMID 26631890.
  8. ↑ Ameli F, Ghafourian F, Masir N (2014). "Systematic Epstein-Barr virus-positive T-cell lymphoproliferative disease presenting as a persistent fever and cough: a case report". J Med Case Rep. 8: 288. doi:10.1186/1752-1947-8-288. PMC 4150421. PMID 25163591.
  9. ↑ Olusina D, Ezemba N, Nzegwu MA (2011). "Pulmonary Lymphomatoid Granulomatosis: Report of A Case and Review of Literature". Niger Med J. 52 (1): 60–63. PMC 3180752. PMID 21968985.
  10. ↑ 10.0 10.1 10.2 10.3 O'Brien S, Schmidt P (2016). "Lymphomatoid Granulomatosis with Paraneoplastic Polymyositis: A Rare Malignancy with Rare Complication". Case Rep Rheumatol. 2016: 8242597. doi:10.1155/2016/8242597. PMC 4757691. PMID 26966605.
  11. ↑ Alinari L, Pant S, McNamara K, Kalmar JR, Marsh W, Allen CM; et al. (2012). "Lymphomatoid granulomatosis presenting with gingival involvement in an immune competent elderly male". Head Neck Pathol. 6 (4): 496–501. doi:10.1007/s12105-012-0378-z. PMC 3500898. PMID 22711054.
  12. ↑ Alexandra G, Claudia G (2018). "Lymphomatoid granulomatosis mimicking cancer and sarcoidosis". Ann Hematol. doi:10.1007/s00277-018-3505-4. PMID 30288554.
  13. ↑ Olmes DG, Agaimy A, Kloska S, Linker RA (2014). "Fatal lymphomatoid granulomatosis with primary CNS-involvement in an immunocompetent 80-year-old woman". BMJ Case Rep. 2014. doi:10.1136/bcr-2014-206825. PMC 4275695. PMID 25535225.
  14. ↑ Costiniuk, Cecilia T.; Karamchandani, Jason; Bessissow, Ali; Routy, Jean-Pierre; Szabo, Jason; Frenette, Charles (2018). "Angiocentric lymph proliferative disorder (lymphomatoid granulomatosis) in a person with newly-diagnosed HIV infection: a case report". BMC Infectious Diseases. 18 (1). doi:10.1186/s12879-018-3128-3. ISSN 1471-2334.
  15. ↑ 15.0 15.1 Bohle M, Rasche K, Müller KM, Schultze-Werninghaus G, Fisseler-Eckhoff A (1999). "[Lymphomatoid granulomatosis: differential diagnosis and therapy]". Med Klin (Munich). 94 (9): 513–9. PMID 10544614.
  16. ↑ 16.0 16.1 Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMC 5922622. PMID doi.org/10.1053/stcs.2002.34450 Check |pmid= value (help).
  17. ↑ 17.0 17.1 Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMC 5922622. PMID https://doi.org/10.1007/s00247-014-3233-4 Check |pmid= value (help).
  18. ↑ Kim JY, Jung KC, Park SH, Choe JY, Kim JE (2018). "Primary lymphomatoid granulomatosis in the central nervous system: A report of three cases". Neuropathology. doi:10.1111/neup.12467. PMID 29635846.
  19. ↑ Kano Y, Kodaira M, Ushiki A, Kosaka M, Yamada M, Shingu K; et al. (2017). "The Complete Remission of Acquired Immunodeficiency Syndrome-associated Isolated Central Nervous System Lymphomatoid Granulomatosis: A Case Report and Review of the Literature". Intern Med. 56 (18): 2497–2501. doi:10.2169/internalmedicine.8776-16. PMC 5643181. PMID 28824078.
  20. ↑ Quinones E, Potes LI, Silva N, Lobato-Polo J (2016). "Lymphomatoid granulomatosis of the brain: A case report". Surg Neurol Int. 7 (Suppl 23): S612–6. doi:10.4103/2152-7806.189732. PMC 5025951. PMID 27656321.
  21. ↑ 21.0 21.1 Halvani A, Owlia MB, Sami R (2010). "Lymphomatoid granulomatosis with splenomegaly and pancytopenia". Zhongguo Fei Ai Za Zhi. 13 (1): 84–6. doi:10.3779/j.issn.1009-3419.2010.01.17. PMC 6000673. PMID 20672711.
  22. ↑ Castrale C, El Haggan W, Chapon F, Reman O, Lobbedez T, Ryckelynck JP; et al. (2011). "Lymphomatoid granulomatosis treated successfully with rituximab in a renal transplant patient". J Transplant. 2011: 865957. doi:10.1155/2011/865957. PMC 3087939. PMID 21559262.
  23. ↑ Liu, Hongli; Chen, Jing; Yu, Dandan; Hu, Jianli (2014). "Lymphomatoid granulomatosis involving the central nervous system: A case report and review of the literature". Oncology Letters. 7 (6): 1843–1846. doi:10.3892/ol.2014.2002. ISSN 1792-1074.
  24. ↑ Patsalides, Athos D.; Atac, Gokce; Hedge, Upendra; Janik, John; Grant, Nicole; Jaffe, Elaine S.; Dwyer, Andrew; Patronas, Nicholas J.; Wilson, Wyndham H. (2005). "Lymphomatoid Granulomatosis: Abnormalities of the Brain at MR Imaging". Radiology. 237 (1): 265–273. doi:10.1148/radiol.2371041087. ISSN 0033-8419.
  25. ↑ Cargini, Pasqualino; Civica, Maria; Sollima, Laura; Di Cola, Emanuela; Pontecorvi, Emanuele; Cutilli, Tommaso (2014). "Oral lymphomatoid granulomatosis, the first sign of a 'rare disease': a case report". Journal of Medical Case Reports. 8 (1). doi:10.1186/1752-1947-8-152. ISSN 1752-1947.
  26. ↑ Sohn EH, Song CJ, Lee HJ, Kim S, Kim JM, Lee AY (2007). "Central nervous system lymphomatoid granulomatosis presenting with parkinsonism". J Clin Neurol. 3 (2): 108–11. doi:10.3988/jcn.2007.3.2.108. PMC 2686859. PMID 19513302.
  27. ↑ Rysgaard CD, Stone MS (2015). "Lymphomatoid granulomatosis presenting with cutaneous involvement: a case report and review of the literature". J Cutan Pathol. 42 (3): 188–93. doi:10.1111/cup.12402. PMID 25355540.
  28. ↑ Gangar P, Venkatarajan S (2015). "Granulomatous Lymphoproliferative Disorders: Granulomatous Slack Skin and Lymphomatoid Granulomatosis". Dermatol Clin. 33 (3): 489–96. doi:10.1016/j.det.2015.03.013. PMID 26143428.
  29. ↑ Carlson, Keith C. (1991). "Cutaneous Signs of Lymphomatoid Granulomatosis". Archives of Dermatology. 127 (11): 1693. doi:10.1001/archderm.1991.01680100093011. ISSN 0003-987X.
  30. ↑ Minars, Norman (1975). "Lymphomatoid Granulomatosis of the Skin". Archives of Dermatology. 111 (4): 493. doi:10.1001/archderm.1975.01630160083009. ISSN 0003-987X.
  31. ↑ Rysgaard, Carolyn D.; Stone, Mary Seabury (2015). "Lymphomatoid granulomatosis presenting with cutaneous involvement: a case report and review of the literature". Journal of Cutaneous Pathology. 42 (3): 188–193. doi:10.1111/cup.12402. ISSN 0303-6987.
  32. ↑ Prieto Herman Reinehr, Clarissa; Corrêa Martins, Carla; Trein Cunha, Vivian; Elen Lira, Franci; Sprinz, Eduardo; Cartell, André; Bakos, Renato Marchiori (2017). "Cutaneous human immunodeficiency virus (HIV)-associated lymphomatoid granulomatosis: complete regression following antiretroviral therapy". International Journal of Dermatology. 56 (5): e100–e102. doi:10.1111/ijd.13551. ISSN 0011-9059.
  33. ↑ Lee, Lynette Y.; Namuduri, Rama; Chan, Michelle M. F.; Quek, Jeffrey K. S.; Koh, Mark J.-A. (2018). "Epstein-Barr virus positive diffuse large B-cell lymphoma presenting with vaginal sloughing and ulcerated skin nodule". Journal of Cutaneous Pathology. 45 (2): 162–166. doi:10.1111/cup.13074. ISSN 0303-6987.
  34. ↑ Berti, Alvise; Felicetti, Mara; Peccatori, Susanna; Bortolotti, Roberto; Guella, Anna; Vivaldi, Paolo; Morelli, Luca; Barabareschi, Mattia; Paolazzi, Giuseppe (2018). "EBV-induced lymphoproliferative disorders in rheumatic patients: A systematic review of the literature". Joint Bone Spine. 85 (1): 35–40. doi:10.1016/j.jbspin.2017.01.006. ISSN 1297-319X.
  35. ↑ Della Rossa, A. (2002). "Churg-Strauss syndrome: clinical and serological features of 19 patients from a single Italian centre". Rheumatology. 41 (11): 1286–1294. doi:10.1093/rheumatology/41.11.1286. ISSN 1460-2172.
  36. ↑ Quaden, C. (2005). "Necrotising sarcoid granulomatosis: clinical, functional, endoscopical and radiographical evaluations". European Respiratory Journal. 26 (5): 778–785. doi:10.1183/09031936.05.00024205. ISSN 0903-1936.
  37. ↑ de Groot, K; Gross, W L (2016). "Wegener's granulomatosis: disease course, assessment of activity and extent and treatment". Lupus. 7 (4): 285–291. doi:10.1191/096120398678920118. ISSN 0961-2033.
  38. ↑ Townsend, William; Linch, David (2012). "Hodgkin's lymphoma in adults". The Lancet. 380 (9844): 836–847. doi:10.1016/S0140-6736(12)60035-X. ISSN 0140-6736.
  39. ↑ Zelenetz, Andrew D.; Abramson, Jeremy S.; Advani, Ranjana H.; Andreadis, C. Babis; Bartlett, Nancy; Bellam, Naresh; Byrd, John C.; Czuczman, Myron S.; Fayad, Luis E.; Glenn, Martha J.; Gockerman, Jon P.; Gordon, Leo I.; Harris, Nancy Lee; Hoppe, Richard T.; Horwitz, Steven M.; Kelsey, Christopher R.; Kim, Youn H.; LaCasce, Ann S.; Nademanee, Auayporn; Porcu, Pierluigi; Press, Oliver; Pro, Barbara; Reddy, Nashitha; Sokol, Lubomir; Swinnen, Lode J.; Tsien, Christina; Vose, Julie M.; Wierda, William G.; Yahalom, Joachim; Zafar, Nadeem (2011). "Non-Hodgkin's Lymphomas". Journal of the National Comprehensive Cancer Network. 9 (5): 484–560. doi:10.6004/jnccn.2011.0046. ISSN 1540-1405.

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Lymphomatoid_granulomatosis_differential_diagnosis&oldid=1555254"