Stomach cancer differential diagnosis: Difference between revisions

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Latest revision as of 00:18, 30 July 2020

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

Overview

Stomach cancer must be differentiated from other diseases presenting with episodic abdominal pain, weight loss and loss of appetite such as gastric lymphoma, gastric metastasis, gastritis, benign gastric ulcer, Menetrier's disease.

Differential Diagnosis

Stomach cancer must be differentiated from other diseases presenting with episodic abdominal pain, weight loss and loss of appetite. The differentials include the following:^[1]^[2]^[3]^[4]^[5]^[6]^[7]^[8]^[9]


Differential Diagnosis
Disease	Cause	Symptoms									Diagnosis	Other findings
		Pain			Nausea & Vomiting	Heartburn	Belching or Bloating	Weight loss	Loss of Appetite	Stools	Endoscopy findings
		Location	Aggravating Factors	Alleviating Factors	Nausea & Vomiting	Heartburn	Belching or Bloating	Weight loss	Loss of Appetite	Stools	Endoscopy findings
Acute gastritis	H. pylori NSAIDS Corticosteroids Alcohol Spicy food Viral infections Crohn's disease Autoimmune diseases Bile reflux Cocaine use Breathing machine or ventilator Ingestion of corrosives	Epigastric pain	Food	Antacids	✔	✔	✔	-	✔	Black stools	Pangastritis or antral gastritis Erosive (Superficial, deep, hemorrhagic) Nonerosive (H. pylori)	-
Chronic gastritis	H. pylori Alcohol Medications Autoimmune diseases Chronic stress	Epigastric pain	Food	Antacids	✔	✔	✔	✔	✔	-	H. pylori gastritis Atrophy Intestinal metaplasia Lymphocytic gastritis Enlarged folds Aphthoid erosions	-
Atrophic gastritis	H. pylori Autoimmune disease	Epigastric pain	-	-	✔	-		✔	✔	-	H. pylori Mucosal atrophy Autoimmune Mucosal atrophy	Iron deficiency anemia Autoimmune gastritis diagnosis includes: Antiparietal and anti-IF antibodies Achlorhydria and hypergastrinemia Low serum cobalamine
Crohn's disease	Autoimmune disease	Abdominal pain	-	-	-	-	-	✔	✔	Chronic diarrhea often bloody with pus or mucus Rectal bleeding	Mucosal nodularity with cobblestoning Multiple aphthous ulcers Linier or serpiginous ulcerations Thickened antral folds Antral narrowing Hypoperistalsis Duodenal strictures	Fever Fatigue Anemia (pernicious anemia)
GERD	Lower esophageal sphincter abnormalities Hiatal hernia Abnormal esophageal contractions Prolonged emptying of stomach Gastrinomas	Epigastric pain	Spicy food Tight fitting clothing	Antacids Head elevation during sleep	✔ (Suspect delayed gastric emptying)	✔	-	-	-	-	Esophagitis Barrette's esophagus Strictures	Other symptoms: Dysphagia Regurgitation Nocturnal cough Hoarseness Complications Esophagitis Strictures Barrette esophagus
Peptic ulcer disease	H. pylori Smoking Alcohol Radiation therapy Medications Zollinger-ellison syndrome	Epigastric pain sometimes extending to back Right upper quadrant pain	Duodenal ulcer Pain aggravates with empty stomach Gastric ulcer Pain aggravates with food	Antacids Duodenal ulcer Pain alleviates with food	✔	✔	-	-	-	Black stools	Gastric ulcers Discrete mucosal lesions with a punched-out smooth ulcer base with whitish fibrinoid base Most ulcers are at the junction of fundus and antrum 0.5-2.5cm Duodenal ulcers Well-demarcated break in the mucosa that may extend into the muscularis propria of the duodenum Found in the first part of duodenum <1cm	Other diagnostic tests Serum gastrin levels Secretin stimulation test Biopsy
Gastrinoma	Associated with MEN type 1	Abdominal pain	-	-	✔ (suspect gastric outlet obstruction)	✔	-	-	-	Black stools	Useful in collecting the tissue for biopsy	May present with symptoms of GERD or peptic ulcer disease Associated with MEN type 1 Diagnostic tests Serum gastrin levels Somatostatin receptor scintigraphy CT and MRI
Gastric Adenocarcinoma	H. pylori infection Smoked and salted food	Abdominal pain	-	-	✔	✔	✔	✔	✔	Black stools, or blood in stools	Esophagogastroduodenoscopy Multiple biopsies are taken to establish the diagnosis	Other symptoms Dysphagia Early satiety Frequent burping
Primary gastric lymphoma	H. pylori infection	Abdominal pain Chest pain	-	-	-	-	-	✔	-	-	Useful in collecting the tissue for biopsy	Other symptoms Painless swollen lymph nodes in neck and armpit Night sweats Fatigue Fever Cough or trouble breathing

References

↑ Sugimachi K, Inokuchi K, Kuwano H, Ooiwa T (1984). "Acute gastritis clinically classified in accordance with data from both upper GI series and endoscopy". Scand J Gastroenterol. 19 (1): 31–7. PMID 6710074.
↑ Sipponen P, Maaroos HI (2015). "Chronic gastritis". Scand J Gastroenterol. 50 (6): 657–67. doi:10.3109/00365521.2015.1019918. PMC 4673514. PMID 25901896.
↑ Sartor RB (2006). "Mechanisms of disease: pathogenesis of Crohn's disease and ulcerative colitis". Nat Clin Pract Gastroenterol Hepatol. 3 (7): 390–407. doi:10.1038/ncpgasthep0528. PMID 16819502.
↑ Sipponen P (1989). "Atrophic gastritis as a premalignant condition". Ann Med. 21 (4): 287–90. PMID 2789799.
↑ Badillo R, Francis D (2014). "Diagnosis and treatment of gastroesophageal reflux disease". World J Gastrointest Pharmacol Ther. 5 (3): 105–12. doi:10.4292/wjgpt.v5.i3.105. PMC 4133436. PMID 25133039.
↑ Ramakrishnan K, Salinas RC (2007). "Peptic ulcer disease". Am Fam Physician. 76 (7): 1005–12. PMID 17956071.
↑ Banasch M, Schmitz F (2007). "Diagnosis and treatment of gastrinoma in the era of proton pump inhibitors". Wien Klin Wochenschr. 119 (19–20): 573–8. doi:10.1007/s00508-007-0884-2. PMID 17985090.
↑ Dicken BJ, Bigam DL, Cass C, Mackey JR, Joy AA, Hamilton SM (2005). "Gastric adenocarcinoma: review and considerations for future directions". Ann Surg. 241 (1): 27–39. PMC 1356843. PMID 15621988.
↑ Ghimire P, Wu GY, Zhu L (2011). "Primary gastrointestinal lymphoma". World J Gastroenterol. 17 (6): 697–707. doi:10.3748/wjg.v17.i6.697. PMC 3042647. PMID 21390139.

Template:WH Template:WS

[pmid6710074-1] Sugimachi K, Inokuchi K, Kuwano H, Ooiwa T (1984). "Acute gastritis clinically classified in accordance with data from both upper GI series and endoscopy". Scand J Gastroenterol. 19 (1): 31–7. PMID 6710074.

[pmid25901896-2] Sipponen P, Maaroos HI (2015). "Chronic gastritis". Scand J Gastroenterol. 50 (6): 657–67. doi:10.3109/00365521.2015.1019918. PMC 4673514. PMID 25901896.

[pmid16819502-3] Sartor RB (2006). "Mechanisms of disease: pathogenesis of Crohn's disease and ulcerative colitis". Nat Clin Pract Gastroenterol Hepatol. 3 (7): 390–407. doi:10.1038/ncpgasthep0528. PMID 16819502.

[pmid2789799-4] Sipponen P (1989). "Atrophic gastritis as a premalignant condition". Ann Med. 21 (4): 287–90. PMID 2789799.

[pmid25133039-5] Badillo R, Francis D (2014). "Diagnosis and treatment of gastroesophageal reflux disease". World J Gastrointest Pharmacol Ther. 5 (3): 105–12. doi:10.4292/wjgpt.v5.i3.105. PMC 4133436. PMID 25133039.

[pmid17956071-6] Ramakrishnan K, Salinas RC (2007). "Peptic ulcer disease". Am Fam Physician. 76 (7): 1005–12. PMID 17956071.

[pmid17985090-7] Banasch M, Schmitz F (2007). "Diagnosis and treatment of gastrinoma in the era of proton pump inhibitors". Wien Klin Wochenschr. 119 (19–20): 573–8. doi:10.1007/s00508-007-0884-2. PMID 17985090.

[pmid15621988-8] Dicken BJ, Bigam DL, Cass C, Mackey JR, Joy AA, Hamilton SM (2005). "Gastric adenocarcinoma: review and considerations for future directions". Ann Surg. 241 (1): 27–39. PMC 1356843. PMID 15621988.

[pmid21390139-9] Ghimire P, Wu GY, Zhu L (2011). "Primary gastrointestinal lymphoma". World J Gastroenterol. 17 (6): 697–707. doi:10.3748/wjg.v17.i6.697. PMC 3042647. PMID 21390139.

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@@ Line 1: / Line 1: @@
 __NOTOC__
+{{Stomach cancer}}
 {{CMG}}{{AE}}{{PSD}}
-{{Stomach cancer}}
 ==Overview==
-Stomach cancer must be differentiated from [[gastric lymphoma]], [[gastric]] [[metastasis]], [[gastritis]], benign gastric [[ulcer]], menetrier disease.
+[[Stomach cancer]] must be differentiated from other [[diseases]] presenting with episodic [[abdominal pain]], [[weight loss]] and [[loss of appetite]] such as [[gastric lymphoma]], [[gastric]] [[metastasis]], [[gastritis]], [[Peptic ulcer|benign gastric ulcer]], [[Ménétrier's disease|Menetrier's disease]].
-==Differential diagnosis==
+==Differential Diagnosis==
-The differential can be broad and includes:
+[[Stomach cancer]] must be differentiated from other [[diseases]] presenting with episodic [[abdominal pain]], [[weight loss]] and [[loss of appetite]]. The differentials include the following:<ref name="pmid6710074">{{cite journal| author=Sugimachi K, Inokuchi K, Kuwano H, Ooiwa T| title=Acute gastritis clinically classified in accordance with data from both upper GI series and endoscopy. | journal=Scand J Gastroenterol | year= 1984 | volume= 19 | issue= 1 | pages= 31-7 | pmid=6710074 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6710074  }} </ref><ref name="pmid25901896">{{cite journal| author=Sipponen P, Maaroos HI| title=Chronic gastritis. | journal=Scand J Gastroenterol | year= 2015 | volume= 50 | issue= 6 | pages= 657-67 | pmid=25901896 | doi=10.3109/00365521.2015.1019918 | pmc=4673514 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25901896  }} </ref><ref name="pmid16819502">{{cite journal| author=Sartor RB| title=Mechanisms of disease: pathogenesis of Crohn's disease and ulcerative colitis. | journal=Nat Clin Pract Gastroenterol Hepatol | year= 2006 | volume= 3 | issue= 7 | pages= 390-407 | pmid=16819502 | doi=10.1038/ncpgasthep0528 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16819502  }} </ref><ref name="pmid2789799">{{cite journal| author=Sipponen P| title=Atrophic gastritis as a premalignant condition. | journal=Ann Med | year= 1989 | volume= 21 | issue= 4 | pages= 287-90 | pmid=2789799 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2789799  }} </ref><ref name="pmid25133039">{{cite journal| author=Badillo R, Francis D| title=Diagnosis and treatment of gastroesophageal reflux disease. | journal=World J Gastrointest Pharmacol Ther | year= 2014 | volume= 5 | issue= 3 | pages= 105-12 | pmid=25133039 | doi=10.4292/wjgpt.v5.i3.105 | pmc=4133436 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25133039  }} </ref><ref name="pmid17956071">{{cite journal| author=Ramakrishnan K, Salinas RC| title=Peptic ulcer disease. | journal=Am Fam Physician | year= 2007 | volume= 76 | issue= 7 | pages= 1005-12 | pmid=17956071 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17956071  }} </ref><ref name="pmid17985090">{{cite journal| author=Banasch M, Schmitz F| title=Diagnosis and treatment of gastrinoma in the era of proton pump inhibitors. | journal=Wien Klin Wochenschr | year= 2007 | volume= 119 | issue= 19-20 | pages= 573-8 | pmid=17985090 | doi=10.1007/s00508-007-0884-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17985090  }} </ref><ref name="pmid15621988">{{cite journal| author=Dicken BJ, Bigam DL, Cass C, Mackey JR, Joy AA, Hamilton SM| title=Gastric adenocarcinoma: review and considerations for future directions. | journal=Ann Surg | year= 2005 | volume= 241 | issue= 1 | pages= 27-39 | pmid=15621988 | doi= | pmc=1356843 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15621988  }} </ref><ref name="pmid21390139">{{cite journal| author=Ghimire P, Wu GY, Zhu L| title=Primary gastrointestinal lymphoma. | journal=World J Gastroenterol | year= 2011 | volume= 17 | issue= 6 | pages= 697-707 | pmid=21390139 | doi=10.3748/wjg.v17.i6.697 | pmc=3042647 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21390139  }} </ref>
+<div style="width: 85%;">
+<small>
+{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
+| colspan="13" style="background: #4479BA; text-align: center;" | {{fontcolor|#FFF|'''Differential Diagnosis'''}}
+|+
+| rowspan="3" style="background:#4479BA; padding: 5px 5px;" align="center" |{{fontcolor|#FFF|'''Disease'''}}
+| rowspan="3" style="background:#4479BA; padding: 5px 5px;" align="center" |{{fontcolor|#FFF|'''Cause'''}}
+| colspan="9" style="background:#4479BA; padding: 5px 5px;" align="center" |{{fontcolor|#FFF|'''Symptoms'''}}
+| style="background:#4479BA; padding: 5px 5px;" align="center" |{{fontcolor|#FFF|'''Diagnosis'''}}
+| rowspan="3" style="background:#4479BA; padding: 5px 5px;" align="center" |{{fontcolor|#FFF|'''Other findings'''}}
+|-
+| colspan="3" style="background:#4479BA; padding: 5px 5px;" align="center" |{{fontcolor|#FFF|'''Pain'''}}
+| rowspan="2" style="background:#4479BA; padding: 5px 5px;" align="center" |{{fontcolor|#FFF|'''Nausea & Vomiting'''}}
+| rowspan="2" style="background:#4479BA; padding: 5px 5px;" align="center" |{{fontcolor|#FFF|'''Heartburn'''}}
+| rowspan="2" style="background:#4479BA; padding: 5px 5px;" align="center" |{{fontcolor|#FFF|'''Belching or Bloating'''}}
+| rowspan="2" style="background:#4479BA; padding: 5px 5px;" align="center" |{{fontcolor|#FFF|'''Weight loss'''}}
+| rowspan="2" style="background:#4479BA; padding: 5px 5px;" align="center" |{{fontcolor|#FFF|'''Loss of Appetite'''}}
+| rowspan="2" style="background:#4479BA; padding: 5px 5px;" align="center" |{{fontcolor|#FFF|'''Stools'''}}
+| rowspan="2" style="background:#4479BA; padding: 5px 5px;" align="center" |{{fontcolor|#FFF|'''Endoscopy findings'''}}
+|-
+| rowspan="1" style="background:#4479BA; padding: 5px 5px;" align="center" |{{fontcolor|#FFF|'''Location'''}}
+| rowspan="1" style="background:#4479BA; padding: 5px 5px;" align="center" |{{fontcolor|#FFF|'''Aggravating Factors'''}}
+| rowspan="1" style="background:#4479BA; padding: 5px 5px;" align="center" |{{fontcolor|#FFF|'''Alleviating Factors'''}}
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" |[[Acute gastritis]]
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* ''[[H. pylori]]''
+* [[NSAIDS]]
+* [[Corticosteroids]]
+* [[Alcohol]]
+* Spicy [[food]]
+* [[Viral infections]]
+* [[Crohn's disease]]
+* [[Autoimmune diseases]]
+* [[Bile]] reflux
+* [[Cocaine]] use
+* Breathing machine or [[ventilator]]
+* Ingestion of [[corrosive|corrosives]]
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* [[Epigastric pain]]
+| style="padding: 5px 5px; background: #F5F5F5;" | [[Food]]
+| style="padding: 5px 5px; background: #F5F5F5;" | [[Antacids]]
+| style="padding: 5px 5px; background: #F5F5F5;" |  ✔
+| style="padding: 5px 5px; background: #F5F5F5;" | ✔
+| style="padding: 5px 5px; background: #F5F5F5;" | ✔
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" | ✔
+| style="padding: 5px 5px; background: #F5F5F5;" | [[Melena|Black stools]]
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* [[Pangastritis]] or antral [[gastritis]]
+* [[Gastric erosion|Erosive]] (Superficial, deep, [[hemorrhagic]])
+* Nonerosive (''[[H. pylori]]'')
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" |[[Gastritis|Chronic gastritis]]
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* ''[[H. pylori]]''
+* [[Alcohol]]
+* Medications
+* [[Autoimmune diseases]]
+* Chronic [[stress]]
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* [[Epigastric pain]]
+| style="padding: 5px 5px; background: #F5F5F5;" | [[Food]]
+| style="padding: 5px 5px; background: #F5F5F5;" | [[Antacids]]
+| style="padding: 5px 5px; background: #F5F5F5;" | ✔
+| style="padding: 5px 5px; background: #F5F5F5;" | ✔
+| style="padding: 5px 5px; background: #F5F5F5;" | ✔
+| style="padding: 5px 5px; background: #F5F5F5;" | ✔
+| style="padding: 5px 5px; background: #F5F5F5;" | ✔
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" | ''[[H. pylori]] [[gastritis]]''
+* [[Atrophy]]
+* [[Intestinal]] [[metaplasia]]
+Lymphocytic [[gastritis]]
+* Enlarged folds
+* Aphthoid erosions
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" |[[Atrophic gastritis]]
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* ''[[H. pylori]]''
+* [[Autoimmune disease]]
+| style="padding: 5px 5px; background: #F5F5F5;" |
+*[[Epigastric pain]]
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" | ✔
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" |
+| style="padding: 5px 5px; background: #F5F5F5;" | ✔
+| style="padding: 5px 5px; background: #F5F5F5;" | ✔
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" | ''[[H. pylori]]''
+* [[Mucosal]] [[atrophy]]
+[[Autoimmune]]
+* [[Mucosal]] [[atrophy]]
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* [[Iron deficiency anemia]]
+*Autoimmune gastritis diagnosis includes:
+**Antiparietal and anti-IF antibodies
+**[[Achlorhydria]] and hypergastrinemia
+**Low serum [[vitamin B12|cobalamine]]
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" |[[Crohn's disease]]
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* [[Autoimmune disease]]
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* [[Abdominal pain]]
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" | ✔
+| style="padding: 5px 5px; background: #F5F5F5;" | ✔
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* Chronic [[diarrhea]] often bloody with [[pus]] or [[mucus]]
+* [[Rectal bleeding]]
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* [[Mucosal]] nodularity with cobblestoning
+* Multiple [[aphthous ulcers]]
+* Linier or serpiginous [[ulcerations]]
+* Thickened antral folds
+* Antral narrowing
+* Hypoperistalsis
+* [[Duodenal]] strictures
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* [[Fever]]
+* [[Fatigue]]
+* [[Anemia]] ([[pernicious anemia]])
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" |[[GERD]]
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* [[Lower esophageal sphincter]] abnormalities
+* [[Hiatal hernia]]
+* Abnormal [[esophageal]] contractions
+* Prolonged emptying of [[stomach]]
+* [[Gastrinomas|Gastrinoma]]<nowiki/>s
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* [[Epigastric pain]]
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* Spicy food
+* Tight fitting clothing
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* [[Antacids]]
+* Head elevation during sleep
+| style="padding: 5px 5px; background: #F5F5F5;" | ✔
-*[[gastric lymphoma]]
+(Suspect delayed gastric emptying)
+| style="padding: 5px 5px; background: #F5F5F5;" | ✔
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* [[Esophagitis]]
+* [[Barrette's esophagus]]
+* [[Strictures]]
+| style="padding: 5px 5px; background: #F5F5F5;" | Other symptoms:
+* [[Dysphagia]]
+* [[Regurgitation]]
+* [[Cough|Nocturnal cough]]
+* [[Hoarseness]]
+Complications
+* [[Esophagitis]]
+* [[Strictures]]
+* Barrette esophagus
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" |[[Peptic ulcer disease]]
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* ''[[H. pylori]]''
+* [[Smoking]]
+* [[Alcohol]]
+* [[Radiation therapy]]
+* Medications
+* Zollinger-ellison syndrome
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* [[Epigastric pain]] sometimes extending to back
+* [[Right upper quadrant pain]]
+| style="padding: 5px 5px; background: #F5F5F5;" |
+'''[[Duodenal ulcer]]'''
+*Pain aggravates with empty stomach
+'''[[Gastric ulcer]]'''
+*Pain aggravates with food
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* [[Antacids]]
-*gastric metastasis
+* [[Duodenal ulcer]]
+:*Pain alleviates with food
+| style="padding: 5px 5px; background: #F5F5F5;" | ✔
+| style="padding: 5px 5px; background: #F5F5F5;" | ✔
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* [[Melena|Black stools]]
+| style="padding: 5px 5px; background: #F5F5F5;" | '''Gastric ulcers'''
+* Discrete [[mucosal]] [[lesions]] with a punched-out smooth [[ulcer]] base with whitish fibrinoid base
+* Most [[ulcers]] are at the junction of [[fundus]] and [[antrum]]
+* 0.5-2.5cm
+'''Duodenal ulcers'''
+* Well-demarcated break in the [[mucosa]] that may extend into the [[muscularis propria]] of the [[duodenum]]
+* Found in the first part of [[duodenum]]
+* <1cm
+| style="padding: 5px 5px; background: #F5F5F5;" | '''Other diagnostic tests'''
+* Serum [[gastrin]] levels
+* [[Secretin]] stimulation test
+* [[Biopsy]]
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" |[[Gastrinoma]]
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* Associated with [[MEN type 1]]
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* [[Abdominal pain]]
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" | ✔
-*gastric stromal [[tumour]] (GIST)
+(suspect [[gastric outlet obstruction]])
-*[[gastritis]]
+| style="padding: 5px 5px; background: #F5F5F5;" | ✔
-*benign gastric (peptic) [[ulcer]]
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
-*Menetrier disease
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
-*secondary changes from [[pancreatitis]] (from extrinsic inflammatory change)
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* [[Melena|Black stools]]
+| style="padding: 5px 5px; background: #F5F5F5;" | Useful in collecting the tissue for [[biopsy]]
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* May present with symptoms of [[GERD]] or [[peptic ulcer disease]]
+* Associated with [[MEN type 1]]
+'''Diagnostic tests'''
+* Serum [[gastrin]] levels
+* [[Somatostatin]] receptor [[scintigraphy]]
+* [[CT]] and [[MRI]]
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" |[[Gastric Cancer|Gastric Adenocarcinoma]]
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* ''[[H. pylori]]'' infection
+* Smoked and salted food
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* [[Abdominal pain]]
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" | ✔
+| style="padding: 5px 5px; background: #F5F5F5;" | ✔
+| style="padding: 5px 5px; background: #F5F5F5;" | ✔
+| style="padding: 5px 5px; background: #F5F5F5;" | ✔
+| style="padding: 5px 5px; background: #F5F5F5;" | ✔
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* [[Melena|Black stools]], or blood in stools
+| style="padding: 5px 5px; background: #F5F5F5;" | '''Esophagogastroduodenoscopy'''
+* Multiple biopsies are taken to establish the diagnosis
+| style="padding: 5px 5px; background: #F5F5F5;" | '''Other symptoms'''
+* [[Dysphagia]]
+* Early [[satiety]]
+* Frequent [[burping]]
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" |[[Gastric lymphoma|Primary gastric lymphoma]]
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* ''[[H. pylori]]'' infection
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* [[Abdominal pain]]
+* [[Chest pain]]
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" | ✔
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" | <nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" | Useful in collecting the [[tissue]] for [[biopsy]]
+| style="padding: 5px 5px; background: #F5F5F5;" | '''Other symptoms'''
+* Painless swollen [[lymph nodes]] in neck and armpit
+* Night sweats
+* [[Fatigue]]
+* [[Fever]]
+* [[Cough]] or trouble breathing
+|}
+</small>
+</div>
 ==References==
 {{reflist|2}}
+{{WH}}
+{{WS}}
 [[Category:Disease]]
-[[Category:Oncology]]
 [[Category:Types of cancer]]
 [[Category:Conditions diagnosed by stool test]]
-[[Category:Primary care]]
+[[Category:Up-To-Date]]
+[[Category:Oncology]]
-{{WH}}
+[[Category:Medicine]]
-{{WS}}
+[[Category:Gastroenterology]]
+[[Category:Surgery]]

Stomach cancer differential diagnosis: Difference between revisions

Latest revision as of 00:18, 30 July 2020

Overview

Differential Diagnosis

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