Lymphadenopathy differential diagnosis: Difference between revisions

Latest revision as of 05:15, 9 December 2021

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [4]; Associate Editor(s)-in-Chief: Amandeep Singh M.D.[5] Ogechukwu Hannah Nnabude, MD

Overview

Lymphadenopathy can be caused by different disease categories include: neoplasms, such as lymphoma; bacterial, viral, and parasite diseases; and inflammatory conditions, such as systemic lupus erythematosus.

Differentiating different causes of Lymphadenopathy

Lymphadenopathy can be caused by different disease categories include: neoplasms such as lymphoma; bacterial, viral, and parasites diseases; and inflammatory conditions, such as systemic lupus erythematosus.

Different causes of Lymphadenopathy can be differentiated from each other based on their different clinical manifestation such as pain, constitutional symptoms; and para clinical symptoms such as blood test and pathology on biopsy.

Diseases		Clinical manifestations							Para-clinical findings			Pathogonomic finding
		Symptoms							Para-clinical findings
		Symptoms							Lab Findings		Biopsy
		Painless or painful Lymphadenopathy	Generalized or localized Lymphadenopathy	Fever	Weight loss	Night Sweats	Rash	Other symptoms	Immunochemistry	Blood work	Biopsy
NEOPLASMS
Non-Hodgkins lymphoma		Painless	Generalized	+	+	+	+	Presents with "B" symptoms Constant fatigue Shortness of breath and cough Abdominal pain or swelling Constipation Nausea andvomiting.	Coombs test may be positive Hypogammaglobulinemia HIV serology Elevated lactate dehydrogenase Abnormal liver function test Hypercalcemia	Anemia Thrombocytopenia Leukopenia Lymphocytosis	Monomorphic medium to large sized lymphocytes seen	N/A
Hodgkin's disease^[1]^[2]^[3]^[4]		Painless	Generalized	+	+	+	+	Presents with "B" symptoms Constant fatigue Shortness of breath and Cough Abdominal pain or swelling Constipation Nausea andvomiting.	Lactate dehydrogenase (LDH) may be increased. ESR elevated Serum creatinine elevated in nephrotic syndrome. Alkaline phosphatase (ALP) increased Hypercalcemia, hypernatremia, and hypoglycemia.	N/A	Fine-needle aspiration Mononucleate and binucleate Reed-Sternberg cells in a background of inflammatory cells	Reed-Sternberg cells on microscopic pathology.
Chronic lymphocytic leukemia^[5]^[6]^[7]^[8]		Painless	Generalized	+	+	+	-	Recurrent bleeding Muscle wasting Generalized weakness Anorexia Abdominal pain Recurrent infections	Monoclonality of kappa and lambda producing B cells Presence of smudge cells Express CD19, CD20, CD23, and CD5 on the cell surface	CBC Absolute lymphocytosis (>5000 cells/μl) Decreased hemoglobin concentration Decreased platelets count	On microscopic histopathological analysis: Small lymphoid cells Thin cytoplasmic border Dense nucleus Lack of nucleolus Clumped chromatin aggregates The presence of smudge cells The presence of gumprecht nuclear shadows	N/A
Small cell carcinoma of the lung^[9]^[10]^[11]^[12]^[13]		Painless	Localized	-	-	-	-	Syndrome of inappropriate antidiuresis (SIADH) Hypercalcemia Cough (most common symptom) Wheezing Dyspnea Hemoptysis Chest pain	Nearly all SCLC are immunoreactive for keratin thyroid transcription factor 1 epithelial membrane antigen Neuroendocrine and neural differentiation result in the expression of molecules like dopa-decarboxylase calcitonin neuron-specific enolase, chromogranin A CD56 gastrin-releasing peptide insulin-like growth factor 1	N/A	The tumor cells are small and round, but they can sometimes be ovoid or spindle shaped. They have a scantycytoplasm with a high mitotic count and a hyperchromatic nuclei.	N/A
Melanoma^[14]^[15]^[16]		Painless	Localized	-	-	-	-	Rapid growth of an existing nevus Bleeding nevus Cutaneous nodules Hyper/hypopigmented skin lesion Melanonychia (brown/blue nail discoloration) Non-healing skin ulcer Painful skin lesion Pruritus Bone pain	Positive for CD133+ Positive for CD34+	N/A	An excisional biopsy (either elliptical, punch, or saucerization) of the thickest portion of the lesion with 1-3 mm margins.	Epidermal atrophy and flattening and prominent dermal invasion
Lymphomatoid granulomatosis^[17]^[18]^[19]^[20]^[21]^[22]^[23]		Painless	Generalized or localized	+	+	-	+	Cough Dyspnea Chest tightness Malaise Fatigue Headaches Seizures Hemiparesis Ataxia Macules Papules Plaques Subcutaneous nodules Larger ulcerated nodules	N/A	CBC Leukopenia Lymphopenia Low CD4 count Leukocytosis is rare Elevated Hematocrit	N/A	On chest CT scan, Halo sign is seen due to the angioinvasive nature of the disease
Angioimmunoblastic lymphadenopathy^[24]^[25]^[26]^[27]		Painless	Generalized	+	+	+	+	Edema Chest pain Abdominal pain Bone pain Fatigue Pale skin color Dark urine Chronic pain and swelling of the joints	Immunophenotyping Positivity for CD2, CD3, CD4, CD5, CD10, CD20, and focal positivity for CXCL13 Negative for ALK1 and CD30 Fluorescence in situ hybridization (FISH)	Complete blood count (CBC) Anemia Eosinophilia	Lymph node or extranodal tissue biopsy is diagnostic of angioimmunoblastic T-cell lymphoma. Characteristic findings on gross pathology, aborization and proliferation of high endothelial venules On microscopic histopathological analysis, CD4+ T-cells, CD8+ T-cells, and polyclonal plasma cells.	Epstein–Barr virus (EBV) has been found in both reactive B-cells and the neoplastic T-cells. Trisomy 3, trisomy 5, and +X are the most frequent chromosomal abnormalities found in cases.
Giant lymph node hyperplasia (Castleman disease)^[28]		Painless	Localized	+	+	-	-	Anemia Loss of appetite Cough Chest discomfort Fatigue Weakness	N/A	Complete blood count and differential count - low white blood cell counts, which may to be due to the overproduction of interleukin 6. Erythrocyte sedimentation rate - elevated in 80% cases.	N/A	Hypersecretion of the cytokine IL-6.
Diseases		Lymphadenopathy		Fever	Weight loss	Night sweats	Rash	Other symptoms	Immunochemistry	Blood work	Biopsy Histopathology	Pathogonomical findings
INFECTIONS
Bacteria	Syphilis^[29]^[30]^[31]^[32]	Painless	Localized	+	-	-	+	Primary syphilis: Chancer Secondary syphilis: Rash Condylomata lata Patchy alopecia Tertiary syphilis Gumma Organ system involvement	Darkfield microscopy to detect T. pallidum. Nontreponemal tests (e.g., VDRLand RPR ) Treponemal tests (e.g. FTA-ABS, the TP-PA assay	N/A	On microscopic histopathological analysis, characteristic findings of syphilis: Mononuclear leukocytic infiltration, macrophages, and lymphocytes. Swelling and proliferation of small blood vessels.	Painless clean base chancre.
Bacteria	Brucellosis^[33]^[34]^[35]^[36]^[37]	Painful	Localized	+	-	-	+	Abdominal pain Hepatosplenomegaly Arthritis	Brucella is most commonly isolated from blood cultures Positive titer of anti-brucella antibodies on serological testing	N/A	N/A	Night sweats, often with characteristic smell, likened to wet hay
Viral	Infectious mononucleosis^[38]	Painful	Localized	+	-	-	+	Low-grade fever without chills Sore throat White patches on tonsils and back of the throat Muscle weakness Fatigue Petechial hemorrhage	A positive reaction to a mono spot test Direct detection of EBV in blood or lymphoid tissues	A normal to moderately elevated white blood cell count An increased total number of lymphocytes Greater than 10% atypical lymphocytes Presence of atypical lymphocytes (a type of mononuclear cell) on the peripheral blood smear.	N/A	Presence of atypical lymphocytes (a type of mononuclear cell) on the peripheral blood smear.
	CMV^[39]^[40]	Painful	Localized	+	-	-	+	Floaters Scotomata Peripheral visual field defects Odynophagia Nausea Lethargy Confusion Altered mental status	Positive PCR for CMV.	Hemolytic anemia Thrombocytopenia Disseminated intravascular coagulation Pancytopenia	CMV infection demonstrates the presence of intranuclear inclusion bodies. These inclusion bodies stain dark pink on an H&E stain, and are also called "Owl's Eye" inclusion bodies.	Owl Eye inclusion bodies.
	HIV^[41]^[42]^[43]^[44]	Painful or painless	Generalized or localized	-	+	-	-	Fatigue Myalgia Arthritic pain Headache Memory loss, depression and other neurological disorders	ELISA Dot blot Latex agglutination assays Western blot assays P24 antigen assays CD4 T-cell count (CD4 count) Plasma HIV RNA viral load	Anaemia Thrombocytopenia Leukopenia	N/A	Plasma HIV RNA viral load
	Cat scratch disease^[45]^[46]^[47]^[48]	Painful	Localized	+	-	-	+	Back pain Headache Sore throat Abdominal pain Vision problems Malaise Alteration of mental status Convulsions	Indirect immunofluorescence or enzymatic immunoassay with titration of IgG or IgM antibodies to detect serum antibody to B henselae. Polymerase chain reaction (PCR) is the most sensitive test	Lymphocytosis is seen in the acute phase. Erythrocyte sedimentation rate - elevated.	N/A	Painful buboes
Mycobacteria	Tuberculosis^[49]^[50]^[51]^[52]^[53]	Painful	Generalized or localized	+	+	+	+	Hemoptysis Chest pain Anorexia Malaise Chills Fatigue Dyspnea	PCR of CSF for tuberculosis Mycobacterial culture of CSF Brain biopsy for acid-fast bacilli staining Culture and acid stain positive for acid-fast bacilli Hyponatremia Hypercalcemia Elevated alkaline phosphatase levels Mild elevation of liver enzymes	Mild normocytic anemia may be present in almost half of patients. Increased erythrocyte sedimentation rate (ESR) Mild leukocytosis	Macrophages, other immune cells such as blood monocytes (tissue macrophages) and lymphocytes also migrate to the Ghon focus aiding in the termination of the infection or initiation of a granulomatous containment.	Gohn's focus
Parasite	Toxoplasmosis^[54]^[55]^[56]^[57]	Painless	Generalized or localized	+	-	+	-	Sore throat Muscle aches and pains	IgG, IgM, IgA antibodies against toxoplasmosis seen by ELISA PCR	N/A	Microscopy of the lesions demonstrate periaqueductal and periventricular vasculitis with necrosis. Fetal tissue and placenta can demonstrate t.gondii cysts with the Wright-Giemsa stain and also with immunoperoxidase staining using t.gondii–specific antibodies.	Multiple ring enhancing lesion on CT Brain.
Diseases		Lymphadenopathy		Fever	Weight loss	Night sweats	Rash	Other symptoms	Immunochemistry	Blood work	Biopsy Histopathology	Pathogonomical findings
AUTOIMMUNE
Systemic lupus erythematosus (SLE)^[58]^[59]^[60]^[61]		Painless	Generalized or localized	+	+/-	-	+	Fatigue Myalgia Joint tenderness Muscle weakness Abdominal pain Bloating Distension	ANA positive Lupus anticoagulant (LA) IgG and IgM anticardiolipin (aCL) antibodies IgG and IgM anti-beta2-glycoprotein (GP) C3: Vary between varying between normal to slightly reduced C4: Reduced CH50: Reduced	Leukopenia Lymphopenia Mild anemia Thrombocytopenia ESR CRPelevated	Lupus erythematosus (LE) cells can be seen in SLE. LE cells are neutrophils that have engulfed an intact nucleus. LE cells are also known as LE bodies.	Malar rash and photosensitivity
Sjögren's syndrome^[62]^[63]^[64]^[65]		Painless	Generalized or localized	-	-	-	+	Xerosis Scaly skin Annular erythema	Anti-Ro/SSA Anti-La/SSB Presence of rheumatoid factor (RF) Presence of anti–alpha-fodrin antibody (diagnostic marker of juvenile Sjögren's syndrome)	Elevated erythrocyte sedimentation rate (ESR) Anemia Leukopenia Thrombocytopenia Eosinophilia	N/A	Keratoconjunctivitis sicca Presence of anti–alpha-fodrin antibody
Sarcoidosis^[66]^[67]^[68]		Painless	Generalized	-	-	-	-	Can involve all organ systems to varying extent and degree.	Serum ACE level Serum chitotriosidase Soluble interleukin-2 receptor Hypercalcemia Kveim test	N/A	Biopsy of lung Non-caseating granuloma	Non-caseating granuloma

References

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[1] Scientific Style and Format: The CBE Manual for Authors, Editors, and Publishers. Cambridge University Press. 1994. pp. 97–. ISBN 978-0-521-47154-1.

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@@ Line 1: / Line 1: @@
 __NOTOC__
 [[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Lymphadenopathy]]
-{{CMG}}; {{AE}} {{ADS}}
+{{CMG}}; {{AE}} {{ADS}} [[Ogechukwu Hannah Nnabude, MD]]
 ==Overview==
-[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
+[[Lymphadenopathy]] can be caused by different disease categories include: [[neoplasms]], such as [[lymphoma]]; [[bacterial]], [[viral]], and [[parasite]] diseases; and inflammatory conditions, such as [[Systemic lupus erythematosus causes|systemic lupus erythematosus]].
-OR
+==Differentiating different causes of Lymphadenopathy ==
+Lymphadenopathy can be caused by different disease categories include: neoplasms such as lymphoma; bacterial, viral, and parasites diseases; and inflammatory conditions, such as [[Systemic lupus erythematosus causes|systemic lupus erythematosus]].
-[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].
+===Different causes of Lymphadenopathy can be differentiated from each other based on their different clinical manifestation such as pain, constitutional symptoms; and para clinical symptoms such as blood test and pathology on biopsy. ===
-==Differentiating [Disease name] from other Diseases==
-[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
-OR
-[Disease name] must be differentiated from [differential dx1], [differential dx2], and [differential dx3].
-OR
-As [disease name] manifests in a variety of clinical forms, differentiation must be established in accordance with the particular subtype. [Subtype name 1] must be differentiated from other diseases that cause [clinical feature 1], such as [differential dx1] and [differential dx2]. In contrast, [subtype name 2] must be differentiated from other diseases that cause [clinical feature 2], such as [differential dx3] and [differential dx4].
-===Differentiating [disease name] from other diseases on the basis of [symptom 1], [symptom 2], and [symptom 3]===
-On the basis [symptom 1], [symptom 2], and [symptom 3], [disease name] must be differentiated from [disease 1], [disease 2], [disease 3], [disease 4], [disease 5], and [disease 6].
 {|
 |-
 ! colspan="2" 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="7" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Clinical manifestations'''
 ! colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Para-clinical findings
 ! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Pathogonomic finding
 |-
-| colspan="6" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Symptoms'''
+| colspan="7" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Symptoms'''
 |-
 ! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
 ! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Biopsy
 |-
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lymphadenopathy
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Painless or painful Lymphadenopathy
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Generalized or localized Lymphadenopathy
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Fever
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Weight loss
@@ Line 45: / Line 33: @@
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Blood work
 |-
-! colspan="12" style="background: #7d7d7d; color: #FFFFFF; text-align: center;" |NEOPLASMS
+! colspan="13" style="background: #7d7d7d; color: #FFFFFF; text-align: center;" |NEOPLASMS
 |-
-| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center" |'''Non-Hodgkins lymphoma'''
+| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center" |'''[[Non-Hodgkin lymphoma|Non-Hodgkins lymphoma]]'''
 | style="background: #F5F5F5; padding: 5px;" |Painless
+| style="background: #F5F5F5; padding: 5px;" |Generalized
 | style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" | +
@@ Line 79: / Line 68: @@
 | colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Hodgkin's lymphoma|Hodgkin's disease]]<ref>{{cite book|title=Scientific Style and Format: The CBE Manual for Authors, Editors, and Publishers|url=https://books.google.com/books?id=PoFJ-OhE63UC&pg=PA97|year=1994|publisher=Cambridge University Press|isbn=978-0-521-47154-1|pages=97–}}</ref><ref name="Lozano_2012">{{cite journal  |vauthors=Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, etal | title = Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. | journal = Lancet | volume = 380 | issue = 9859 | pages = 2095–128 | date = Dec 15, 2012 | oclc = 23245604 | doi = 10.1016/S0140-6736(12)61728-0 }}</ref><ref name="pmid15164877">{{cite journal| author=Shishodia S, Aggarwal BB| title=Nuclear factor-kappaB activation mediates cellular transformation, proliferation, invasion angiogenesis and metastasis of cancer. | journal=Cancer Treat Res | year= 2004 | volume= 119 | issue=  | pages= 139-73 | pmid=15164877 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15164877  }}</ref><ref name="pmid8639794">{{cite journal| author=Bargou RC, Leng C, Krappmann D, Emmerich F, Mapara MY, Bommert K et al.| title=High-level nuclear NF-kappa B and Oct-2 is a common feature of cultured Hodgkin/Reed-Sternberg cells. | journal=Blood | year= 1996 | volume= 87 | issue= 10 | pages= 4340-7 | pmid=8639794 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8639794  }}</ref>'''
 | style="background: #F5F5F5; padding: 5px;" |Painless
+| style="background: #F5F5F5; padding: 5px;" |Generalized
 | style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" | +
@@ Line 107: / Line 97: @@
 | colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Chronic lymphocytic leukemia |Chronic lymphocytic leukemia]]<ref name="pmid25461996">{{cite journal| author=Nabhan C, Rosen ST| title=Chronic lymphocytic leukemia: a clinical review. | journal=JAMA | year= 2014 | volume= 312 | issue= 21 | pages= 2265-76 | pmid=25461996 | doi=10.1001/jama.2014.14553 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25461996  }}</ref><ref name="pmid25908509">{{cite journal| author=Hallek M| title=Chronic lymphocytic leukemia: 2015 Update on diagnosis, risk stratification, and treatment. | journal=Am J Hematol | year= 2015 | volume= 90 | issue= 5 | pages= 446-60 | pmid=25908509 | doi=10.1002/ajh.23979 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25908509  }}</ref><ref name="patho">Chronic Lymphocytic Leukemia. Libre Pathology (2015) http://librepathology.org/wiki/index.php/B_cell_small_lymphocytic_lymphoma/chronic_lymphocytic_leukemia Accessed on October, 12 2015</ref><ref name="pmid259085092">{{cite journal| author=Hallek M| title=Chronic lymphocytic leukemia: 2015 Update on diagnosis, risk stratification, and treatment. | journal=Am J Hematol | year= 2015 | volume= 90 | issue= 5 | pages= 446-60 | pmid=25908509 | doi=10.1002/ajh.23979 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25908509  }}</ref>'''
 | style="background: #F5F5F5; padding: 5px;" |Painless
+| style="background: #F5F5F5; padding: 5px;" |Generalized
 | style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" | +
@@ Line 170: / Line 161: @@
 }}</ref>'''
 | style="background: #F5F5F5; padding: 5px;" |Painless
+| style="background: #F5F5F5; padding: 5px;" |Localized
 | style="background: #F5F5F5; padding: 5px;" | -
 | style="background: #F5F5F5; padding: 5px;" | -
@@ Line 205: / Line 197: @@
 | colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Melanoma]]<ref name="pmid16822996">{{cite journal| author=Miller AJ, Mihm MC| title=Melanoma. | journal=N Engl J Med | year= 2006 | volume= 355 | issue= 1 | pages= 51-65 | pmid=16822996 | doi=10.1056/NEJMra052166 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16822996  }}</ref><ref name="book1">{{cite book|last=Schanderdorf D, Kochs C, Livingstone E |date=2013 |title=Handbook of Cutaneous Melanoma: A Guide to Diagnosis and Treatment |publisher=Springer }}</ref><ref name="book2">{{cite book|last=Mooi W, Krausz T|date=2007 |title=Pathology of Melanocytic Disorders 2nd Ed. |publisher=CRC Press}}</ref>'''
 | style="background: #F5F5F5; padding: 5px;" |Painless
+| style="background: #F5F5F5; padding: 5px;" |Localized
 | style="background: #F5F5F5; padding: 5px;" | -
 | style="background: #F5F5F5; padding: 5px;" | -
@@ Line 220: / Line 213: @@
 *[[Bone pain]]
 | style="background: #F5F5F5; padding: 5px;" |
-* Positive for CD133+
+* Positive for [[CD133|CD133+]]
-* Positive for CD34+
+* Positive for [[CD34]]+
 | style="background: #F5F5F5; padding: 5px;" |
 * N/A
@@ Line 231: / Line 224: @@
 | colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Lymphomatoid granulomatosis]]<ref name="pmid21297689">{{cite journal |vauthors=Denburg JA, Bienenstock J |title=Physiology of the immune response |journal=Can Fam Physician |volume=25 |issue= |pages=301–7 |date=March 1979 |pmid=21297689 |pmc=2382958 |doi= |url=}}</ref><ref name="pmid9547995">{{cite journal| author=Jaffe ES, Wilson WH| title=Lymphomatoid granulomatosis: pathogenesis, pathology and clinical implications. | journal=Cancer Surv | year= 1997 | volume= 30 | issue=  | pages= 233-48 | pmid=9547995 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9547995  }}</ref><ref name="pmidhttps://doi.org/10.1016/S0046-8177(72)80005-4">{{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/10.1016/S0046-8177(72)80005-4 | 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><ref name="pmid11688570">{{cite journal| author=Beaty MW, Toro J, Sorbara L, Stern JB, Pittaluga S, Raffeld M et al.| title=Cutaneous lymphomatoid granulomatosis: correlation of clinical and biologic features. | journal=Am J Surg Pathol | year= 2001 | volume= 25 | issue= 9 | pages= 1111-20 | pmid=11688570 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11688570  }}</ref><ref name="pmid22361129">{{cite journal| author=Bartosik W, Raza A, Kalimuthu S, Fabre A| title=Pulmonary lymphomatoid granulomatosis mimicking lung cancer. | journal=Interact Cardiovasc Thorac Surg | year= 2012 | volume= 14 | issue= 5 | pages= 662-4 | pmid=22361129 | doi=10.1093/icvts/ivr083 | pmc=3329320 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22361129  }}</ref><ref name="pmid22214969">{{cite journal| author=Colby TV| title=Current histological diagnosis of lymphomatoid granulomatosis. | journal=Mod Pathol | year= 2012 | volume= 25 Suppl 1 | issue=  | pages= S39-42 | pmid=22214969 | doi=10.1038/modpathol.2011.149 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22214969  }}</ref><ref name="pmid22745203">{{cite journal| author=Hare SS, Souza CA, Bain G, Seely JM, Gomes MM et al.| title=The radiological spectrum of pulmonary lymphoproliferative disease. | journal=Br J Radiol | year= 2012 | volume= 85 | issue= 1015 | pages= 848-64 | pmid=22745203 | doi=10.1259/bjr/16420165 | pmc=3474050 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22745203  }}</ref>'''
 | style="background: #F5F5F5; padding: 5px;" |Painless
+| style="background: #F5F5F5; padding: 5px;" |Generalized or localized
 | style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" | +
@@ Line 266: / Line 260: @@
 | colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Angioimmunoblastic T-cell lymphoma|Angioimmunoblastic lymphadenopathy]]<ref name="who1">{{cite book |last=Swerdlow |first=S.H. |last2=Campo |first2=E. |last3=Harris |first3=N.L. |last4=Jaffe |first4=E.S. |last5=Pileri |first5=S.A. |last6=Stein |first6=H. |last7=Thiele |first7=J. |last8=Vardiman |first8=J.W |chapter=11 Mature T- and NK-cell neoplasms: Angioimmunoblastic T-cell lymphoma |title=WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues |edition=4th |series=IARC WHO Classification of Tumours |volume=2 |publisher=IARC |year=2008 |isbn=9283224310 |url=http://apps.who.int/bookorders/anglais/detart1.jsp?codlan=1&codcol=70&codcch=4002&content=1}}</ref><ref name="quin1">[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=10524524&query_hl=30&itool=pubmed_ExternalLink] Quintanilla-Martinez L, Fend F, Moguel LR, Spilove L, Beaty MW, Kingma DW, Raffeld M, Jaffe ES. "Peripheral T-cell lymphoma with Reed-Sternberg-like cells of B-cell phenotype and genotype associated with Epstein-Barr virus infection." '''Am J Surg Pathol'''. 1999 Oct;23(10):1233-40. PMID: 10524524</ref><ref name="ree1">[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=9630171&query_hl=32&itool=pubmed_ExternalLink] Ree HJ, Kadin ME, Kikuchi M, Ko YH, Go JH, Suzumiya J, Kim DS. "Angioimmunoblastic lymphoma (AILD-type T-cell lymphoma) with hyperplastic germinal centers." '''Am J Surg Pathol'''. 1998 Jun;22(6):643-55. PMID: 9630171</ref><ref name="kane12">[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=3261178&query_hl=40&itool=pubmed_ExternalLink] Kaneko Y, Maseki N, Sakurai M, Takayama S, Nanba K, Kikuchi M, Frizzera G. "Characteristic karyotypic pattern in T-cell lymphoproliferative disorders with reactive "angioimmunoblastic lymphadenopathy with dysproteinemia-type" features." '''Blood'''. 1988 Aug;72(2):413-21. PMID: 3261178</ref>'''
 | style="background: #F5F5F5; padding: 5px;" |Painless
+| style="background: #F5F5F5; padding: 5px;" |Generalized
 | style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" | +
@@ Line 272: / Line 267: @@
 | style="background: #F5F5F5; padding: 5px;" |
 *[[Edema]]
-*Chest pain
+*[[Chest pain]]
 *[[Abdominal pain]]
 *[[Bone pain]]
@@ Line 295: / Line 290: @@
 *[[Trisomy]] 3, trisomy 5, and +X are the most frequent chromosomal abnormalities found in cases.
 |-
-| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Giant lymph node hyperplasia ([[Castleman's disease|Castleman disease]])<ref>Aoki Y, Yarchoan R, Wyvill K, Okamoto S, Little RF, Tosato G. Detection of viral interleukin-6 in Kaposi sarcoma-associated herpesvirus-linked disorders. Blood 2001;97(7):2173-6.</ref>'''
+| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Castleman's disease|Giant lymph node hyperplasia]] ([[Castleman's disease|Castleman disease]])<ref>Aoki Y, Yarchoan R, Wyvill K, Okamoto S, Little RF, Tosato G. Detection of viral interleukin-6 in Kaposi sarcoma-associated herpesvirus-linked disorders. Blood 2001;97(7):2173-6.</ref>'''
 | style="background: #F5F5F5; padding: 5px;" |Painless
+| style="background: #F5F5F5; padding: 5px;" |Localized
 | style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" | +
@@ Line 311: / Line 307: @@
 * N/A
 | style="background: #F5F5F5; padding: 5px;" |
-*Complete blood count and differential count - [[low white blood cell counts]], which may to be due to the overproduction of [[interleukin 6]].
+*[[Complete blood count]] and differential count - [[low white blood cell counts]], which may to be due to the overproduction of [[interleukin 6]].
 *[[Erythrocyte sedimentation rate]] - elevated in 80% cases.
 | style="background: #F5F5F5; padding: 5px;" |
@@ Line 320: / Line 316: @@
 ! colspan="2" |Diseases
 !Lymphadenopathy
+!
 ! colspan="1" rowspan="1" |Fever
 !Weight loss
@@ Line 332: / Line 329: @@
 findings
 |-
-! colspan="12" style="background: #7d7d7d; color: #FFFFFF; text-align: center;" |INFECTIONS
+! colspan="13" style="background: #7d7d7d; color: #FFFFFF; text-align: center;" |INFECTIONS
 |-
 | rowspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Bacteria'''
 | style="background:#DCDCDC;" align="center" + |'''[[Syphilis]]<ref name="pmid21694502">{{cite journal| author=Carlson JA, Dabiri G, Cribier B, Sell S| title=The immunopathobiology of syphilis: the manifestations and course of syphilis are determined by the level of delayed-type hypersensitivity. | journal=Am J Dermatopathol | year= 2011 | volume= 33 | issue= 5 | pages= 433-60 | pmid=21694502 | doi=10.1097/DAD.0b013e3181e8b587 | pmc=3690623 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21694502  }}</ref><ref name="pmid1386838">{{cite journal| author=Fitzgerald TJ| title=The Th1/Th2-like switch in syphilitic infection: is it detrimental? | journal=Infect Immun | year= 1992 | volume= 60 | issue= 9 | pages= 3475-9 | pmid=1386838 | doi= | pmc=257347 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1386838  }}</ref><ref name="pmid10194456">{{cite journal| author=Singh AE, Romanowski B| title=Syphilis: review with emphasis on clinical, epidemiologic, and some biologic features. | journal=Clin Microbiol Rev | year= 1999 | volume= 12 | issue= 2 | pages= 187-209 | pmid=10194456 | doi= | pmc=88914 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10194456  }}</ref><ref name="pmid1911961">{{cite journal| author=Engelkens HJ, ten Kate FJ, Vuzevski VD, van der Sluis JJ, Stolz E| title=Primary and secondary syphilis: a histopathological study. | journal=Int J STD AIDS | year= 1991 | volume= 2 | issue= 4 | pages= 280-4 | pmid=1911961 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1911961  }}</ref>'''
-| style="background: #F5F5F5; padding: 5px;" |Painless and localized
+| style="background: #F5F5F5; padding: 5px;" |Painless
+| style="background: #F5F5F5; padding: 5px;" |Localized
 | style="background:#F5F5F5;" align="center" + | +
 | style="background:#F5F5F5;" align="center" + |<nowiki>-</nowiki>
@@ Line 365: / Line 363: @@
 | style="background:#DCDCDC;" align="center" + |'''[[Brucellosis]]<ref name="pmid15930423">{{cite journal| author=Pappas G, Akritidis N, Bosilkovski M, Tsianos E| title=Brucellosis. | journal=N Engl J Med | year= 2005 | volume= 352 | issue= 22 | pages= 2325-36 | pmid=15930423 | doi=10.1056/NEJMra050570 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15930423  }}</ref><ref name="pmid8698508">{{cite journal| author=Zhan Y, Liu Z, Cheers C| title=Tumor necrosis factor alpha and interleukin-12 contribute to resistance to the intracellular bacterium Brucella abortus by different mechanisms. | journal=Infect Immun | year= 1996 | volume= 64 | issue= 7 | pages= 2782-6 | pmid=8698508 | doi= | pmc=174139 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8698508  }}</ref><ref name="pmid2915152">{{cite journal| author=Gazapo E, Gonzalez Lahoz J, Subiza JL, Baquero M, Gil J, de la Concha EG| title=Changes in IgM and IgG antibody concentrations in brucellosis over time: importance for diagnosis and follow-up. | journal=J Infect Dis | year= 1989 | volume= 159 | issue= 2 | pages= 219-25 | pmid=2915152 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2915152  }}</ref><ref name="pmid10858243">{{cite journal| author=Arenas GN, Staskevich AS, Aballay A, Mayorga LS| title=Intracellular trafficking of Brucella abortus in J774 macrophages. | journal=Infect Immun | year= 2000 | volume= 68 | issue= 7 | pages= 4255-63 | pmid=10858243 | doi= | pmc=101738 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10858243  }}</ref><ref name="pmid15694858">{{cite journal| author=Lapaque N, Moriyon I, Moreno E, Gorvel JP| title=Brucella lipopolysaccharide acts as a virulence factor. | journal=Curr Opin Microbiol | year= 2005 | volume= 8 | issue= 1 | pages= 60-6 | pmid=15694858 | doi=10.1016/j.mib.2004.12.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15694858  }}</ref>'''
 | style="background: #F5F5F5; padding: 5px;" |Painful
+| style="background: #F5F5F5; padding: 5px;" |Localized
 | style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" | -
@@ Line 370: / Line 369: @@
 | style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" |
-* Abdominal pain
+* [[Abdominal pain]]
-* hepatosplenomegaly
+* [[Hepatosplenomegaly]]
-* Arthritis
+* [[Arthritis]]
 | style="background: #F5F5F5; padding: 5px;" |
 * [[Brucella|''Brucella'']] is most commonly isolated from blood cultures
@@ Line 387: / Line 386: @@
 | style="background:#DCDCDC;" align="center" + |'''[[Infectious mononucleosis]]<ref>{{cite journal |author=Chapman AL, Watkin R, Ellis CJ |title=Abdominal pain in acute infectious mononucleosis |journal=BMJ |volume=324 |issue=7338 |pages=660–1 |year=2002 |pmid=11895827 |doi=10.1136/bmj.324.7338.660}}</ref>'''
 | style="background: #F5F5F5; padding: 5px;" |Painful
+| style="background: #F5F5F5; padding: 5px;" |Localized
 | style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
 | style="background:#F5F5F5;" align="center" + |<nowiki>-</nowiki>
@@ Line 413: / Line 413: @@
 | style="background:#DCDCDC;" align="center" + |'''[[CMV]]<ref name="pmid25304390">{{cite journal| author=Griffiths P, Lumley S| title=Cytomegalovirus. | journal=Curr Opin Infect Dis | year= 2014 | volume= 27 | issue= 6 | pages= 554-9 | pmid=25304390 | doi=10.1097/QCO.0000000000000107 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25304390  }}</ref><ref name="pmid27526428">{{cite journal| author=Pytka D, Czarkowska-Pączek B| title=[CMV infection in elderly]. | journal=Przegl Lek | year= 2016 | volume= 73 | issue= 4 | pages= 241-4 | pmid=27526428 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27526428  }}</ref>'''
 | style="background: #F5F5F5; padding: 5px;" |Painful
+| style="background: #F5F5F5; padding: 5px;" |Localized
 | style="background:#F5F5F5;" align="left" + |<nowiki>+</nowiki>
 | style="background:#F5F5F5;" align="left" + |<nowiki>-</nowiki>
@@ Line 464: / Line 465: @@
 }}</ref>'''
-| style="background: #F5F5F5; padding: 5px;" |Painful/
+| style="background: #F5F5F5; padding: 5px;" |Painful or painless
-painless
+| style="background: #F5F5F5; padding: 5px;" |Generalized or localized
 | style="background: #F5F5F5; padding: 5px;" |<nowiki>-</nowiki>
 | style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki>
@@ Line 495: / Line 496: @@
 | style="background:#DCDCDC;" align="center" + | '''[[Cat scratch disease]]<ref>{{cite journal |author=Chomel BB |title=Experimental transmission of Bartonella henselae by the cat flea |journal=J. Clin. Microbiol. |volume=34 |issue=8 |pages=1952–6 |year=1996 |month=August |pmid=8818889 |pmc=229161 |author-separator=, |author2=Kasten RW |author3=Floyd-Hawkins K |display-authors=3 |last4=Chi |first4=B |last5=Yamamoto |first5=K |last6=Roberts-Wilson |first6=J |last7=Gurfield |first7=AN |last8=Abbott |first8=RC |last9=Pedersen |first9=NC}}</ref><ref>{{cite journal |author=Higgins JA, Radulovic S, Jaworski DC, Azad AF |title=Acquisition of the cat scratch disease agent Bartonella henselae by cat fleas (Siphonaptera:Pulicidae) |journal=J. Med. Entomol. |volume=33 |issue=3 |pages=490–5 |year=1996 |month=May |pmid=8667399}}</ref><ref>{{cite journal |author=Telford SR III, Wormser GP |title=Bartonella spp. transmission by ticks not established |journal=Emerg Infect Dis |volume=16 |issue=3 |pages=379–84 |year=2010 |month=March |pmid= 20202410 |doi=10.3201/eid1603.090443}}</ref><ref>{{cite journal |author=Foil L |title=Experimental infection of domestic cats with Bartonella henselae by inoculation of Ctenocephalides felis (Siphonaptera: Pulicidae) feces |journal=J. Med. Entomol. |volume=35 |issue=5 |pages=625–8 |year=1998 |month=September |pmid=9775583 |author-separator=, |author2=Andress E |author3=Freeland RL |display-authors=3 |last4=Roy |first4=AF |last5=Rutledge |first5=R |last6=Triche |first6=PC |last7=O'Reilly |first7=KL}}</ref>'''
 | style="background: #F5F5F5; padding: 5px;" |Painful
+| style="background: #F5F5F5; padding: 5px;" |Localized
 | style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki>
 | style="background: #F5F5F5; padding: 5px;" |<nowiki>-</nowiki>
@@ Line 522: / Line 524: @@
 | style="background:#DCDCDC;" align="center" + |'''[[Tuberculosis]]<ref name="Herrmann_2005">{{cite journal |author=Herrmann J, Lagrange P |title=Dendritic cells and Mycobacterium tuberculosis: which is the Trojan horse? |journal=Pathol Biol (Paris) |volume=53 |issue=1 |pages=35–40 |year=2005 | pmid = 15620608}}</ref><ref name="pmid22811737">{{cite journal| author=Silva Miranda M, Breiman A, Allain S, Deknuydt F, Altare F| title=The tuberculous granuloma: an unsuccessful host defence mechanism providing a safety shelter for the bacteria? | journal=Clin Dev Immunol | year= 2012 | volume= 2012 | issue=  | pages= 139127 | pmid=22811737 | doi=10.1155/2012/139127 | pmc=PMC3395138 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22811737  }}</ref><ref name="pmid228117372">{{cite journal| author=Silva Miranda M, Breiman A, Allain S, Deknuydt F, Altare F| title=The tuberculous granuloma: an unsuccessful host defence mechanism providing a safety shelter for the bacteria? | journal=Clin Dev Immunol | year= 2012 | volume= 2012 | issue=  | pages= 139127 | pmid=22811737 | doi=10.1155/2012/139127 | pmc=PMC3395138 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22811737  }}</ref><ref name="pmid21420161">{{cite journal| author=Lawn SD, Zumla AI| title=Tuberculosis. | journal=Lancet | year= 2011 | volume= 378 | issue= 9785 | pages= 57-72 | pmid=21420161 | doi=10.1016/S0140-6736(10)62173-3 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21420161  }}</ref><ref name="pmid23425167">{{cite journal| author=Zumla A, Raviglione M, Hafner R, von Reyn CF| title=Tuberculosis. | journal=N Engl J Med | year= 2013 | volume= 368 | issue= 8 | pages= 745-55 | pmid=23425167 | doi=10.1056/NEJMra1200894 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23425167  }}</ref>'''
 | style="background: #F5F5F5; padding: 5px;" |Painful
+| style="background: #F5F5F5; padding: 5px;" |Generalized or localized
 | style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki>
 | style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki>
@@ Line 556: / Line 559: @@
 | style="background:#DCDCDC;" align="center" + |'''[[Toxoplasmosis]]<ref name="pmid19870956">{{cite journal| author=Wolf A, Cowen D, Paige BH| title=TOXOPLASMIC ENCEPHALOMYELITIS : IV. EXPERIMENTAL TRANSMISSION OF THE INFECTION TO ANIMALS FROM A HUMAN INFANT. | journal=J Exp Med | year= 1940 | volume= 71 | issue= 2 | pages= 187-214 | pmid=19870956 | doi= | pmc=2135077 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19870956  }}</ref><ref name="pmid18128617">{{cite journal| author=FRENKEL JK| title=Pathogenesis, diagnosis and treatment of human toxoplasmosis. | journal=J Am Med Assoc | year= 1949 | volume= 140 | issue= 4 | pages= 369-77 | pmid=18128617 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18128617  }}</ref><ref name="pmid4592096">{{cite journal| author=Frenkel JK| title=Pathology and pathogenesis of congenital toxoplasmosis. | journal=Bull N Y Acad Med | year= 1974 | volume= 50 | issue= 2 | pages= 182-91 | pmid=4592096 | doi= | pmc=1749352 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4592096  }}</ref><ref name="pmid7026410">{{cite journal| author=Conley FK, Jenkins KA, Remington JS| title=Toxoplasma gondii infection of the central nervous system. Use of the peroxidase-antiperoxidase method to demonstrate toxoplasma in formalin fixed, paraffin embedded tissue sections. | journal=Hum Pathol | year= 1981 | volume= 12 | issue= 8 | pages= 690-8 | pmid=7026410 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7026410  }}</ref>'''
 | style="background: #F5F5F5; padding: 5px;" |Painless
+| style="background: #F5F5F5; padding: 5px;" |Generalized or localized
 | style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki>
 | style="background: #F5F5F5; padding: 5px;" | <nowiki>-</nowiki>
@@ Line 576: / Line 580: @@
 ! colspan="2" |Diseases
 !Lymphadenopathy
+!
 ! colspan="1" rowspan="1" |Fever
 !Weight loss
@@ Line 588: / Line 593: @@
 findings
 |-
-! colspan="12" style="background: #7d7d7d; color: #FFFFFF; text-align: center;" |AUTOIMMUNE
+! colspan="13" style="background: #7d7d7d; color: #FFFFFF; text-align: center;" |AUTOIMMUNE
 |-
 | colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Systemic lupus erythematosus causes|'''Systemic lupus erythematosus''']]
 '''(SLE)<ref name="pmid8519610">{{cite journal |vauthors=Elkon K |title=Autoantibodies in systemic lupus erythematosus |journal=Curr Opin Rheumatol |volume=7 |issue=5 |pages=384–8 |year=1995 |pmid=8519610 |doi= |url=}}</ref><ref name="pmid25449682">{{cite journal |vauthors=Yaniv G, Twig G, Shor DB, Furer A, Sherer Y, Mozes O, Komisar O, Slonimsky E, Klang E, Lotan E, Welt M, Marai I, Shina A, Amital H, Shoenfeld Y |title=A volcanic explosion of autoantibodies in systemic lupus erythematosus: a diversity of 180 different antibodies found in SLE patients |journal=Autoimmun Rev |volume=14 |issue=1 |pages=75–9 |year=2015 |pmid=25449682 |doi=10.1016/j.autrev.2014.10.003 |url=}}</ref><ref name="pmid23672591">{{cite journal |vauthors=Dye JR, Ullal AJ, Pisetsky DS |title=The role of microparticles in the pathogenesis of rheumatoid arthritis and systemic lupus erythematosus |journal=Scand. J. Immunol. |volume=78 |issue=2 |pages=140–8 |year=2013 |pmid=23672591 |doi=10.1111/sji.12068 |url=}}</ref><ref name="pmid15593221">{{cite journal |vauthors=Kirou KA, Lee C, George S, Louca K, Papagiannis IG, Peterson MG, Ly N, Woodward RN, Fry KE, Lau AY, Prentice JG, Wohlgemuth JG, Crow MK |title=Coordinate overexpression of interferon-alpha-induced genes in systemic lupus erythematosus |journal=Arthritis Rheum. |volume=50 |issue=12 |pages=3958–67 |year=2004 |pmid=15593221 |doi=10.1002/art.20798 |url=}}</ref>'''
 | style="background: #F5F5F5; padding: 5px;" |Painless
+| style="background: #F5F5F5; padding: 5px;" |Generalized or localized
 | style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" | +/-
@@ Line 628: / Line 634: @@
 | colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Sjögren's syndrome case study one|Sjögren's syndrome]]<ref name="pmid24162151">{{cite journal |vauthors=Ramos-Casals M, Brito-Zerón P, Solans R, Camps MT, Casanovas A, Sopeña B, Díaz-López B, Rascón FJ, Qanneta R, Fraile G, Pérez-Alvarez R, Callejas JL, Ripoll M, Pinilla B, Akasbi M, Fonseca E, Canora J, Nadal ME, de la Red G, Fernández-Regal I, Jiménez-Heredia I, Bosch JA, Ayala MD, Morera-Morales L, Maure B, Mera A, Ramentol M, Retamozo S, Kostov B |title=Systemic involvement in primary Sjogren's syndrome evaluated by the EULAR-SS disease activity index: analysis of 921 Spanish patients (GEAS-SS Registry) |journal=Rheumatology (Oxford) |volume=53 |issue=2 |pages=321–31 |date=February 2014 |pmid=24162151 |doi=10.1093/rheumatology/ket349 |url=}}</ref><ref name="pmid23436818">{{cite journal |vauthors=Yazdany J, Schmajuk G, Robbins M, Daikh D, Beall A, Yelin E, Barton J, Carlson A, Margaretten M, Zell J, Gensler LS, Kelly V, Saag K, King C |title=Choosing wisely: the American College of Rheumatology's Top 5 list of things physicians and patients should question |journal=Arthritis Care Res (Hoboken) |volume=65 |issue=3 |pages=329–39 |date=March 2013 |pmid=23436818 |pmc=4106486 |doi=10.1002/acr.21930 |url=}}</ref><ref name="pmid26766898">{{cite journal |vauthors=Beckman KA, Luchs J, Milner MS |title=Making the diagnosis of Sjögren's syndrome in patients with dry eye |journal=Clin Ophthalmol |volume=10 |issue= |pages=43–53 |date=2016 |pmid=26766898 |pmc=4699514 |doi=10.2147/OPTH.S80043 |url=}}</ref><ref name="pmid28367079">{{cite journal |vauthors=Both T, Dalm VA, van Hagen PM, van Daele PL |title=Reviewing primary Sjögren's syndrome: beyond the dryness - From pathophysiology to diagnosis and treatment |journal=Int J Med Sci |volume=14 |issue=3 |pages=191–200 |date=2017 |pmid=28367079 |pmc=5370281 |doi=10.7150/ijms.17718 |url=}}</ref>'''
 | style="background: #F5F5F5; padding: 5px;" |Painless
+| style="background: #F5F5F5; padding: 5px;" |Generalized or localized
 | style="background: #F5F5F5; padding: 5px;" | -
 | style="background: #F5F5F5; padding: 5px;" | -
@@ Line 655: / Line 662: @@
 | colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Sarcoidosis]]<ref>Iannuzzi MC, Rybicki BA, Teirstein AS: Sarcoidosis. N Engl J Med 357:2153–2165, 2007.</ref><ref>Zissel G: Cellular activation in the immune response of sarcoidosis. Semin Respir Crit Care Med 35:307–315, 2014.</ref><ref>Rosen Y: Pathology of sarcoidosis. Semin Respir Crit Care Med 28(1):36–52, 2007.</ref>'''
 | style="background: #F5F5F5; padding: 5px;" |Painless
+| style="background: #F5F5F5; padding: 5px;" |Generalized
 | style="background: #F5F5F5; padding: 5px;" | -
 | style="background: #F5F5F5; padding: 5px;" | -
@@ Line 675: / Line 683: @@
 * Non-[[caseating]][[granuloma]]
 |}
 ==References==
 {{Reflist|2}}
+{{WH}}
+{{WS}}
-[[Category:primary care]]
 [[Category:Inflammations]]
 [[Category:Dermatology]]
 [[Category:Hematology]]
 [[Category:Physical examination]]
 [[Category:Needs content]]
-{{WH}}
-{{WS}}