Large cell carcinoma of the lung differential diagnosis: Difference between revisions

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__NOTOC__
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{{Large cell carcinoma of the lung}}
[[Image:Home_logo1.png|right|250px|link=http://www.wikidoc.org/index.php/Large_cell_carcinoma_of_the_lung]]
{{CMG}}{{AE}}{{MV}}
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==Overview==
==Overview==


Large cell carcinoma of the lung must be differentiated from other diseases that cause chronic dry [[cough]], [[weight loss]], [[fatigue]], and [[dyspnea]] among adults such as [[tuberculosis]], pulmonary fungal disease, lung abscess, and [[metastases]].<ref name="pmid24455507">{{cite journal| author=Bhatt M, Kant S, Bhaskar R| title=Pulmonary tuberculosis as differential diagnosis of non-small cell lung cancer | journal=South Asian J Cancer | year= 2012 | volume= 1 | issue= 1 | pages= 36-42 | pmid=24455507 | doi=10.4103/2278-330X.96507 | pmc=PMC3876596 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24455507  }}</ref><ref name="pmid19640168">{{cite journal |vauthors=Singh VK, Chandra S, Kumar S, Pangtey G, Mohan A, Guleria R |title=A common medical error: lung cancer misdiagnosed as sputum negative tuberculosis |journal=Asian Pac. J. Cancer Prev. |volume=10 |issue=3 |pages=335–8 |year=2009 |pmid=19640168 |doi= |url=}}</ref>
Large cell carcinoma of the lung must be differentiated from other diseases that cause non-productive [[cough]], [[weight loss]], [[fatigue]], and [[dyspnea]] among adults such as [[tuberculosis]], pulmonary fungal disease, lung abscess, and more importantly from other causes of non-small cell lung cancers, such as adenocarcinoma and squamous cell lung cancer.<ref name="pmid24455507">{{cite journal| author=Bhatt M, Kant S, Bhaskar R| title=Pulmonary tuberculosis as differential diagnosis of non-small cell lung cancer | journal=South Asian J Cancer | year= 2012 | volume= 1 | issue= 1 | pages= 36-42 | pmid=24455507 | doi=10.4103/2278-330X.96507 | pmc=PMC3876596 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24455507  }}</ref><ref name="pmid19640168">{{cite journal |vauthors=Singh VK, Chandra S, Kumar S, Pangtey G, Mohan A, Guleria R |title=A common medical error: lung cancer misdiagnosed as sputum negative tuberculosis |journal=Asian Pac. J. Cancer Prev. |volume=10 |issue=3 |pages=335–8 |year=2009 |pmid=19640168 |doi= |url=}}</ref>


==Differential Diagnosis==
==Differential Diagnosis==
*The table below summarizes the findings that differentiate large cell carcinoma of the lung, from other diseases that cause chronic dry [[cough]], [[weight loss]], [[fatigue]], and [[dyspnea]] among adults such as [[tuberculosis]], pulmonary fungal disease, lung abscess, and [[metastases]].<ref name="pmid24455507">{{cite journal| author=Bhatt M, Kant S, Bhaskar R| title=Pulmonary tuberculosis as differential diagnosis of non-small cell lung cancer | journal=South Asian J Cancer | year= 2012 | volume= 1 | issue= 1 | pages= 36-42 | pmid=24455507 | doi=10.4103/2278-330X.96507 | pmc=PMC3876596 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24455507  }}</ref><ref name="pmid19640168">{{cite journal |vauthors=Singh VK, Chandra S, Kumar S, Pangtey G, Mohan A, Guleria R |title=A common medical error: lung cancer misdiagnosed as sputum negative tuberculosis |journal=Asian Pac. J. Cancer Prev. |volume=10 |issue=3 |pages=335–8 |year=2009 |pmid=19640168 |doi= |url=}}</ref>
*The table below summarizes the findings that differentiate large cell carcinoma of the lung, from other diseases that cause non-productive cough, [[weight loss]], [[fatigue]], and [[dyspnea]] among adults such as [[tuberculosis]], pulmonary fungal disease, lung abscess, and more importantly other causes of  non-small cell lung cancers, such as adenocarcinoma and squamous cell lung cancer.<ref name="pmid24455507">{{cite journal| author=Bhatt M, Kant S, Bhaskar R| title=Pulmonary tuberculosis as differential diagnosis of non-small cell lung cancer | journal=South Asian J Cancer | year= 2012 | volume= 1 | issue= 1 | pages= 36-42 | pmid=24455507 | doi=10.4103/2278-330X.96507 | pmc=PMC3876596 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24455507  }}</ref><ref name="pmid19640168">{{cite journal |vauthors=Singh VK, Chandra S, Kumar S, Pangtey G, Mohan A, Guleria R |title=A common medical error: lung cancer misdiagnosed as sputum negative tuberculosis |journal=Asian Pac. J. Cancer Prev. |volume=10 |issue=3 |pages=335–8 |year=2009 |pmid=19640168 |doi= |url=}}</ref>


{| style="border: 0px; font-size: 90%; margin: 3px; width: 1000px" align="center"
| valign="top" |
|+
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Differential Diagnosis}}
! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Similar Features}}
! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Differentiating Features}}
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |''' [[Pulmonary tuberculosis]]'''
| style="padding: 5px 5px; background: #F5F5F5;" |
*Cough, weight loss, fatigue, and dyspnea
| style="padding: 5px 5px; background: #F5F5F5;" | 
*In pulmonary tuberculosis, differentiating features include: size increase despite optimal medical therapy, patients age is usually younger, hemoptysis is an early feature, and CXR anatomical predilection for upper lobes
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |''' [[ Lung abscess]]'''
| style="padding: 5px 5px; background: #F5F5F5;" |
*Non-productive cough, weight loss, and chest pain
| style="padding: 5px 5px; background: #F5F5F5;" |
*In lung abscess, differentiating features include: acute or sub-acute onset, CXR anatomical predilection for upper lobes,  and  usually resolve with antibiotic
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Pneumonia]]'''
| style="padding: 5px 5px; background: #F5F5F5;" | 
*Cough, weight loss, fatigue, and dyspnea
| style="padding: 5px 5px; background: #F5F5F5;" |
*In pneumonia, differentiating features include: good response to antibiotics, acute onset, predilection on CXR is consolidation, laboratory markers indicate infection
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" | '''[[Aspergillosis|Pulmonary fungal infection]]'''
| style="padding: 5px 5px; background: #F5F5F5;" |
*Non-productive cough, weight loss, fatigue, and dyspnea
| style="padding: 5px 5px; background: #F5F5F5;" |
*In pulmonary fungal infection, differentiating features include: CXR findings: air-cresecent sign, no response to antibioitcs, and  mimics tuberculosis
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Non small cell lung cancer|Other non-small cell lung cancers]]'''
| style="padding: 5px 5px; background: #F5F5F5;" | 
*Non-productive cough, weight loss, fatigue, and dyspnea
| style="padding: 5px 5px; background: #F5F5F5;" |
*In  other non-small cell lung cancers , differentiating features include: histopathologica features, such as larger size of the anaplastic cells, a higher cytoplasmic-to-nuclear size ratio, and a lack of "salt-and-pepper" chromatin
|}


==References==
==References==
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Latest revision as of 20:15, 19 February 2019

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

Overview

Large cell carcinoma of the lung must be differentiated from other diseases that cause non-productive cough, weight loss, fatigue, and dyspnea among adults such as tuberculosis, pulmonary fungal disease, lung abscess, and more importantly from other causes of non-small cell lung cancers, such as adenocarcinoma and squamous cell lung cancer.[1][2]

Differential Diagnosis

  • The table below summarizes the findings that differentiate large cell carcinoma of the lung, from other diseases that cause non-productive cough, weight loss, fatigue, and dyspnea among adults such as tuberculosis, pulmonary fungal disease, lung abscess, and more importantly other causes of non-small cell lung cancers, such as adenocarcinoma and squamous cell lung cancer.[1][2]
Differential Diagnosis Similar Features Differentiating Features
Pulmonary tuberculosis
  • Cough, weight loss, fatigue, and dyspnea
  • In pulmonary tuberculosis, differentiating features include: size increase despite optimal medical therapy, patients age is usually younger, hemoptysis is an early feature, and CXR anatomical predilection for upper lobes
Lung abscess
  • Non-productive cough, weight loss, and chest pain
  • In lung abscess, differentiating features include: acute or sub-acute onset, CXR anatomical predilection for upper lobes, and usually resolve with antibiotic
Pneumonia
  • Cough, weight loss, fatigue, and dyspnea
  • In pneumonia, differentiating features include: good response to antibiotics, acute onset, predilection on CXR is consolidation, laboratory markers indicate infection
Pulmonary fungal infection
  • Non-productive cough, weight loss, fatigue, and dyspnea
  • In pulmonary fungal infection, differentiating features include: CXR findings: air-cresecent sign, no response to antibioitcs, and mimics tuberculosis
Other non-small cell lung cancers
  • Non-productive cough, weight loss, fatigue, and dyspnea
  • In other non-small cell lung cancers , differentiating features include: histopathologica features, such as larger size of the anaplastic cells, a higher cytoplasmic-to-nuclear size ratio, and a lack of "salt-and-pepper" chromatin

References

  1. ↑ 1.0 1.1 Bhatt M, Kant S, Bhaskar R (2012). "Pulmonary tuberculosis as differential diagnosis of non-small cell lung cancer". South Asian J Cancer. 1 (1): 36–42. doi:10.4103/2278-330X.96507. PMC 3876596. PMID 24455507.
  2. ↑ 2.0 2.1 Singh VK, Chandra S, Kumar S, Pangtey G, Mohan A, Guleria R (2009). "A common medical error: lung cancer misdiagnosed as sputum negative tuberculosis". Asian Pac. J. Cancer Prev. 10 (3): 335–8. PMID 19640168.


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