Sandbox: DDx pancrease: Difference between revisions

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! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|'''Differential Diagnosis'''}}
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|'''Differential Diagnosis'''}}
! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|'''Clinical Presentation'''}}
! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|'''Clinical Presentation'''}}
! style="background: #4479BA; width: 450px;" | {{fontcolor|#FFF|'''Laboratory Findings'''}}
! style="background: #4479BA; width: 450px;" | {{fontcolor|#FFF|'''Lab values'''}}
! style="background: #4479BA; width: 450px;" | {{fontcolor|#FFF|'''Imaging'''}}
! style="background: #4479BA; width: 450px;" | {{fontcolor|#FFF|'''Imaging'''}}
! style="background: #4479BA; width: 450px;" | {{fontcolor|#FFF|'''Histopathology'''}}
! style="background: #4479BA; width: 450px;" | {{fontcolor|#FFF|'''Histopathology'''}}
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
'''Age'''
'''Insulinoma'''
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:::::Patients older than 3 years of age
* Weight loss
* Vague abdominal pain
* Loss of appetite
* Nausea and vomiting
* Jaundice
* Anxiety
* '''Diaphoresis'''
* '''Tremor'''
* '''Palpitations'''
* '''Seizures'''
* '''Coma'''
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
:::::Patients younger than 3 years of age
* Decreased hemoglobin level
* Increased billirubin level (conjugated and total)
* Increase alkaline phosphatase
* Increased gamma-glutamyl transpeptidase
* Increased spartate aminotransferase
* Increased alanine aminotransferase
* Increased amylase and/or lipase
* '''Hypoglycemia'''
* '''Hyperinsulinemia'''
* '''Elevated C-peptide level'''
* '''Elevated Pro-insulin level'''
| style="padding: 5px 5px; background: #F5F5F5;"|
| style="padding: 5px 5px; background: #F5F5F5;"|
:::::Patients older than 3 years of age
* CT scan: calcification and hyperattenuation of the mass
* MRI: Hypointense on T1-weighted image, hyperintense on T2-weighted MRI, and signal enhancement on T1 C+ image
* U/S: Homogeneously hypoechoic mass rounded in shape with distinct margins
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
:::::Patients younger than 3 years of age
* Solid or gyriform patterns, usually without glands
 
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:::M1-M3 stage '''or''' presence of [[leptomeningeal]] seeding
:::M1-M3 stage '''or''' presence of [[leptomeningeal]] seeding
|}
|}
ic
Zollinger-Ellison syndrome, Adenocarcinoma of pancreas, Acinar cell carcinoma of pancreas, Adenosquamous carcinoma, Colloid carcinoma, Hepatoid carcinoma, Intraductal papillary mucinous neoplasm, Mucinous cystic neoplasm, Pancreatic intraepithelial neoplasia, Pancreatoblastoma, Serous cystadenoma, Signet ring cell carcinoma, Solid-pseudopapillary neoplasm, Undifferentiated carcinoma, Undifferentiated carcinoma with osteoclast-like giant cell, Neuroendocrine tumors, Pancreatic ductal adenocarcinoma, Intraductal papillary mucinous neoplasm (IPMN), Serous cystadenoma, mucinous cystic neoplasm, solid-pseudopapillary tumour of pancreas, insulinoma, gastrinoma, glucagonoma, VIPoma, somatostatinoma, pancreatic lymphangioma, pancreatic teratoma, pancreatic lymphoma, schwannoma, neurofibroma, sarcoma, intraductal tubular neoplasm (ITN), metastases to pancreas, Von Hippel-Landau (VHL)-associated serous cystic neoplasm
Pancreatic atrophy, pancreatic lipoma, Lymphoepithelial cyst

Revision as of 23:41, 21 October 2015
Differential Diagnosis Clinical Presentation Lab values Imaging Histopathology

Insulinoma

  • Weight loss
  • Vague abdominal pain
  • Loss of appetite
  • Nausea and vomiting
  • Jaundice
  • Anxiety
  • Diaphoresis
  • Tremor
  • Palpitations
  • Seizures
  • Coma
  • Decreased hemoglobin level
  • Increased billirubin level (conjugated and total)
  • Increase alkaline phosphatase
  • Increased gamma-glutamyl transpeptidase
  • Increased spartate aminotransferase
  • Increased alanine aminotransferase
  • Increased amylase and/or lipase
  • Hypoglycemia
  • Hyperinsulinemia
  • Elevated C-peptide level
  • Elevated Pro-insulin level
  • CT scan: calcification and hyperattenuation of the mass
  • MRI: Hypointense on T1-weighted image, hyperintense on T2-weighted MRI, and signal enhancement on T1 C+ image
  • U/S: Homogeneously hypoechoic mass rounded in shape with distinct margins
  • Solid or gyriform patterns, usually without glands

Extent of previous surgical resection

<1.5 cm² residual tumor after resection
Subtotal resection or >1.5 cm² residual tumor after resection
<1.5 cm² residual tumor after resection
Subtotal resection or >1.5 cm² residual tumor after resection

Tumor stage

M0 stage confirmed by MRI and CSF sampling
M1-M3 stage or presence of leptomeningeal seeding
M0 stage confirmed by MRI and CSF sampling
M1-M3 stage or presence of leptomeningeal seeding
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