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

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{{CMG}}
{{CMG}}
==Overview==
==Overview==
Depending on the presentation, [[lung cancer]] should be differentiated from other lung diseases such as [[pulmonary tuberculosis]], lung [[abscess]], and [[respiratory tract]] infection.  Once [[lung cancer]] is confirmed, small cell carcinoma should be differentiated from other [[NSCLC|non-small cell carcinoma]] based on histopathological findings.
Depending on the presentation, [[lung cancer]] should be differentiated from other lung diseases such as [[pulmonary tuberculosis]], lung [[abscess]], and [[respiratory tract]] infection and [[autoimmune]] diseases affecting the [[respiratory tract]].  Once [[lung cancer]] is confirmed, small cell carcinoma should be differentiated from other [[NSCLC|non-small cell carcinoma]] based on histopathological findings.


==Differential Diagnosis==
==Differential Diagnosis==

Revision as of 14:20, 28 March 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Depending on the presentation, lung cancer should be differentiated from other lung diseases such as pulmonary tuberculosis, lung abscess, and respiratory tract infection and autoimmune diseases affecting the respiratory tract. Once lung cancer is confirmed, small cell carcinoma should be differentiated from other non-small cell carcinoma based on histopathological findings.

Differential Diagnosis

Small cell lung cancer should be differentiated from other diseases causing cough, hemoptysis and weight loss. The following are the differentials:[1]

Organ system Diseases Clinical manifestations Diagnosis Other features
Symptoms Physical exam
Onset Duration Productive cough Hemoptysis Weight lost Fever Dyspnea Ascultation Lab findings Imaging PFT Gold standard
Respiratory Parenchyma Lung cancer[2][3] Chronic
  • Years
+ + + +/− + The following investigations may be helpful:
  • Not specific
Interstitial lung disease[4][5] Chronic
  • Variable
+ + + The following investigations may be helpful:
  • Lung biopsy when lab, imaging, and PFT has indeterminate result
Tuberculosis (TB)[6][7] Chronic
  • More than 2 or 3 weeks
+ + + + +
Cardiac Pulmonary hypertension[8][9] Chronic
  • More than 2 years
+ + + The following investigations may be helpful:
Organ system Diseases Clinical manifestations Diagnosis Other features
Symptoms Physical exam
Onset Duration Productive cough Hemoptysis Weight lost Fever Dyspnea Ascultation Lab findings Imaging PFT Gold standard
Autoimmune Wegener's disease (GPA) [10][11] Chronic
  • Months
+ + + + + The following investigations may be helpful:
Microscopic polyangitis (MPA)[12] Chronic
  • Variable
+ + + + + The following investigations may be helpful:
Churg−Strauss[13][14] Chronic
  • Variable
+ + + + +
  • Infiltrates in chest X−Ray
  • Ground glass opacities, tree−in−bud sign and small nodules in chest CT

References

  1. Bhatt M, Kant S, Bhaskar R (2012). "Pulmonary tuberculosis as differential diagnosis of lung cancer". South Asian J Cancer. 1 (1): 36–42. doi:10.4103/2278-330X.96507. PMC 3876596. PMID 24455507.
  2. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D (2011). "Global cancer statistics". CA Cancer J Clin. 61 (2): 69–90. doi:10.3322/caac.20107. PMID 21296855.
  3. Ost DE, Jim Yeung SC, Tanoue LT, Gould MK (2013). "Clinical and organizational factors in the initial evaluation of patients with lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines". Chest. 143 (5 Suppl): e121S–e141S. doi:10.1378/chest.12-2352. PMC 4694609. PMID 23649435.
  4. Lama VN, Martinez FJ (2004). "Resting and exercise physiology in interstitial lung diseases". Clin. Chest Med. 25 (3): 435–53, v. doi:10.1016/j.ccm.2004.05.005. PMID 15331185.
  5. Chetta A, Marangio E, Olivieri D (2004). "Pulmonary function testing in interstitial lung diseases". Respiration. 71 (3): 209–13. doi:10.1159/000077416. PMID 15133338.
  6. Perlman DC, el-Sadr WM, Nelson ET, Matts JP, Telzak EE, Salomon N, Chirgwin K, Hafner R (1997). "Variation of chest radiographic patterns in pulmonary tuberculosis by degree of human immunodeficiency virus-related immunosuppression. The Terry Beirn Community Programs for Clinical Research on AIDS (CPCRA). The AIDS Clinical Trials Group (ACTG)". Clin. Infect. Dis. 25 (2): 242–6. PMID 9332519.
  7. Barnes PF, Verdegem TD, Vachon LA, Leedom JM, Overturf GD (1988). "Chest roentgenogram in pulmonary tuberculosis. New data on an old test". Chest. 94 (2): 316–20. PMID 2456183.
  8. Brown LM, Chen H, Halpern S, Taichman D, McGoon MD, Farber HW, Frost AE, Liou TG, Turner M, Feldkircher K, Miller DP, Elliott CG (2011). "Delay in recognition of pulmonary arterial hypertension: factors identified from the REVEAL Registry". Chest. 140 (1): 19–26. doi:10.1378/chest.10-1166. PMC 3198486. PMID 21393391.
  9. Sun XG, Hansen JE, Oudiz RJ, Wasserman K (2003). "Pulmonary function in primary pulmonary hypertension". J Am Coll Cardiol. 41 (6): 1028–35. PMID 12651053.
  10. Hoffman GS, Kerr GS, Leavitt RY, Hallahan CW, Lebovics RS, Travis WD, Rottem M, Fauci AS (1992). "Wegener granulomatosis: an analysis of 158 patients". Ann. Intern. Med. 116 (6): 488–98. PMID 1739240.
  11. Falk RJ, Gross WL, Guillevin L, Hoffman GS, Jayne DR, Jennette JC, Kallenberg CG, Luqmani R, Mahr AD, Matteson EL, Merkel PA, Specks U, Watts RA (2011). "Granulomatosis with polyangiitis (Wegener's): an alternative name for Wegener's granulomatosis". Arthritis Rheum. 63 (4): 863–4. doi:10.1002/art.30286. PMID 21374588.
  12. Jennette, J. Charles; Falk, Ronald J. (1997). "Small-Vessel Vasculitis". New England Journal of Medicine. 337 (21): 1512–1523. doi:10.1056/NEJM199711203372106. ISSN 0028-4793.
  13. Vaglio A, Buzio C, Zwerina J (2013). "Eosinophilic granulomatosis with polyangiitis (Churg-Strauss): state of the art". Allergy. 68 (3): 261–73. doi:10.1111/all.12088. PMID 23330816.
  14. Lanham JG, Elkon KB, Pusey CD, Hughes GR (1984). "Systemic vasculitis with asthma and eosinophilia: a clinical approach to the Churg-Strauss syndrome". Medicine (Baltimore). 63 (2): 65–81. PMID 6366453.

References


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