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==Differentiating Pancoast tumor from other Diseases== | ==Differentiating Pancoast tumor from other Diseases== | ||
Pancoast tumor must be differentiated from other causes of mass located in the apical region of the chest which may present with pain in the shoulder region. | |||
Differential diagnosis of Pancoast tumor is as follows: | |||
Pancoast tumor is a subtype of lung cancer with characteristic location at the lung apex, must be differentiated from other diseases that cause chronic [[cough]], [[weight loss]], [[hemoptysis]], and [[dyspnea]] among adults such as [[tuberculosis]], pulmonary fungal disease, lung abscess, and secondary [[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="pmid22242302">{{cite journal| author=Kamiya K, Yoshizu A, Misumi Y, Hida N, Okamoto H, Yoshida S| title=[Lung abscess which needed to be distinguished from lung cancer; report of a case]. | journal=Kyobu Geka | year= 2011 | volume= 64 | issue= 13 | pages= 1204-7 | pmid=22242302 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22242302 }} </ref><ref name="pmid24008649">{{cite journal| author=Matsuoka T, Uematsu H, Iwakiri S, Itoi K| title=[Chronic eosinophilic pneumonia presenting as a solitary nodule, suspicious of lung cancer;report of a case]. | journal=Kyobu Geka | year= 2013 | volume= 66 | issue= 10 | pages= 941-3 | pmid=24008649 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24008649 }} </ref> | |||
==Differential Diagnosis== | |||
*The table below summarizes the findings that differentiate Pancoast tumor from other conditions that cause chronic [[cough]], [[weight loss]], [[hemoptysis]], and [[dyspnea]].<ref name="pmid24455507">{{cite journal| author=Bhatt M, Kant S, Bhaskar R| title=Pulmonary tuberculosis as differential diagnosis of 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="pmid22242302">{{cite journal| author=Kamiya K, Yoshizu A, Misumi Y, Hida N, Okamoto H, Yoshida S| title=[Lung abscess which needed to be distinguished from lung cancer; report of a case]. | journal=Kyobu Geka | year= 2011 | volume= 64 | issue= 13 | pages= 1204-7 | pmid=22242302 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22242302 }} </ref><ref name="pmid24008649">{{cite journal| author=Matsuoka T, Uematsu H, Iwakiri S, Itoi K| title=[Chronic eosinophilic pneumonia presenting as a solitary nodule, suspicious of lung cancer;report of a case]. | journal=Kyobu Geka | year= 2013 | volume= 66 | issue= 10 | pages= 941-3 | pmid=24008649 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24008649 }} </ref> | |||
{| style="border: 0px; font-size: 90%; margin: 3px; width: 1000px" align=center | |||
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! 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;"| Chronic [[cough]], [[weight loss]], [[hemoptysis]], nocturnal diaphoresis, [[dyspnea]] | |||
|style="padding: 5px 5px; background: #F5F5F5;"|In pulmonary tuberculosis, differentiating features include: resolution (or decrease in size) after medical therapy, patients age is usually younger, [[hemoptisis]] 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;"|Chronic [[cough]], [[weight loss]], [[hemoptysis]], and [[dyspnea]] | |||
|style="padding: 5px 5px; background: #F5F5F5;"|In lung abscess, differentiating features include: acute or subacute 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]], [[fatigue]], and [[dyspnea]] | |||
|style="padding: 5px 5px; background: #F5F5F5;"|In pneumonia, differentiating features include: high grade fever, 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;"|'''[[Fungal infection]]''' | |||
|style="padding: 5px 5px; background: #F5F5F5;"|Chronic [[cough]], [[weight loss]], [[hemoptysis]], and [[dyspnea]] | |||
|style="padding: 5px 5px; background: #F5F5F5;"|In fungal infection, differentiating features include: CXR findings (air-cresecent sign), no response to antibioitcs, and mimcs tuberculosis | |||
|- | |||
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"|'''[[Chronic eosinophilic pneumonia]]''' | |||
|style="padding: 5px 5px; background: #F5F5F5;"|Chronic [[cough]], [[weight loss]], [[hemoptysis]], and [[dyspnea]] | |||
|style="padding: 5px 5px; background: #F5F5F5;"|In chronic eosinophilic pneumonia , differentiating features include: parasite infection or medication exposure, and increased serum [[IgE]] levels | |||
|} | |||
In [[superior vena cava syndrome]], obstruction of the [[superior vena cava]] by a tumor (mass effect) causes facial swelling, [[cyanosis]] and dilatation of the veins of the head and neck. | In [[superior vena cava syndrome]], obstruction of the [[superior vena cava]] by a tumor (mass effect) causes facial swelling, [[cyanosis]] and dilatation of the veins of the head and neck. | ||
Revision as of 05:35, 23 February 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Differentiating Pancoast tumor from other Diseases
Pancoast tumor must be differentiated from other causes of mass located in the apical region of the chest which may present with pain in the shoulder region. Differential diagnosis of Pancoast tumor is as follows: Pancoast tumor is a subtype of lung cancer with characteristic location at the lung apex, must be differentiated from other diseases that cause chronic cough, weight loss, hemoptysis, and dyspnea among adults such as tuberculosis, pulmonary fungal disease, lung abscess, and secondary metastases.[1][2][3]
Differential Diagnosis
- The table below summarizes the findings that differentiate Pancoast tumor from other conditions that cause chronic cough, weight loss, hemoptysis, and dyspnea.[1][2][3]
| Differential Diagnosis | Similar Features | Differentiating Features |
|---|---|---|
| Pulmonary tuberculosis | Chronic cough, weight loss, hemoptysis, nocturnal diaphoresis, dyspnea | In pulmonary tuberculosis, differentiating features include: resolution (or decrease in size) after medical therapy, patients age is usually younger, hemoptisis is an early feature, and CXR anatomical predilection for upper lobes |
| Lung abscess | Chronic cough, weight loss, hemoptysis, and dyspnea | In lung abscess, differentiating features include: acute or subacute onset, CXR anatomical predilection for upper lobes, and usually resolve with antibiotic |
| Pneumonia | Cough, fatigue, and dyspnea | In pneumonia, differentiating features include: high grade fever, good response to antibiotics, acute onset, predilection on CXR is consolidation, laboratory markers indicate infection |
| Fungal infection | Chronic cough, weight loss, hemoptysis, and dyspnea | In fungal infection, differentiating features include: CXR findings (air-cresecent sign), no response to antibioitcs, and mimcs tuberculosis |
| Chronic eosinophilic pneumonia | Chronic cough, weight loss, hemoptysis, and dyspnea | In chronic eosinophilic pneumonia , differentiating features include: parasite infection or medication exposure, and increased serum IgE levels |
In superior vena cava syndrome, obstruction of the superior vena cava by a tumor (mass effect) causes facial swelling, cyanosis and dilatation of the veins of the head and neck.
A pancoast tumor is an apical tumor that is typically found in conjunction with a smoking history. The clinical signs and symptoms can be confused with neurovascular compromise at the level of the thoracic outlet. The patient's smoking history, rapid onset of clinical signs and symptoms, and pleuritic pain can suggest an apical tumor.
References
- ↑ 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.
- ↑ 2.0 2.1 Kamiya K, Yoshizu A, Misumi Y, Hida N, Okamoto H, Yoshida S (2011). "[Lung abscess which needed to be distinguished from lung cancer; report of a case]". Kyobu Geka. 64 (13): 1204–7. PMID 22242302.
- ↑ 3.0 3.1 Matsuoka T, Uematsu H, Iwakiri S, Itoi K (2013). "[Chronic eosinophilic pneumonia presenting as a solitary nodule, suspicious of lung cancer;report of a case]". Kyobu Geka. 66 (10): 941–3. PMID 24008649.