Sandbox Maliha

Differential Diagnosis	Key Symptoms	Characteristic Lab Findings	CT Scan	Characteristic Histopathological Features
Insulinoma	Diaphoresis Tremor Palpitations Seizures Coma	Hypoglycemia Hyperinsulinemia Elevated C-peptide level Elevated Pro-insulin level	Calcification and hyperattenuation of the mass	Solid or gyriform cellular patterns Amyloid deposition Nesidioblastosis may be present Absence of glands
VIPoma	Watery diarrhea Dehydration Lethargy Muscle weakness Flushing	Elevated (VIP) levels Elevated neurotensin levels Hypokalemia Hypomagnesaemia Hypercalcaemia Metabolic acidosis	Hypervascularity with diffuse multiple metastatic nodulation	Solid sheets Uniform cuboidal cells Centrally located nuclei Stippled chromatin Granular eosinophilic cytoplasm
Gastrinoma	Epigastric abdominal pain Diarrhea Heartburn Hematemesis	Elevated serum gastrin level Positive secretin stimulation test	Small hypoattenuating nodule ± calcification	Lobular-trabecular pattern Gastrin+ tumor cells Infiltration of Brunner glands

Disease	History and Symptoms	Physical Examination	Laboratory Findings	Imaging	Other Diagnostic Tests	Features on Biopsy
Pilocytic Astrocytoma
Diffuse Astrocytoma	Acute	10-20 minutes	Same as stable angina but often more severe	Same as stable angina	Same as stable angina but occurs with lower levels of exertion & rest	Same as stable angina	Same as stable angina	Same as stable angina
Anaplastic Astrocytoma	Acute	Commonly > 20 minutes	Same as stable angina but often more severe	Same as stable angina	Same as stable angina but occurs with lower levels of exertion & rest	Usually unrelieved by nitroglycerine and rest	Same as stable angina	Same as stable angina
Glioblastoma	Acute, recurrent episodes of angina	Same as stable angina	Same as stable angina	Same as stable angina	Same as stable angina	Same as stable angina	Same as stable angina	Not specific
Oligodendroglioma	Sudden severe progressive pain (common) or chronic (rare)	Variable	Tearing, ripping sensation, knife like	Depends on area of dissection	Variable	Unrelenting pain, unrelieved by nitroglycerine and rest	Radiating to back, between shoulder blades (dissection in ascending aorta)	Trauma, Surgical manipulation, pregnancy, hypertension, connective tissue disease like marfan's syndrome (cystic medial degeneration)
Ependymoma	Acute or subacute	May last for hours to days	Sharp, localized	Retrosternal	Increases with coughing, deep breathing, supine position	Relieved by sitting up and leaning forward	Radiation to shoulder, neck, back abdomen	Not specific
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