Lymphomatoid granulomatosis differential diagnosis: Difference between revisions
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Finally Cutaneous Lymphamatoid granulomatosis must also be differtiated from other diseases that cause:<ref name="pmid20672711">{{cite journal| author=Halvani A, Owlia MB, Sami R| title=Lymphomatoid granulomatosis with splenomegaly and pancytopenia. | journal=Zhongguo Fei Ai Za Zhi | year= 2010 | volume= 13 | issue= 1 | pages= 84-6 | pmid=20672711 | doi=10.3779/j.issn.1009-3419.2010.01.17 | pmc=6000673 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20672711 }} </ref><ref name="pmid25355540">{{cite journal| author=Rysgaard CD, Stone MS| title=Lymphomatoid granulomatosis presenting with cutaneous involvement: a case report and review of the literature. | journal=J Cutan Pathol | year= 2015 | volume= 42 | issue= 3 | pages= 188-93 | pmid=25355540 | doi=10.1111/cup.12402 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25355540 }} </ref><ref name="pmid26143428">{{cite journal| author=Gangar P, Venkatarajan S| title=Granulomatous Lymphoproliferative Disorders: Granulomatous Slack Skin and Lymphomatoid Granulomatosis. | journal=Dermatol Clin | year= 2015 | volume= 33 | issue= 3 | pages= 489-96 | pmid=26143428 | doi=10.1016/j.det.2015.03.013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26143428 }} </ref> | Finally Cutaneous Lymphamatoid granulomatosis must also be differtiated from other diseases that cause:<ref name="pmid20672711">{{cite journal| author=Halvani A, Owlia MB, Sami R| title=Lymphomatoid granulomatosis with splenomegaly and pancytopenia. | journal=Zhongguo Fei Ai Za Zhi | year= 2010 | volume= 13 | issue= 1 | pages= 84-6 | pmid=20672711 | doi=10.3779/j.issn.1009-3419.2010.01.17 | pmc=6000673 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20672711 }} </ref><ref name="pmid25355540">{{cite journal| author=Rysgaard CD, Stone MS| title=Lymphomatoid granulomatosis presenting with cutaneous involvement: a case report and review of the literature. | journal=J Cutan Pathol | year= 2015 | volume= 42 | issue= 3 | pages= 188-93 | pmid=25355540 | doi=10.1111/cup.12402 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25355540 }} </ref><ref name="pmid26143428">{{cite journal| author=Gangar P, Venkatarajan S| title=Granulomatous Lymphoproliferative Disorders: Granulomatous Slack Skin and Lymphomatoid Granulomatosis. | journal=Dermatol Clin | year= 2015 | volume= 33 | issue= 3 | pages= 489-96 | pmid=26143428 | doi=10.1016/j.det.2015.03.013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26143428 }} </ref> | ||
*Erythematous rash | *Erythematous rash<ref name="pmid27051739">{{cite journal| author=Shaigany S, Weitz NA, Husain S, Geskin L, Grossman ME| title=A case of lymphomatoid granulomatosis presenting with cutaneous lesions. | journal=JAAD Case Rep | year= 2015 | volume= 1 | issue= 4 | pages= 234-7 | pmid=27051739 | doi=10.1016/j.jdcr.2015.05.008 | pmc=4808726 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27051739 }} </ref> | ||
*Macules | *Macules | ||
*Papules | *Papules<ref name="pmid27051739">{{cite journal| author=Shaigany S, Weitz NA, Husain S, Geskin L, Grossman ME| title=A case of lymphomatoid granulomatosis presenting with cutaneous lesions. | journal=JAAD Case Rep | year= 2015 | volume= 1 | issue= 4 | pages= 234-7 | pmid=27051739 | doi=10.1016/j.jdcr.2015.05.008 | pmc=4808726 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27051739 }} </ref> | ||
*Plaques | *Plaques | ||
*Subcutaneous nodules | *Subcutaneous nodules<ref name="pmid27051739">{{cite journal| author=Shaigany S, Weitz NA, Husain S, Geskin L, Grossman ME| title=A case of lymphomatoid granulomatosis presenting with cutaneous lesions. | journal=JAAD Case Rep | year= 2015 | volume= 1 | issue= 4 | pages= 234-7 | pmid=27051739 | doi=10.1016/j.jdcr.2015.05.008 | pmc=4808726 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27051739 }} </ref> | ||
*Larger ulcerated nodules | *Larger ulcerated nodules<ref name="pmid27051739">{{cite journal| author=Shaigany S, Weitz NA, Husain S, Geskin L, Grossman ME| title=A case of lymphomatoid granulomatosis presenting with cutaneous lesions. | journal=JAAD Case Rep | year= 2015 | volume= 1 | issue= 4 | pages= 234-7 | pmid=27051739 | doi=10.1016/j.jdcr.2015.05.008 | pmc=4808726 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27051739 }} </ref> | ||
The differentials are the following Dermatomyositis, and Psoriasis<ref name="BertiFelicetti2018">{{cite journal|last1=Berti|first1=Alvise|last2=Felicetti|first2=Mara|last3=Peccatori|first3=Susanna|last4=Bortolotti|first4=Roberto|last5=Guella|first5=Anna|last6=Vivaldi|first6=Paolo|last7=Morelli|first7=Luca|last8=Barabareschi|first8=Mattia|last9=Paolazzi|first9=Giuseppe|title=EBV-induced lymphoproliferative disorders in rheumatic patients: A systematic review of the literature|journal=Joint Bone Spine|volume=85|issue=1|year=2018|pages=35–40|issn=1297319X|doi=10.1016/j.jbspin.2017.01.006}}</ref><ref name="pmid26966605">{{cite journal| author=O'Brien S, Schmidt P| title=Lymphomatoid Granulomatosis with Paraneoplastic Polymyositis: A Rare Malignancy with Rare Complication. | journal=Case Rep Rheumatol | year= 2016 | volume= 2016 | issue= | pages= 8242597 | pmid=26966605 | doi=10.1155/2016/8242597 | pmc=4757691 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26966605 }} </ref> | The differentials are the following Dermatomyositis, and Psoriasis<ref name="BertiFelicetti2018">{{cite journal|last1=Berti|first1=Alvise|last2=Felicetti|first2=Mara|last3=Peccatori|first3=Susanna|last4=Bortolotti|first4=Roberto|last5=Guella|first5=Anna|last6=Vivaldi|first6=Paolo|last7=Morelli|first7=Luca|last8=Barabareschi|first8=Mattia|last9=Paolazzi|first9=Giuseppe|title=EBV-induced lymphoproliferative disorders in rheumatic patients: A systematic review of the literature|journal=Joint Bone Spine|volume=85|issue=1|year=2018|pages=35–40|issn=1297319X|doi=10.1016/j.jbspin.2017.01.006}}</ref><ref name="pmid26966605">{{cite journal| author=O'Brien S, Schmidt P| title=Lymphomatoid Granulomatosis with Paraneoplastic Polymyositis: A Rare Malignancy with Rare Complication. | journal=Case Rep Rheumatol | year= 2016 | volume= 2016 | issue= | pages= 8242597 | pmid=26966605 | doi=10.1155/2016/8242597 | pmc=4757691 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26966605 }} </ref> | ||
===Differentiating Lymphamatoid Granulomatosis === | ===Differentiating Lymphamatoid Granulomatosis === |
Revision as of 15:11, 6 December 2018
Lymphomatoid granulomatosis Microchapters |
Differentiating Lymphomatoid granulomatosis from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Lymphamtoid granulomatosis must be differentiated from Bronchocentric granulomatosis and Churg-Strauss, Necrotizing sarcoid granulomatosis, Wegeners granulomatosis, Hodgkins disease, Non-hodgkin lymphoma, and Nasal angiocentric lymphoma
Differentiating Lymphamatoid granulomatosis from other Diseases
As Lymphamatoid granulomatosis manifests in a variety of clinical forms, differentiation must be established in accordance with the particular subtypes pulmonary being the most common. The sub types are the following:[1][2][3][4][5][6]
Other Symptoms that are asscociated with the pulmonary symptoms are:[10][11][12]
From the symptoms listed above; Lymphamatoid granulomatosis is usually differtiated from the following diseases Bronchocentric granulomatosis and Churg-Strauss, Necrotizing sarcoid granulomatosis, Wegeners granulomatosis, Hodgkins disease, Non-hodgkin lymphoma, and Nasal angiocentric lymphoma.[15][16][17]
In contrast, CNS lymphamatoid granulomatosis must be differentiated from other diseases that cause:[18][19][20][21]
The differentials are the following CVA, Brain tumors or CNS lymphoma and Parkinsonism.[26]
Finally Cutaneous Lymphamatoid granulomatosis must also be differtiated from other diseases that cause:[21][27][28]
The differentials are the following Dermatomyositis, and Psoriasis[29][10]
Differentiating Lymphamatoid Granulomatosis
On the basis of Cough, Dyspnea, and Chest tightness, Lymphamatoid granulomatosis must be differentiated from Bronchocentric granulomatosis and Churg-Strauss, Necrotizing sarcoid granulomatosis, Wegeners granulomatosis, Hodgkins disease, Non-hodgkin lymphoma, and Nasal angiocentric lymphoma.[15][16][17]
Diseases | Clinical manifestations | Para-clinical findings | Gold standard | Additional findings | ||||||
---|---|---|---|---|---|---|---|---|---|---|
Symptoms | Physical examination | |||||||||
Lab Findings | Imaging | Histopathology | ||||||||
Cough | Dyspnea | Chest tightness | Auscultation | X-ray | CT scan | |||||
Lymphmatoid granulomatosis | + | + | + | Wheezing
Rales Rhonchi |
EBV infused B-cells on blood scan |
|
Poorly defined nodular peribronchovascular infiltrates with air-bronchograms. |
|
| |
Churg-Strauss syndrome | + | + | + | Wheezing
Rales Rhonchi |
|
Pulmonary infiltrates:
Typically, these are transient patchy alveolar infiltrates. |
|
|
+ P-ANCA |
|
Necrotizing sarcoid granulomatosis | + | + | - | Wheezing | Increased levels of ACE in the blood | Hilar adenopathy | bihilar lymphadenopathy and reticulonodular infiltrates |
|
High levels of ACE in blood |
|
Diseases | Cough | Dyspnea | Chest thightness | Auscultation | Lab findings | X-ray | CT scan | Histopathology | Gold standard | Additional findings |
Wegeners granulomatosis | + | + | - | Wheezing | C- ANCA
Urinalysis: Hematuria Red cell casts Biopsy: Granulomatous inflmmation within the arterial wall or in the perivascular area |
|
Pulmonary nodules with or without cavitation and airspace consolidation |
|
| |
Hodgkin disease | - | - | - |
|
|
Massive mediastinal soft tissue masses consistent with lymphoma |
|
Reed Sternberg cells | Development of Hodgkin's disease may in some patients be preceded by enhanced activation of Epstein–Barr virus | |
Non-hodgkin lymphoma | - | - | - | Can be caused by;
EBV HIV Hep C HTLV Lymphomatous appearing B and T cells( condition arises from B and T cells) |
Mediastinal widening due to grossly enlarged right paratracheal and left paratracheal nodes. | Mediastinum can show enlarged tracheobronchial and subcarinal nodes. small bilateral pleural effusion can be seen |
|
Pop corn cells in NLPHL | Symptoms include enlarged lymph nodes, fever, night sweats, weight loss, and tiredness |
References
- ↑ Roschewski M, Wilson WH (2012). "Lymphomatoid granulomatosis". Cancer J. 18 (5): 469–74. doi:10.1097/PPO.0b013e31826c5e19. PMID 23006954.
- ↑ Fernandez-Alvarez R, Gonzalez M, Fernandez A, Gonzalez-Rodriguez A, Sancho J, Dominguez F; et al. (2014). "Lymphomatoid granulomatosis of central nervous system and lung driven by epstein barr virus proliferation: successful treatment with rituximab-containing chemotherapy". Mediterr J Hematol Infect Dis. 6 (1): e2014017. doi:10.4084/MJHID.2014.017. PMC 3965717. PMID 24678394.
- ↑ 3.0 3.1 3.2 3.3 3.4 {{cite journal| author=Shaigany S, Weitz NA, Husain S, Geskin L, Grossman ME| title=A case of lymphomatoid granulomatosis presenting with cutaneous lesions. | journal=JAAD Case Rep | year= 2015 | volume= 1 | issue= 4 | pages= 234-7 | pmid=27051739 | doi=10.1016/j.jdcr.2015.05.008 | pmc=4808726 | url=
- Pulmonary
- CNS
- Cutaneous
- ↑ Miloslavsky EM, Stone JH, Unizony SH (2015). "Challenging mimickers of primary systemic vasculitis". Rheum Dis Clin North Am. 41 (1): 141–60, ix. doi:10.1016/j.rdc.2014.09.011. PMID 25399945.
- ↑ Tagliavini E, Rossi G, Valli R, Zanelli M, Cadioli A, Mengoli MC; et al. (2013). "Lymphomatoid granulomatosis: a practical review for pathologists dealing with this rare pulmonary lymphoproliferative process". Pathologica. 105 (4): 111–6. PMID 24466760.
- ↑ Fauci AS, Haynes BF, Costa J, Katz P, Wolff SM (1982). "Lymphomatoid Granulomatosis. Prospective clinical and therapeutic experience over 10 years". N Engl J Med. 306 (2): 68–74. doi:10.1056/NEJM198201143060203. PMID 7053488.
- ↑ Xu B, Liu H, Wang B, Zhang H, Wu H, Jin R; et al. (2015). "Fever, Dry Cough and Exertional Dyspnea: Pulmonary Lymphomatoid Granulomatosis Masquerading as Pneumonia, Granulomatosis with Polyangiitis and Infectious Mononucleosis". Intern Med. 54 (23): 3045–9. doi:10.2169/internalmedicine.54.4822. PMID 26631890.
- ↑ Ameli F, Ghafourian F, Masir N (2014). "Systematic Epstein-Barr virus-positive T-cell lymphoproliferative disease presenting as a persistent fever and cough: a case report". J Med Case Rep. 8: 288. doi:10.1186/1752-1947-8-288. PMC 4150421. PMID 25163591.
- ↑ Olusina D, Ezemba N, Nzegwu MA (2011). "Pulmonary Lymphomatoid Granulomatosis: Report of A Case and Review of Literature". Niger Med J. 52 (1): 60–63. PMC 3180752. PMID 21968985.
- ↑ 10.0 10.1 10.2 10.3 O'Brien S, Schmidt P (2016). "Lymphomatoid Granulomatosis with Paraneoplastic Polymyositis: A Rare Malignancy with Rare Complication". Case Rep Rheumatol. 2016: 8242597. doi:10.1155/2016/8242597. PMC 4757691. PMID 26966605.
- ↑ Alinari L, Pant S, McNamara K, Kalmar JR, Marsh W, Allen CM; et al. (2012). "Lymphomatoid granulomatosis presenting with gingival involvement in an immune competent elderly male". Head Neck Pathol. 6 (4): 496–501. doi:10.1007/s12105-012-0378-z. PMC 3500898. PMID 22711054.
- ↑ Alexandra G, Claudia G (2018). "Lymphomatoid granulomatosis mimicking cancer and sarcoidosis". Ann Hematol. doi:10.1007/s00277-018-3505-4. PMID 30288554.
- ↑ Olmes DG, Agaimy A, Kloska S, Linker RA (2014). "Fatal lymphomatoid granulomatosis with primary CNS-involvement in an immunocompetent 80-year-old woman". BMJ Case Rep. 2014. doi:10.1136/bcr-2014-206825. PMC 4275695. PMID 25535225.
- ↑ Costiniuk, Cecilia T.; Karamchandani, Jason; Bessissow, Ali; Routy, Jean-Pierre; Szabo, Jason; Frenette, Charles (2018). "Angiocentric lymph proliferative disorder (lymphomatoid granulomatosis) in a person with newly-diagnosed HIV infection: a case report". BMC Infectious Diseases. 18 (1). doi:10.1186/s12879-018-3128-3. ISSN 1471-2334.
- ↑ 15.0 15.1 Bohle M, Rasche K, Müller KM, Schultze-Werninghaus G, Fisseler-Eckhoff A (1999). "[Lymphomatoid granulomatosis: differential diagnosis and therapy]". Med Klin (Munich). 94 (9): 513–9. PMID 10544614.
- ↑ 16.0 16.1 Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMC 5922622. PMID doi.org/10.1053/stcs.2002.34450 Check
|pmid=
value (help). - ↑ 17.0 17.1 Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMC 5922622. PMID https://doi.org/10.1007/s00247-014-3233-4 Check
|pmid=
value (help). - ↑ Kim JY, Jung KC, Park SH, Choe JY, Kim JE (2018). "Primary lymphomatoid granulomatosis in the central nervous system: A report of three cases". Neuropathology. doi:10.1111/neup.12467. PMID 29635846.
- ↑ Kano Y, Kodaira M, Ushiki A, Kosaka M, Yamada M, Shingu K; et al. (2017). "The Complete Remission of Acquired Immunodeficiency Syndrome-associated Isolated Central Nervous System Lymphomatoid Granulomatosis: A Case Report and Review of the Literature". Intern Med. 56 (18): 2497–2501. doi:10.2169/internalmedicine.8776-16. PMC 5643181. PMID 28824078.
- ↑ Quinones E, Potes LI, Silva N, Lobato-Polo J (2016). "Lymphomatoid granulomatosis of the brain: A case report". Surg Neurol Int. 7 (Suppl 23): S612–6. doi:10.4103/2152-7806.189732. PMC 5025951. PMID 27656321.
- ↑ 21.0 21.1 Halvani A, Owlia MB, Sami R (2010). "Lymphomatoid granulomatosis with splenomegaly and pancytopenia". Zhongguo Fei Ai Za Zhi. 13 (1): 84–6. doi:10.3779/j.issn.1009-3419.2010.01.17. PMC 6000673. PMID 20672711.
- ↑ Castrale C, El Haggan W, Chapon F, Reman O, Lobbedez T, Ryckelynck JP; et al. (2011). "Lymphomatoid granulomatosis treated successfully with rituximab in a renal transplant patient". J Transplant. 2011: 865957. doi:10.1155/2011/865957. PMC 3087939. PMID 21559262.
- ↑ Liu, Hongli; Chen, Jing; Yu, Dandan; Hu, Jianli (2014). "Lymphomatoid granulomatosis involving the central nervous system: A case report and review of the literature". Oncology Letters. 7 (6): 1843–1846. doi:10.3892/ol.2014.2002. ISSN 1792-1074.
- ↑ Patsalides, Athos D.; Atac, Gokce; Hedge, Upendra; Janik, John; Grant, Nicole; Jaffe, Elaine S.; Dwyer, Andrew; Patronas, Nicholas J.; Wilson, Wyndham H. (2005). "Lymphomatoid Granulomatosis: Abnormalities of the Brain at MR Imaging". Radiology. 237 (1): 265–273. doi:10.1148/radiol.2371041087. ISSN 0033-8419.
- ↑ Cargini, Pasqualino; Civica, Maria; Sollima, Laura; Di Cola, Emanuela; Pontecorvi, Emanuele; Cutilli, Tommaso (2014). "Oral lymphomatoid granulomatosis, the first sign of a 'rare disease': a case report". Journal of Medical Case Reports. 8 (1). doi:10.1186/1752-1947-8-152. ISSN 1752-1947.
- ↑ Sohn EH, Song CJ, Lee HJ, Kim S, Kim JM, Lee AY (2007). "Central nervous system lymphomatoid granulomatosis presenting with parkinsonism". J Clin Neurol. 3 (2): 108–11. doi:10.3988/jcn.2007.3.2.108. PMC 2686859. PMID 19513302.
- ↑ Rysgaard CD, Stone MS (2015). "Lymphomatoid granulomatosis presenting with cutaneous involvement: a case report and review of the literature". J Cutan Pathol. 42 (3): 188–93. doi:10.1111/cup.12402. PMID 25355540.
- ↑ Gangar P, Venkatarajan S (2015). "Granulomatous Lymphoproliferative Disorders: Granulomatous Slack Skin and Lymphomatoid Granulomatosis". Dermatol Clin. 33 (3): 489–96. doi:10.1016/j.det.2015.03.013. PMID 26143428.
- ↑ Berti, Alvise; Felicetti, Mara; Peccatori, Susanna; Bortolotti, Roberto; Guella, Anna; Vivaldi, Paolo; Morelli, Luca; Barabareschi, Mattia; Paolazzi, Giuseppe (2018). "EBV-induced lymphoproliferative disorders in rheumatic patients: A systematic review of the literature". Joint Bone Spine. 85 (1): 35–40. doi:10.1016/j.jbspin.2017.01.006. ISSN 1297-319X.