Small intestine cancer differential diagnosis: Difference between revisions

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== tab ==
== tab ==


{|
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
| colspan="4" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Clinical manifestations'''
! colspan="6" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Para-clinical findings
| colspan="1" rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Gold standard'''
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Comments
|-
| colspan="4" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Symptoms'''
|-
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Constipation/Diarrhea
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Blood in stool
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Abdominal pain
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other symptoms
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Anemia
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Tumor marker
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Endoscopy
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |CT scan
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other imaging study
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Adenocarcinoma]]
| style="background: #F5F5F5; padding: 5px;" | +/-
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| style="background: #F5F5F5; padding: 5px;" | +/-
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* [[Tenesmus]]
* Diminished caliber of stools
* [[Mucus]] in stools
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |[[CEA]]+
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* [[Sigmoidoscopy]] may show [[Polyp|polyps]], [[Ulceration|ulcerating]] and infiltrating [[lesions]]
* [[Colonoscopy]]<ref name="pmid27733426">{{cite journal |vauthors=Doubeni CA, Corley DA, Quinn VP, Jensen CD, Zauber AG, Goodman M, Johnson JR, Mehta SJ, Becerra TA, Zhao WK, Schottinger J, Doria-Rose VP, Levin TR, Weiss NS, Fletcher RH |title=Effectiveness of screening colonoscopy in reducing the risk of death from right and left colon cancer: a large community-based study |journal=Gut |volume=67 |issue=2 |pages=291–298 |date=February 2018 |pmid=27733426 |doi=10.1136/gutjnl-2016-312712 |url=}}</ref> can reveal detail images of [[polyps]] and [[cancerous]] [[lesions]]
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*Luminal narrowing and [[bowel obstruction]]
*Circumferential thickening of the bowel wall
*[[Enlarged lymph nodes]]
*Pulmonary [[metastases]]
*Peritoneal metastases
*[[Metastases|Hepatic metastases]]
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* [[PET scan|PET scans]] for detailed images
* [[MRI]]
* [[Barium enema]] shows the [[luminal]] abnormalities
* [[Genetic testing]] to see hereditary etiology<ref name="RathoreHussain2013">{{cite journal|last1=Rathore|first1=Saima|last2=Hussain|first2=Mutawarra|last3=Ali|first3=Ahmad|last4=Khan|first4=Asifullah|title=A Recent Survey on Colon Cancer Detection Techniques|journal=IEEE/ACM Transactions on Computational Biology and Bioinformatics|volume=10|issue=3|year=2013|pages=545–563|issn=1545-5963|doi=10.1109/TCBB.2013.84}}</ref>
* On gross pathology:<ref name="pmid21969498">{{cite journal| author=Weiss JM, Pfau PR, O'Connor ES, King J, LoConte N, Kennedy G et al.| title=Mortality by stage for right- versus left-sided colon cancer: analysis of surveillance, epidemiology, and end results--Medicare data. | journal=J Clin Oncol | year= 2011 | volume= 29 | issue= 33 | pages= 4401-9 | pmid=21969498 | doi=10.1200/JCO.2011.36.4414 | pmc=3221523 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21969498  }}</ref>
** [[Polyp|Polypoid]] or fungating exophytic lesion (right-sided colorectal tumors)


**Circumferential and annular lesions producing an "apple-core" appearance on [[barium enema]] x-ray (left-sided tumors).
| style="background: #F5F5F5; padding: 5px;" |Glandular structures, consisting of:<ref name="pmid8265100">{{cite journal |vauthors=Secco GB, Fardelli R, Campora E, Lapertosa G, Gentile R, Zoli S, Prior C |title=Primary mucinous adenocarcinomas and signet-ring cell carcinomas of colon and rectum |journal=Oncology |volume=51 |issue=1 |pages=30–4 |date=1994 |pmid=8265100 |doi=10.1159/000227306 |url=}}</ref>
* Sheets or cords of malignant cells,
* Cellular atypia, Pleomorphism
* High mitotic rate
| style="background: #F5F5F5; padding: 5px;" |[[Biopsy]] and [[histopathological]] analysis
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|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |AVM<ref name="pmid28139503">{{cite journal |vauthors=Lee HH, Kwon HM, Gil S, Kim YS, Cho M, Seo KJ, Chae HS, Cho YS |title=Endoscopic resection of asymptomatic, colonic, polypoid arteriovenous malformations: Two case reports and a literature review |journal=Saudi J Gastroenterol |volume=23 |issue=1 |pages=67–70 |date=2017 |pmid=28139503 |pmc=5329980 |doi=10.4103/1319-3767.199111 |url=}}</ref>
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|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Diverticulitis<ref name="pmid16187597">{{cite journal |vauthors=Shen SH, Chen JD, Tiu CM, Chou YH, Chiang JH, Chang CY, Lee CH |title=Differentiating colonic diverticulitis from colon cancer: the value of computed tomography in the emergency setting |journal=J Chin Med Assoc |volume=68 |issue=9 |pages=411–8 |date=September 2005 |pmid=16187597 |doi=10.1016/S1726-4901(09)70156-X |url=}}</ref>
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| style="background: #F5F5F5; padding: 5px;" | +
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* Fever+/- chills
* Nausea+/- vomiting
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* Leukocytosis
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* Evidence of inflammation
* Outpouchings of the colonic wall
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|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Hemorrhoid
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| style="background: #F5F5F5; padding: 5px;" |
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Anal fissure
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|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Infectious colitis
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|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Peutz-Jeghers syndrome]]<ref name="pmid27298573">{{cite journal |vauthors=Zhong ME, Niu BZ, Ji WY, Wu B |title=Laparoscopic restorative proctocolectomy with ileal pouch-anal anastomosis for Peutz-Jeghers syndrome with synchronous rectal cancer |journal=World J. Gastroenterol. |volume=22 |issue=22 |pages=5293–6 |date=June 2016 |pmid=27298573 |doi=10.3748/wjg.v22.i22.5293 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
* [[Mucocutaneous]]  [[hyperpigmentation]] (mouth, hands, and feet)<ref name="KopacovaTacheci20092">{{cite journal|last1=Kopacova|first1=Marcela|last2=Tacheci|first2=Ilja|last3=Rejchrt|first3=Stanislav|last4=Bures|first4=Jan|title=Peutz-Jeghers syndrome: Diagnostic and therapeuticapproach|journal=World Journal of Gastroenterology|volume=15|issue=43|year=2009|pages=5397|issn=1007-9327|doi=10.3748/wjg.15.5397}}</ref><ref name="GiardielloTrimbath2006">{{cite journal|last1=Giardiello|first1=F|last2=Trimbath|first2=J|title=Peutz-Jeghers Syndrome and Management Recommendations|journal=Clinical Gastroenterology and Hepatology|volume=4|issue=4|year=2006|pages=408–415|issn=15423565|doi=10.1016/j.cgh.2005.11.005}}</ref><ref name="urlPeutz-Jeghers syndrome | Genetic and Rare Diseases Information Center (GARD) – an NCATS Program">{{cite web |url=https://rarediseases.info.nih.gov/diseases/7378/peutz-jeghers-syndrome#ref_8500 |title=Peutz-Jeghers syndrome &#124; Genetic and Rare Diseases Information Center (GARD) – an NCATS Program |format= |work= |accessdate=}}</ref>
* [[Fatigue]]
* [[Weight loss]]
* [[Rectal prolapse]]
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" |
* [[Hamartomatous intestinal polyposis|Multiple polyps]] <ref name="urlPeutz-Jeghers Syndrome - GeneReviews® - NCBI Bookshelf2">{{cite web |url=https://www.ncbi.nlm.nih.gov/books/NBK1266/#pjs.Diagnosis |title=Peutz-Jeghers Syndrome - GeneReviews® - NCBI Bookshelf |format= |work= |accessdate=}}</ref>
* [[mucocutaneous]] [[pigmentation]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Polyps|Multiple polyps]]
*[[Intussusception]]
*[[Bowel obstruction]]<ref name="urlPeutz-Jeghers syndrome | Radiology Reference Article | Radiopaedia.org">{{cite web |url=https://radiopaedia.org/articles/peutz-jeghers-syndrome-2 |title=Peutz-Jeghers syndrome &#124; Radiology Reference Article &#124; Radiopaedia.org |format= |work= |accessdate=}}</ref>
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* [[Barium enema]]
* [[PET scan|PET-CT]]
* [[MRI]]
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* Multiple [[hamartomatous]] [[polyps]] on [[Histological|histological analysis]]<ref name="urlPeutz-Jeghers Syndrome - GeneReviews® - NCBI Bookshelf">{{cite web |url=https://www.ncbi.nlm.nih.gov/books/NBK1266/#pjs.Diagnosis |title=Peutz-Jeghers Syndrome - GeneReviews® - NCBI Bookshelf |format= |work= |accessdate=}}</ref><ref name="BeggsLatchford2010">{{cite journal|last1=Beggs|first1=A. D.|last2=Latchford|first2=A. R.|last3=Vasen|first3=H. F. A.|last4=Moslein|first4=G.|last5=Alonso|first5=A.|last6=Aretz|first6=S.|last7=Bertario|first7=L.|last8=Blanco|first8=I.|last9=Bulow|first9=S.|last10=Burn|first10=J.|last11=Capella|first11=G.|last12=Colas|first12=C.|last13=Friedl|first13=W.|last14=Moller|first14=P.|last15=Hes|first15=F. J.|last16=Jarvinen|first16=H.|last17=Mecklin|first17=J.-P.|last18=Nagengast|first18=F. M.|last19=Parc|first19=Y.|last20=Phillips|first20=R. K. S.|last21=Hyer|first21=W.|last22=Ponz de Leon|first22=M.|last23=Renkonen-Sinisalo|first23=L.|last24=Sampson|first24=J. R.|last25=Stormorken|first25=A.|last26=Tejpar|first26=S.|last27=Thomas|first27=H. J. W.|last28=Wijnen|first28=J. T.|last29=Clark|first29=S. K.|last30=Hodgson|first30=S. V.|title=Peutz-Jeghers syndrome: a systematic review and recommendations for management|journal=Gut|volume=59|issue=7|year=2010|pages=975–986|issn=0017-5749|doi=10.1136/gut.2009.198499}}</ref>
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*[[Genetic testing]] for [[STK11]]
*[[Colonoscopy]] <ref name="KopacovaTacheci20093">{{cite journal|last1=Kopacova|first1=Marcela|last2=Tacheci|first2=Ilja|last3=Rejchrt|first3=Stanislav|last4=Bures|first4=Jan|title=Peutz-Jeghers syndrome: Diagnostic and therapeuticapproach|journal=World Journal of Gastroenterology|volume=15|issue=43|year=2009|pages=5397|issn=1007-9327|doi=10.3748/wjg.15.5397}}</ref>
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|-
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
| colspan="4" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Clinical manifestations'''
! colspan="6" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Para-clinical findings
| colspan="1" rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Gold standard'''
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Comments
|-
| colspan="4" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Symptoms'''
|-
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Constipation/Diarrhea
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Blood in stool
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Abdominal pain
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other symptoms
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Anemia
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Tumor Markers
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Colonoscopy
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |CT scan
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other imaging
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Carcinoid|Carcinoids]]<ref name="pmid20011309">{{cite journal |vauthors=Chung TP, Hunt SR |title=Carcinoid and neuroendocrine tumors of the colon and rectum |journal=Clin Colon Rectal Surg |volume=19 |issue=2 |pages=45–8 |date=May 2006 |pmid=20011309 |pmc=2780103 |doi=10.1055/s-2006-942343 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |[[Diarrhea]]
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +
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*[[Flushing (physiology)|Flushing]]<ref name="symptoms">Signs and symptoms of carcinoid syndrome. National Cancer Institute. http://www.cancer.gov/types/gi-carcinoid-tumors/patient/gi-carcinoid-treatment-pdq</ref>
*[[Wheezing]]
*[[Shortness of breath]]
*[[Palpitations]]
*[[Weight gain]]
*[[Hirsutism]]
*[[Weakness]]
*[[Leg edema]]
| style="background: #F5F5F5; padding: 5px;" | +
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* Urinary [[5-hydroxyindoleacetic acid]] (5-HIAA)<ref name="diagnostics">Diagnostics: Biochemical Markers, Imaging, and Approach. National cancer institute. http://www.cancer.gov/types/gi-carcinoid-tumors/hp/gi-carcinoid-treatment-pdq</ref>
* Chromogranin A (CgA)
* Other biochemical markers include:
**[[Substance P]]
**[[Neurotensin]]
**[[Bradykinin]]
**[[Human chorionic gonadotropin]]
**Neuropeptide L
**[[Pancreatic polypeptide]]
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* Infiltrating, ulcerating or fungating lesions in the wall of colon
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* Well-defined single or multiple lesions
* Round or ovoid in shape
* Variable in size ranges between 2-5 cm
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* [[PET scan]]
* [[MRI]]
* Ki-67 index<ref name="pmid22525418">{{cite journal |vauthors=Rindi G, Falconi M, Klersy C, Albarello L, Boninsegna L, Buchler MW, Capella C, Caplin M, Couvelard A, Doglioni C, Delle Fave G, Fischer L, Fusai G, de Herder WW, Jann H, Komminoth P, de Krijger RR, La Rosa S, Luong TV, Pape U, Perren A, Ruszniewski P, Scarpa A, Schmitt A, Solcia E, Wiedenmann B |title=TNM staging of neoplasms of the endocrine pancreas: results from a large international cohort study |journal=J. Natl. Cancer Inst. |volume=104 |issue=10 |pages=764–77 |date=May 2012 |pmid=22525418 |doi=10.1093/jnci/djs208 |url=}}</ref>
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* Solid or spongy nests of cells accentuated by neatly outlined luminal spaces <ref name="pmid28637502">{{cite journal |vauthors=Fang C, Wang W, Zhang Y, Feng X, Sun J, Zeng Y, Chen Y, Li Y, Chen M, Zhou Z, Chen J |title=Clinicopathologic characteristics and prognosis of gastroenteropancreatic neuroendocrine neoplasms: a multicenter study in South China |journal=Chin J Cancer |volume=36 |issue=1 |pages=51 |date=June 2017 |pmid=28637502 |pmc=5480192 |doi=10.1186/s40880-017-0218-3 |url=}}</ref>
* Peripheral nuclear palisading
* Granular eosinophilic cytoplasm.
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* [[Biopsy]] and [[Histopathology|histopathological analysis]]
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|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Juvenile polyposis syndrome|Juvenile Polyposis Coli]]<ref name="pmid7054044">{{cite journal |vauthors=Grotsky HW, Rickert RR, Smith WD, Newsome JF |title=Familial juvenile polyposis coli. A clinical and pathologic study of a large kindred |journal=Gastroenterology |volume=82 |issue=3 |pages=494–501 |date=March 1982 |pmid=7054044 |doi= |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |[[Diarrhea]]
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* Prolapsing [[polyp]]<ref name="pmid22171123">{{cite journal |vauthors=Brosens LA, Langeveld D, van Hattem WA, Giardiello FM, Offerhaus GJ |title=Juvenile polyposis syndrome |journal=World J. Gastroenterol. |volume=17 |issue=44 |pages=4839–44 |date=November 2011 |pmid=22171123 |pmc=3235625 |doi=10.3748/wjg.v17.i44.4839 |url=}}</ref>
* [[Intussusception]]
* [[Macrocephalus]]
* [[Hypotonia]]
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| style="background: #F5F5F5; padding: 5px;" | -
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* >5 juvenile [[Polyp|polyps]] in the [[colon]] and [[rectum]]<ref name="pmid22965402">{{cite journal |vauthors=Latchford AR, Neale K, Phillips RK, Clark SK |title=Juvenile polyposis syndrome: a study of genotype, phenotype, and long-term outcome |journal=Dis. Colon Rectum |volume=55 |issue=10 |pages=1038–43 |date=October 2012 |pmid=22965402 |doi=10.1097/DCR.0b013e31826278b3 |url=}}</ref>
* Multiple [[Polyps|juvenile polyps]] in [[gastrointestinal tract]]
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* Will show [[Polyps|multiple polyps]] in [[gastrointestinal tract]]
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* [[PET scan]]
* [[MRI]]
| style="background: #F5F5F5; padding: 5px;" |[[Hamartomatous intestinal polyposis|Hamartomatous polyps]] on [[Histopathology|histopathological analysis]]
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* Visualization of multiple [[polyps]] in [[gastrointestinal tract]] by [[endoscopy]]
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* Individuals who meet clinical criteria  should get genetic testing  germline mutation in the ''BMPR1A'' and ''SMAD4'' genes.<ref name="pmid229654022">{{cite journal |vauthors=Latchford AR, Neale K, Phillips RK, Clark SK |title=Juvenile polyposis syndrome: a study of genotype, phenotype, and long-term outcome |journal=Dis. Colon Rectum |volume=55 |issue=10 |pages=1038–43 |date=October 2012 |pmid=22965402 |doi=10.1097/DCR.0b013e31826278b3 |url=}}</ref>
* Increased risk of colorectal and gastric cancer<ref name="pmid229654023">{{cite journal |vauthors=Latchford AR, Neale K, Phillips RK, Clark SK |title=Juvenile polyposis syndrome: a study of genotype, phenotype, and long-term outcome |journal=Dis. Colon Rectum |volume=55 |issue=10 |pages=1038–43 |date=October 2012 |pmid=22965402 |doi=10.1097/DCR.0b013e31826278b3 |url=}}</ref>
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Gastrointestinal stromal tumor|Gastrointestinal Stromal Tumors (GIST)]]<ref name="pmid24778074">{{cite journal |vauthors=Niazi AK, Kaley K, Saif MW |title=Gastrointestinal stromal tumor of colon: a case report and review of literature |journal=Anticancer Res. |volume=34 |issue=5 |pages=2547–50 |date=May 2014 |pmid=24778074 |doi= |url=}}</ref><ref name="pmid247780742">{{cite journal |vauthors=Niazi AK, Kaley K, Saif MW |title=Gastrointestinal stromal tumor of colon: a case report and review of literature |journal=Anticancer Res. |volume=34 |issue=5 |pages=2547–50 |date=May 2014 |pmid=24778074 |doi= |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
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* Mostly [[asymptomatic]]<ref name="pmid15613856">{{cite journal |vauthors=Miettinen M, Sobin LH, Lasota J |title=Gastrointestinal stromal tumors of the stomach: a clinicopathologic, immunohistochemical, and molecular genetic study of 1765 cases with long-term follow-up |journal=Am. J. Surg. Pathol. |volume=29 |issue=1 |pages=52–68 |date=January 2005 |pmid=15613856 |doi= |url=}}</ref>
* Are discovered incidentally
* Non-specific symptoms
* Early satiety and bloating
| style="background: #F5F5F5; padding: 5px;" | +/-
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* KIT protein
* [[CD117|CD 117 antigen]]
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* Subepithelial round masses
* Smooth margins
* Normal overlying [[mucosa]] may be intact or [[Ulcerated lesion|ulcerated]]
* Bulging into [[Gastrointestinal tract|gastrointestinal]] [[lumen]]
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* Study of choice
* Evaluate extent and dimensions
* Evaluate metastatic disease
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* [[MRI]]
* [[Endoscopic ultrasound|Endoscopic]] [[ultrasonography]]
* [[PET scan]]<ref name="pmid16222452">{{cite journal |vauthors=Kamiyama Y, Aihara R, Nakabayashi T, Mochiki E, Asao T, Kuwano H, Oriuchi N, Endo K |title=18F-fluorodeoxyglucose positron emission tomography: useful technique for predicting malignant potential of gastrointestinal stromal tumors |journal=World J Surg |volume=29 |issue=11 |pages=1429–35 |date=November 2005 |pmid=16222452 |doi=10.1007/s00268-005-0045-6 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
**[[Spindle cells|Spindle cell]] type are [[eosinophilic]] cells arranged in the form of whorls or fascicles.<ref name="pmid12075401">{{cite journal |vauthors=Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, Miettinen M, O'Leary TJ, Remotti H, Rubin BP, Shmookler B, Sobin LH, Weiss SW |title=Diagnosis of gastrointestinal stromal tumors: a consensus approach |journal=Int. J. Surg. Pathol. |volume=10 |issue=2 |pages=81–9 |date=April 2002 |pmid=12075401 |doi=10.1177/106689690201000201 |url=}}</ref><ref name="pmid120754012">{{cite journal |vauthors=Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, Miettinen M, O'Leary TJ, Remotti H, Rubin BP, Shmookler B, Sobin LH, Weiss SW |title=Diagnosis of gastrointestinal stromal tumors: a consensus approach |journal=Int. J. Surg. Pathol. |volume=10 |issue=2 |pages=81–9 |date=April 2002 |pmid=12075401 |doi=10.1177/106689690201000201 |url=}}</ref>
**[[Epithelioid]] [[GIST|GISTs]] are rounded cells with oval nuclei and vesicular chromatin and appears nested<ref name="pmid15223958">{{cite journal |vauthors=Medeiros F, Corless CL, Duensing A, Hornick JL, Oliveira AM, Heinrich MC, Fletcher JA, Fletcher CD |title=KIT-negative gastrointestinal stromal tumors: proof of concept and therapeutic implications |journal=Am. J. Surg. Pathol. |volume=28 |issue=7 |pages=889–94 |date=July 2004 |pmid=15223958 |doi= |url=}}</ref>
**On [[immunohistochemical staining]] they are positive for [[Molecular marker|molecular markers]] [[CD117]] antigen and KIT protein.
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* [[Biopsy]] and [[Histopathological|histopathological analysis]]
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* [[Cytological|Cytologic analysis]], and [[immunohistochemistry]] for KIT protein expression confirms the [[diagnosis]] of these [[Lesion|lesions]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Hamartoms
| style="background: #F5F5F5; padding: 5px;" |in progress
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |Colorectal Lymphoma<ref name="pmid20011310">{{cite journal |vauthors=Quayle FJ, Lowney JK |title=Colorectal lymphoma |journal=Clin Colon Rectal Surg |volume=19 |issue=2 |pages=49–53 |date=May 2006 |pmid=20011310 |pmc=2780105 |doi=10.1055/s-2006-942344 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |ccomplete
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Kaposi's sarcoma]]
| style="background: #F5F5F5; padding: 5px;" |complete
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|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Ulcerative colitis]]<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |Diarrhea
| style="background: #F5F5F5; padding: 5px;" |<big>+</big>
| style="background: #F5F5F5; padding: 5px;" |LLQ<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Vitamin B12 defi. anemia<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref>
* Autoimmune hemolytic anemia
| style="background: #F5F5F5; padding: 5px;" |
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* Continuous lesions, presence of crypts, formation of residual mucosal tissue<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref>
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* Mucosal and submucosal inflammation<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref>
* Hemorrhage or inflammatory polymorphonuclear cells aggregate in the lamina propria
* Distorted crypts
* Crypt abscess
| style="background: #F5F5F5; padding: 5px;" |
* Endoscopy and a mucosal biopsy<ref name="pmid16902215" />
| style="background: #F5F5F5; padding: 5px;" |
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Crohn's disease<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |Diarrhea
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |LRQ<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
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* Vitamin B12 defi. anemia<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref>
* Autoimmune hemolytic anemia
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Discontinuous lesions, strictures, linear ulcerations<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
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| style="background: #F5F5F5; padding: 5px;" |
* Transmural pattern of inflammation<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref>
* Mucosal damage
* Focal infiltration of leukocytes into the epithelium
* Granulomas
| style="background: #F5F5F5; padding: 5px;" |
* Endoscopy and a mucosal biopsy<ref name="pmid16902215">{{cite journal |vauthors=Collins P, Rhodes J |title=Ulcerative colitis: diagnosis and management |journal=BMJ |volume=333 |issue=7563 |pages=340–3 |date=August 2006 |pmid=16902215 |pmc=1539087 |doi=10.1136/bmj.333.7563.340 |url=}}</ref>
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|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Irritable bowel syndrome
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Appendicitis]]
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|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
!Diseases
!Symptom 1
! colspan="1" rowspan="1" |Symptom 2
!Symptom 3
!Physical exam 1
!Lab 1
!Lab 2
!Imaging 1
!Imaging 2
!Imaging 3
!Histopathology
|'''Gold standard'''
!Additional findings
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Strangulated hernia]]
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| style="background: #F5F5F5; padding: 5px;" |<nowiki/>
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |Bowel endometriosis
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|}
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Revision as of 15:27, 24 January 2019

Small intestine cancer Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Qurrat-ul-ain Abid, M.D.[2]Parminder Dhingra, M.D. [3]

Overview

Small intestine cancer must be differentiated from Crohn's disease, intestinal tuberculosis, ulcerative colitis, large intestine cancer, peptic ulcer disease, and irritable bowel syndrome (IBS).

Differential Diagnosis

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