Hodgkin's lymphoma differential diagnosis

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

Differential Diagnosis

The following conditions must be considered in the differential diagnosis of Hodgkin's lymphoma: DDx [1][2][3][4][5][6][7]
  • Sarcoidosis DDx
  • Lymphocytic lymphoma DDx
  • Miliary tuberculosis DDx
  • Infectious mononucleosis DDx
  • Thoracic aortic aneurysm DDx
  • Substernal goiter DDx
  • Thymoma DDx
  • Actinomycosis DDx
  • Chronic lymphocytic leukemia DDx
  • Superior vena cava syndrome DDx
  • Unicentric Castleman disease DDx
  • Adult Still disease DDx
  • Small cell lung carcinoma DDx
  • Malignant histiocytosis DDx


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2] Mahshid Mir, M.D. [3]

Differential Diagnosis
DDx Alphabetic Order
A B
C D
E F
G H
I J
K L
M N
O P
Q R
S T
U V
W X
Y Z


Template:WikiDoc Sources

Clinical manifestations
  • Mental nerve neuropathy
  • Alcohol intolerance
  • Exfoliative dermatitis
  • Epitrochlear lymph node enlargement
  • Inguinal lymph node enlargement
  • Hepatomegaly
  • Liver mass
  • Superior vena cava obstruction
  • Inferior vena cava obstruction
  • Femoral lymph node enlargement
  • Popliteal lymph node enlargement
  • Pemberton sign positive
  • Pel-Ebstein fever
  • Chylous ascites
  • Axillary lymph node enlargement
  • Erythema multiforme
  • Erythema nodosum
  • Hepatosplenomegaly
  • Mesenteric lymph node enlargement
  • Paraplegia
  • Pruritus
  • Spinal cord compression
  • Spleen enlargement
  • Urinary tract obstruction
  • Generalized diffuse lymph node enlargement
  • Airway compression or obstruction
  • Cryptococcosis
  • Bone pain
  • Cervical lymph node enlargement
  • Recurrent fever
  • Recurrent infection
  • Fixed lymph node
  • Neck mass
  • Night sweats
  • Malaise
  • Supraclavicular lymph node enlargement
  • Sweating increase
  • Fever unknown origin
  • Remittent fever
  • Painless lymphadenopathy
  • Regional lymph node enlargement
Laboratory abnormalities
  • Nucleated red cells
  • Hypogammaglobulinemia
  • Pancytopenia
  • Lymphocytes decreased
  • Granulomas on biopsy
Radiographic features
  • Retroperitoneal lymph node enlargement
  • Biliary tract dilatation on abdominal ultrasound
  • Bone lesion
  • Mediastinal mass,adenopathy, or widening on chest xray
  • Middle mediastinal mass on chest xray
  • Mediastinal lymph node enlargement
  • Anterior mediastinal mass on chest radiograph
  • Increased uptake on abdomen gallium scan
  • Ivory vertebra
  • Increased uptake on mediastinum gallium scan


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [4] Mahshid Mir, M.D. [5]

Differential Diagnosis
DDx Alphabetic Order
A B
C D
E F
G H
I J
K L
M N
O P
Q R
S T
U V
W X
Y Z


Template:WikiDoc Sources

Clinical manifestations
  • Corneal deposit
  • Corneal opacity
  • Parotid gland swelling
  • Polyneuropathy
  • Cranial nerve paralysis
  • Airway compression or obstruction
  • Retinal granuloma
  • Erythema nodosum
  • Uveitis
  • Ankle pain
  • Facial paralysis
  • Salivary gland swelling
  • Massive splenomegaly
  • Cryptococcosis
  • Generalized rash, papules (elevated, <0.5cm)
  • Iridocyclitis
  • Iritis
  • Dry cough
  • Night sweats
  • Spleen enlargement
  • Bilateral uveitis
  • Generalized diffuse lymph node enlargement
  • Polyarthritis
Laboratory abnormalities
  • Hypercalcemia
  • Increased lymphocytes in pleural effusion
  • Decreased Lymphocytes
  • Hypercalciuria
  • Mild-moderate elevation of alkaline phosphatase
  • PFT's: restrictive defect
  • PFT's: diffusion capacity decreased
  • Elevated serum angiotensin-converting enzyme
  • Increased vitamin D, 1,25-dihydroxy
Radiographic features
  • Heart conduction abnormality on electrocardiographic
  • Atrioventricular block
  • Retroperitoneal lymph node enlargement
  • Lung cyst on chest radiography
  • Interstitial infiltrate ( incl. reticulonodular )on chest radiography
  • Increased mediastinal uptake on gallium scan
  • Increased lung uptake on gallium scan
  • Mediastinal lymph node enlargement
  • Bone marrow granulomas
  • Mediastinal mass, adenopathy, or widening on chest radiography
  • Granulomas on biopsy
  • Hilar lymph node enlargement on chest radiography


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [6] Mahshid Mir, M.D. [7]

Differential Diagnosis
DDx Alphabetic Order
A B
C D
E F
G H
I J
K L
M N
O P
Q R
S T
U V
W X
Y Z


Template:WikiDoc Sources

Clinical manifestations
  • Mental nerve neuropathy
  • Exfoliative dermatitis
  • Lower extremity paralysis
  • Gout
  • Esophageal candidiasis
  • Abdominal mass
  • Biliary tract obstruction
  • Breast mass
  • Epitrochlear lymph node enlargement
  • Erythema multiforme
  • Erythema nodosum
  • Esophageal obstruction
  • Facial edema
  • Gastric obstruction
  • Thyroid nodule
  • Hepatosplenomegaly
  • Intestinal obstruction
  • Intussusception
  • Liver mass
  • Mesenteric lymph node enlargement
  • Mucous membrane bleeding
  • Night sweats
  • Paraplegia
  • Pruritus
  • Anergy
  • Spinal cord compression
  • Stool clay color
  • Stool color yellow
  • Superior vena cava obstruction
  • Supraclavicular lymph node enlargement
  • Testicular mass
  • Urinary tract obstruction
  • Inferior vena cava obstruction
  • Generalized diffuse lymph node enlargement
  • Massive splenomegaly
  • Femoral lymph node enlargement
  • Popliteal lymph node enlargement
  • Airway compression or obstruction
  • Cryptococcosis
  • Recurrent infection
  • Fixed lymph node
  • Neck mass
  • Spleen enlargement
  • Fever unknown origin
  • Regional lymph node enlargement
  • Painless lymphadenopathy
  • Cancer
  • Lymphoma
  • Non-Hodgkin lymphoma
Laboratory abnormalities
  • Extreme hypercalcemia (>14 mg/dl)
  • Prolonged bleeding time
  • Markedly increased ESR
  • Hypogammaglobulinemia
  • Pancytopenia
  • Lymphocytes decreased
  • Pleural effusion (Exudate)
  • Bone marrow plasma cells increased
  • Lymphocytes increased in pleural effusion
  • Pleural effusion (Chylous)
  • Malignant ascites
  • Cryoglobulinemia
  • Vitamin D, 1,25-dihydroxy increased
Radiographic features
  • Bladder mass or abnormal shape on IVP
  • Bone destruction
  • Kidney mass
  • Mediastinal lymph node enlargement
  • Bone lesion
  • Retroperitoneal lymph node enlargement
  • Mediastinal mass, adenopathy, or widening on chest radiography
  • Anterior mediastinal mass on chest radiography
  • Biliary tract dilatation on abdominal ultrasound
  • Increased mediastinal uptake on gallium scan
  • Increased abdominal uptake on gallium scan


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [8] Mahshid Mir, M.D. [9]

Differential Diagnosis
DDx Alphabetic Order
A B
C D
E F
G H
I J
K L
M N
O P
Q R
S T
U V
W X
Y Z


Template:WikiDoc Sources

Clinical manifestations
  • Prison inmate
  • Retinal granuloma
  • Erythema nodosum
  • Travel history (Haiti)
  • Immunosuppressive therapy
  • Severe weight loss
  • Corticosteroid use
  • Pleuritic chest pain
  • Progressive dyspnea
  • Fever unknown origin
  • Retinitis
  • Tuberculosis exposure
Laboratory abnormalities
  • Pancytopenia
  • PPD positive
  • Nucleated red cells
  • Bone marrow granulomas
  • AFB smear positive
  • Granulomas on biopsy
Radiographic features
  • Increased abdominal uptake on gallium scan
  • Multiple hypodense liver lesions on abdominal CT
  • Multiple non-calcified pulmonary nodules on chest radiography


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [10] Mahshid Mir, M.D. [11]

Differential Diagnosis
DDx Alphabetic Order
A B
C D
E F
G H
I J
K L
M N
O P
Q R
S T
U V
W X
Y Z


Template:WikiDoc Sources

Clinical manifestations
  • Optic neuritis
  • Epitrochlear lymph node enlargement
  • Periorbital edema
  • Pharyngeal petechia
  • Spleen enlargement
  • Spleen palpable
  • Tonsillitis
  • Left upper quadrant abdominal tenderness
  • Axillary lymph node enlargement
  • Inguinal lymph node enlargement
  • Pesenteric lymph node enlargement
  • Pharyngeal exudate
  • Pharyngeal erythema
  • Spleen tenderness
  • Tonsillar exudate
  • Generalized diffuse lymph node enlargement
  • Cervical lymph node enlargement
  • Pharyngeal swelling
  • Sore throat
Laboratory abnormalities
  • Marked elevationSGPT (ALT)
  • SGPT (ALT) elevated
  • Lymphocytes increased
  • Atypical lymphocytes increased
  • Heterophile antibody positive
  • Monocytes increased
  • Epstein-Barr virus titre positive


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [12] Mahshid Mir, M.D. [13]

Differential Diagnosis
DDx Alphabetic Order
A B
C D
E F
G H
I J
K L
M N
O P
Q R
S T
U V
W X
Y Z


Template:WikiDoc Sources

Clinical manifestations
  • Cocaine use
  • Turner syndrome
  • Pemberton sign positive
  • Marfan syndrome
  • Aortic valve regurgitation
  • Superior vena cava obstruction
  • Ascending aortic dilation
Radiographic features
  • Anterior mediastinal mass on chest radiography
  • Middle mediastinal mass on chest radiography
  • Posterior mediastinal mass on chest radiography
  • Aorta prominent or enlarged on chest radiography


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [14] Mahshid Mir, M.D. [15]

Differential Diagnosis
DDx Alphabetic Order
A B
C D
E F
G H
I J
K L
M N
O P
Q R
S T
U V
W X
Y Z


Template:WikiDoc Sources

Clinical manifestations
  • Upper extremity edema
  • Chest mass
  • Neck mass
  • Thyroid enlargement
  • Tracheal compression
  • Pemberton sign positive
Laboratory abnormalities
  • TSH elevated
Radiographic features
  • Mediastinal mass, adenopathy, or widening on chest radiograph


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [16] Mahshid Mir, M.D. [17]

Differential Diagnosis
DDx Alphabetic Order
A B
C D
E F
G H
I J
K L
M N
O P
Q R
S T
U V
W X
Y Z


Template:WikiDoc Sources

Clinical manifestations
  • Bulbar palsy
  • Facial candida infection
  • Facial cyanosis
  • Jugular venous distention
  • Mouth candida infection
  • Superior vena cava obstruction
  • Diplopia
  • Pemberton sign positive
Laboratory abnormalities
  • Pancytopenia
  • Antistriational antibodies
Radiographic features
  • Mediastinal mass, adenopathy, or widening on chest radiograph
  • Anterior mediastinal mass on chest radiograph


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [18] Mahshid Mir, M.D. [19]

Differential Diagnosis
DDx Alphabetic Order
A B
C D
E F
G H
I J
K L
M N
O P
Q R
S T
U V
W X
Y Z


Template:WikiDoc Sources

Clinical manifestations
  • Tongue mass
  • Trismus
  • Pericardial constriction
  • Pharyngeal swelling
  • Pharyngeal tenderness
  • Abdominal fistula
  • Bronchial fistula
  • Empyema
  • Lung abscess
  • Right lower quadrant abdominal mass
  • Chest wall suppuration
  • Gingival fistula
  • Chest wall fistula
  • Gingival swelling
  • Gingival tenderness
  • Jaw induration
  • Mandibular swelling
Laboratory abnormalities
  • Branching Gram-positive bacilli on Gram stain
  • Sulfur granule
Radiographic features
  • Mediastinal mass, adenopathy, or widening on chest radiography
  • Intracardiac mass on echocardiogram
  • Hepatic cyst(s)


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [20] Mahshid Mir, M.D. [21]

Differential Diagnosis
DDx Alphabetic Order
A B
C D
E F
G H
I J
K L
M N
O P
Q R
S T
U V
W X
Y Z


Template:WikiDoc Sources

Clinical manifestations
  • Skin infiltration
  • Sternal tenderness
  • Lymph node firmness
Laboratory abnormalities
  • Hemolysis
  • Prolonged bleeding time
  • Monoclonal gammopathy
  • Cryoglobulinemia
  • Marked increase of leukocytes
  • Clonal B-lymphocytes on flow cytometry
  • Lymphocytes increased
Radiographic features
  • Mediastinal mass, adenopathy, or widening on chest radiography

The following findings (if present) would make this disease less likely:

  • Left shift
  • Metamyelocytes increased


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [22] Mahshid Mir, M.D. [23]

Differential Diagnosis
DDx Alphabetic Order
A B
C D
E F
G H
I J
K L
M N
O P
Q R
S T
U V
W X
Y Z


Template:WikiDoc Sources

Clinical manifestations
  • Stridor
  • Facial erythema
  • Forehead vein distention
  • Lymphoma
  • Tracheal displacement
  • Chest vein distention
  • Facial cyanosis
  • Collateral circulation increase
  • Conjunctival edema
  • Conjunctival vein distention
  • Upper extremity edema
  • Upper extremity erythema
  • Head edema
  • Jugular venous distention with inspiration
  • Lung tumor
  • Extremity cyanosis
  • Upper extremity vein distention
  • Facial edema
  • Neck edema
  • Jugular venous distention
  • Lung cancer
  • Upper extremity cyanosis
  • Facial vein distention
  • Superior vena cava obstruction
Radiographic features
  • Mediastinal lymph node enlargement
  • Non-calcified pulmonary nodule (< 4 cm) on chest radiography
  • Mediastinal mass, adenopathy, or widening on chest radiography

The following findings (if present) would exclude this disease:

  • hepatojugular reflux


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [24] Mahshid Mir, M.D. [25]

Differential Diagnosis
DDx Alphabetic Order
A B
C D
E F
G H
I J
K L
M N
O P
Q R
S T
U V
W X
Y Z


Template:WikiDoc Sources

Radiographic features
  • Mediastinal mass, adenopathy, or widening on chest radiography


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [26] Mahshid Mir, M.D. [27]

Differential Diagnosis
DDx Alphabetic Order
A B
C D
E F
G H
I J
K L
M N
O P
Q R
S T
U V
W X
Y Z


Template:WikiDoc Sources

Clinical manifestations
  • Ankylosis
  • Hepatosplenomegaly
  • Severe weight loss
  • Recurrent fever
  • Night sweats
  • Wrist pain
  • Generalized diffuse lymph node enlargement
  • Fever unknown origin
  • Remittent fever
  • High grade fever
  • Polyarticular
  • Evanescent rash
Laboratory abnormalities
  • Leukocytes, marked increase
  • ESR markedly increased
  • Serum ferritin greatly increased

The following findings (if present) would make this disease less likely:

  • monoarticular

The following findings (if present) would exclude this disease:

  • asymptomatic


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [28] Mahshid Mir, M.D. [29]

Differential Diagnosis
DDx Alphabetic Order
A B
C D
E F
G H
I J
K L
M N
O P
Q R
S T
U V
W X
Y Z


Template:WikiDoc Sources

Clinical manifestations
  • Acanthosis nigricans
  • Axillary lymph node enlargement
  • Axillary lymph node pain
  • Dysphagia
  • Esophageal obstruction
  • Heart tamponade
  • Pericardial effusion
  • Lower rib tenderness
  • Tracheal displacement
  • Hoarseness
  • Digital clubbing
  • Airway compression or obstruction
  • Pemberton sign positive
  • Velvet palms
  • Horner syndrome
  • Superior vena cava obstruction
  • Bone pain
  • Spinal cord compression
  • Supraclavicular lymph node enlargement
  • Intracranial metastatic tumor
  • Acute symmetrical peripheral neuropathy
  • Hemoptysis
  • Right supraclavicular lymph node enlargement
  • Tobacco smoking
Laboratory abnormalities
  • Bone destruction
  • Unilateral diaphragm elevation on chest radiography
  • Non-calcified pulmonary nodule (< 4 cm) on chest radiography
  • Mediastinal mass, adenopathy, or widening on chest radiography
  • Pleural effusion
  • Pleural effusion (bloody)
  • Non-calcified pulmonary mass (>= 4 cm)on chest radiography
  • Hyponatremia
  • Bone marrow tumor cells
  • Serum calcitonin increased
  • Hilar lymph node enlargement on chest radiography
Radiographic features
  • Normal on chest radiography
  • Normal on chest CT (contrast enhanced)


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [30] Mahshid Mir, M.D. [31]

Differential Diagnosis
DDx Alphabetic Order
A B
C D
E F
G H
I J
K L
M N
O P
Q R
S T
U V
W X
Y Z


Template:WikiDoc Sources

Clinical manifestations
  • Tendon xanthoma
  • Xanthoma
  • Tuberous xanthoma
  • Planar xanthoma
  • Palmar planar xanthoma
  • Hepatosplenomegaly
  • Spleen enlargement
  • Panniculitis
  • Generalized diffuse lymph node enlargement
Laboratory abnormalities
  • ESR markedly increased
  • Serum ferritin greatly increased
  • ESR mildly or moderately increased
  • C-reactive protein elevated

References

  1. ↑ Ferri, Fred (2011). Ferri's differential diagnosis: a practical guide to the differential diagnosis of symptoms, signs, and clinical disorders. Philadelphia, PA: Elsevier/Mosby. ISBN 978-0323076999.
  2. ↑ Siegenthaler, Walter (2007). Differential diagnosis in internal medicine: from symptom to diagnosis. Stuttgart New York: Thieme. ISBN 978-1588905512.
  3. ↑ Mesko, Dusan (2002). Differential diagnosis by laboratory medicine: a quick reference for physicians. Berlin New York: Springer-Verlag. ISBN 978-3540430575.
  4. ↑ Reeder and Felson's gamuts in radiology: comprehensive lists of roentgen differential diagnosis. Place of publication not identified: Springer. 2014. ISBN 978-1475781229.
  5. ↑ Burgener, Francis (2008). Differential diagnosis in conventional radiology. Stuttgart New York: Thieme. ISBN 978-1588902757.
  6. ↑ Gattuso, Paolo (2015). Differential diagnosis in surgical pathology. Philadelphia, PA: Saunders/Elsevier. ISBN 978-1455770137.
  7. ↑ "DXplain".
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