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Feb 2018 DOI 10.14302/issn.2639-1716.jn-18-1965
T. Caracciolo JamieCorresponding author
Department of Diagnostic Imaging, Moffitt Cancer Center, Tampa, FL
Lipomatous tumors are among the most common primary musculoskeletal neoplasms affecting both pediatric and adult patient populations. Patient age, tumor location, and imaging features all contribute to the differential diagnosis of musculoskeletal tumors. Tumors identified outside of common patient demographics or in unusual locations may lead to preoperative misdiagnosis. We present an uncommon adipocytic tumor occurring at an uncommon age which was proven at surgery to represent a preoperatively unexpected diagnosis. A 13 year old male presented with a fatty anterior proximal thigh mass; age and magnetic resonance findings suggested lipoblastoma. However, following complete surgical resection, histopathology confirmed hibernoma, a benign lipomatous tumor characterized by the presence of white and multivacuolated brown fat cells, the vast majority of which occur in adult patients.
Mar 2024 DOI 10.14302/issn.2694-1201.jsn-22-4184
Ekladious AdelCorresponding author
Sarcoidosis is granulomatous autoinflammatory autoimmune remitting relapsing disease affecting every organ in the body, it is the most difficult disease to diagnose in the absence of serum or imaging biomarker. Differential diagnosis is broad which included inflammatory, infective, neurodegenerative and neoplastic, histological biopsy is the only confirmative marker, and even histological confirmation is not robust as infection, malignancy and some drugs can induce granuloma, the most common organs affected are lung, lymph nodes, skin, eyes, liver, and less commonly pituitary gland, bones, brain, peripheral nerves, and heart, causing bilateral hilar lymphadenopathy, granulomatous lymphadenitis.
Dec 2022 DOI 10.14302/issn.2574-4526.jddd-22-4151
Darouichi M.Corresponding author
Institute Medical Champel, 1206.Champel, Geneva, Switzerland
Steroid cell tumors of the ovary are particularly rare, secreting sex hormones, characterized by steroid cell proliferation and represent only 0.1% of all ovarian tumors. They are classified into three subtypes according to their cell of origin: stromal luteoma, Leydig cell tumors and a third subtype of unknown lineage corresponds to a not specified steroid cell tumor (SCT-NOS). This third subtype accounts for 60% of steroid cell tumors. The clinical manifestations of SCT-NOS can take many forms, including pain, abdominal distension, but perhaps the most visible presentations are those related to hormonal activity and virilization of the tumor. We present a rare case of a 48-year-old woman with vaginal bleeding and a history of trunk obesity, hirsutism for 2 years and hypothyroidism with hormone replacement therapy. Clinical examination revealed a characteristic of obesity, virilization. Serum testosterone was 3.62 µg / L and CA-125 was 40.67. Magnetic resonance imaging identified a left ovarian solid mass and histopathology confirmed a steroid cell tumor not specific. The patient underwent exploratory laparotomy and left salpingoophorectomy. Macroscopically, the mass is well circumscribed, solid, homogeneous and yellowish. Microscopically, the tumor is mainly composed of eosinophilic or vacuolar granular cytoplasm. Immunohistochemistry showed that the tumor cells were strongly positive for inhibin. The postoperative period was uneventful. Through this rare observation, we will discuss the aspects that characterize this type of tumor and present some guidelines to be used in the differential diagnosis, as well as the difficulties encountered in the clinical, radiological and therapeutic fields.
Feb 2022 DOI 10.14302/issn.2689-5773.jcdp-22-4065
Zaichick VladimirCorresponding author
Prof., Dr. Vladimir Zaichick, Medical Radiological Research Centre, Korolyev St. 4, Obninsk 249036, Russia.
Thyroid malignant nodules (TMNs) are the most common endocrine cancer. The etiology and pathogenesis of TMNs must be considered as multifactorial. Diagnostic evaluation of TMNs represents a challenge, since there are numerous benign and malignant thyroid disorders that need to be exactly attributed. The present study was performed to clarify the possible role of some trace elements (TEs) as cancer biomarker. For this aim thyroid tissue levels of copper (Cu), iron (Fe), iodine (I), rubidium (Rb), strontium (Sr), and zinc (Zn) were prospectively evaluated in malignant tumor and thyroid tissue adjacent to tumor of 41 patients with TMNs. Measurements were performed using energy-dispersive X-ray fluorescent analysis. Results of the study were additionally compared with previously obtained data for the same TEs in “normal” thyroid tissue. From results obtained, it was possible to conclude that the common characteristics of TMNs in comparison with “normal” thyroid and visually “intact” thyroid tissue adjacent to tumor were drastically reduced level of I. It was supposed that the drastically reduced level of I content in cancerous tissue could possibly be explored for differential diagnosis of benign and malignant thyroid nodules.
Jan 2022
PrachiCorresponding author
Senior Resident, Department of Pathology, Dharamshila Narayana Super speciality Hospital, New Delhi
This case report describes plasma cell pleocytosis occurring after bone marrow transplantation for multiple myeloma. The authors outline clinical presentation, cerebrospinal fluid findings, and differential diagnosis, emphasizing the need to consider hematologic relapse or CNS involvement in post‑transplant patients with neurologic symptoms. Management considerations and follow‑up strategies are discussed.
Nov 2021
Sanavi SuzanCorresponding author
Abourayhan Polyclinic, Social Security Organization
A case report describes urticaria as an initial manifestation of COVID‑19. It outlines clinical course, differential diagnosis, and implications for testing and isolation.
Feb 2021 DOI 10.14302/issn.2381-862X.jwrh-21-3708
Muthyala TanujaCorresponding author
Assistant Professor, Department of Obstetrics & gynecology, All India Institute of Medical sciences, Mangalagiri, Guntur, Andhra Pradesh
Fetal mesentric lymphangioma, a congenital fetal abdominal cystic malformation has a rare occurrence. Antenatal detection, its differential diagnosis, prenatal management options and parental counseling regarding postnatal prognosis of such a case are thus rarely discussed. We report two cases of antenatally detected fetal cystic abdominal mass with a provisional diagnosis of abdominal lymphangioma. Postnatally one of the neonates developed features of intestinal obstruction and required surgical intervention. Intra-operative findings and histopathology report confirmed a mesentric lymphangioma. The other neonate had associated subcutaneous lymphangiectasia in left lumbar region, left sided inguinal hernia, undescended testes and was asymptomatic postnatally and managed conservatively.
Dec 2020 DOI 10.14302/issn.2372-6601.jhor-20-3673
Zaichick VladimirCorresponding author
Prof., Dr. Vladimir Zaichick, Medical Radiological Research Centre, Korolyev St. 4, Obninsk 249036, Russia.
The prostate gland is subject to various disorders. The etiology and pathogenesis of these diseases remain not well understood. Moreover, despite technological advancements, the differential diagnosis of prostate disorders has become progressively more complex and controversial. It was suggested that the antimony (Sb) level in prostatic tissue plays an important role in prostatic carcinogenesis and its measurement may be useful as a cancer biomarker. These suggestions promoted more detailed studies of the Sb content in the prostatic tissue of healthy subjects. The present study evaluated by systematic analysis the published data for Sb content analyzed in prostatic tissue of “normal” glands. This evaluation reviewed 1998 studies, all of which were published in the years from 1921 to 2020 and were located by searching the databases PubMed, Scopus, ELSEVIER-EMBASE, Cochrane Library, and the Web of Science. The articles were analyzed and “Median of Means” and “Range of Means” were used to examine heterogeneity of the measured Sb content in prostates of apparently healthy men. The objective analysis was performed on data from the 23 studies, which included 1173 subjects. It was found that the range of means of prostatic Sb content reported in the literature for “normal” gland varies widely from 0.0066 mg/kg to 0.071 mg/kg with median of means 0.0085 mg/kg on a wet mass basis. Because of small sample size and high data heterogeneity, we recommend other primary studies be performed.
Jun 2020 DOI 10.14302/issn.2574-4526.jddd-20-3410
Darouichi M.Corresponding author
Institute Medical Champel, 1206, champel, Geneva, Switzerland
Glandular-cystic bladder cystitis is a rare, benign non-tumor condition, preferentially located on the area of the bladder trigone and can simulate a malignant tumor. It is a benign reactive metaplasia of the bladder submucosa, characterized by hyperplasia of the islets of Von Brunn and cystic. It is classified among reactive epithelial anomalies of the urothelium, such as islet hyperplasia of Von Brünn, cystitis, glandular cystitis, nephrogenic metaplasia and epidermoid metaplasia. It presents a clinical diagnostic challenge having the expression of a simple recurrent cystitis and misleading the radiological diagnosis evoking a malignant tumor of the bladder. Its certainty diagnosis is histological. We report the case of a 38-year-old young man who consulted for recurrent cystitis. The CT scan showed a vegetative tissue structure of the middle and left medial vesical floor, sawtooth 3 cm long axis suspecting a tumor of the bladder. The patient underwent transurethral resection of the bladder lesion. The histological and immunohistochemical examination concluded with glandular and cystic cystitis (minor form). In the light of this observation, we will discuss the diagnostic difficulties, the pathophysiological mechanisms, the radiological aspects, the anatomopathological, therapeutic features and the prognosis of this rare condition. The literature regarding this entity has been reviewed and the differential diagnosis was discussed.
May 2020 DOI 10.14302/issn.2692-5257.ijgp-20-3335
Luis Turabian JoseCorresponding author
Specialist in Family and Community Medicine, Health Center Santa Maria de Benquerencia, Regional Health Service of Castilla la Mancha (SESCAM), Toledo, Spain
The consultation is the activity of meeting and communication between an individual and the doctor for the knowledge and solution of a health problem. In today's busy world of general medicine, constant demands for the general practitioner (GP) arise: she or he should not only make a diagnosis not only should make a differential diagnosis during consultation, but must also establish a good relationship, explore patient ideas, concerns and expectations and negotiate a management plan, taking into account limited resources, the quality framework and results, having Information technology skills, plus, the need to promote health during any consultation. Normally the GP has only 10 minutes to achieve all that, as well as to manage your own emotions, agendas and uncertainty. In this way, novice doctors may find it difficult to move in this situation of complexity, and they can also observe a gap in the literature that really guides them in practice. Rigorous preparation is the key to success for many endeavours. Some tips to perform an efficient and safe consultation work in general medicine are suggested: 1) Focus on the next patient; 2) Preparing the consultation before entering the patient, memorizing the patient's previous history; 3) Establishing a connection with the patient; 4) Remembering the elements that must be in each consultation (the current reason, update other previous processes, chronic diseases and continued attention, "case finding", health promotion); 5) Striking a balance between empathy and assertiveness; 6) Putting in writing and contextualized the clinical record; and 7) Making reflection-safety questions, learning questions, and preparation questions for the next visit. Rigorous preparation is the key to success for the general practitioner in every consultation. Think about these topics of the consultation before doing it, and after it, prepare the next consultation of that patient. All these things are force multipliers.
Nov 2019 DOI 10.14302/issn.2641-5518.jcci-19-3098
Caner EdizCorresponding author
Department of Urology, University of Health Sciences (Istanbul), Sultan Abdulhamid Han Education and Research Hospital, Istanbul, Turkey
Idiopathic retroperitoneal fibrosis also known as Ormonds disease is a rare disorder characterized by the development of fibrotic tissue in the retroperitoneum. The fibrotic tissue may compress ureters, leading to obstructive nephrouropathy and renal failure. A 58-year-old man with fatigue, loss of appetite and unable to urinate was admitted to our clinic. Because of the serum creatinine value of 5.3 mg/dl, urinary ultrasonography was performed and bilateral grade 3 hydronephrosis with moderate level urine in bladder was detected. Hydronephrosis did not regress by transurethral foley catheter and suspicious appearance in the retroperitoneal area was found in abdominal magnetic resonance imaging. Tru-cut biopsy result of the current lesion was finally reported as a connective tissue. Bilateral double j catheter insertion was performed and started to immunosuppression therapy with corticosteroid. Two months later, double j catheters were removed and hydronephrosis was not detected in follow-up. In this case report, we tried to explain that, retroperitoneal fibrosis should be considered in the differential diagnosis of postrenal acute renal failure, even in patients without a classic symptom such as pain. In addition, early surgical intervention should be avoided in such patients.
Jul 2017 DOI 10.14302/issn.2576-9359.jot-17-1597
Borges da Costa JoãoCorresponding author
Clínica Universitária de Dermatologia de Lisboa, CHLN, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
Cutaneous lymphoma after organ transplantation is rare and its diagnosis may be delayed by both atypical clinical manifestations and failure to consider it in the differential diagnosis. Beside skin-directed therapy for the stage, immunosuppression reduction is also important for disease control. We describe a clinical case of mycosis fungoides after renal transplantation and discuss the therapeutic options.
May 2015 DOI 10.14302/issn.2324-7339.jcrhap-13-235
Di Bella StefanoCorresponding author
National Institute for Infectious Diseases
A clinical case of painful mucocutaneous lesions in an HIV‑1 seropositive woman is presented. The report discusses differential diagnosis, diagnostic work‑up in resource‑limited settings, and targeted therapy considerations.
May 2015 DOI 10.14302/issn.2574-4496.jtc-13-347
Emilio MevioCorresponding author
Primary thyroid leiomyosarcoma, is extremely rare, with only 19 cases reported in the literature to date. Onset of the tumor, which usually develops in only one lobe of the thyroid, is sudden and the tumor spreads rapidly to surrounding tissues. Preoperative differential diagnosis is extremely difficult. The long-term prognosis for the patient is extremely poor and unrelated to treatment. Indeed, thyroidectomy and neck dissection followed by adjuvant chemotherapy and/or radiation therapy have not been shown to affect rate of recurrence and long-term survival. The authors describe the case of a patient with leiomyosarcoma of the thyroid gland and review the relevant literature, considering the differential diagnoses and alternative treatment strategies.
Feb 2015 DOI 10.14302/issn.2578-2371.jslr-14-543
Soufi MehdiCorresponding author
Department of digestive Surgery, Faculty of medicine Oujda, University Mohammed first, Oujda -Morocco
Liver is most commonly involved organ in hydatid cyst. Primary splenic hydatid cysts are rare; we report a case of an isolated giant hydatid cyst of spleen in a 17-year-old man. The diagnosis was confirmed by imaging findings and serology. Partial cystectomy was performed with success. In cystic lesions of spleen, hydatid cyst should be kept in patrician’s mind in the differential diagnosis. Although splenectomy is the gold standard for treating hydatid disease of the spleen, in young patient spleen-preserving surgery seems give good results.