Bladder cancer differential diagnosis: Difference between revisions

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Revision as of 16:33, 5 February 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shanshan Cen, M.D. [2]

Overview

Bladder cancer must be differentiated from renal cancer, renal stones, prostate cancer, and cystitis.

Differential Diagnosis

The most common presentation of bladder cancer is hematuria, in the advanced cases, the presentation can be bladder mass. Bladder cancer must be differentiated from other causes of hematuria as in the below table:

		Symptoms						Physical examina			Lab Findings	Diagnosi
Diseases		Clinical manifestations									Para-clinical findings		Gold standard
		Symptoms						Physical examina			Para-clinical findings
		Low back pain	Fever	Nausea/ Vomiting	Urinary symptoms			Hypertension	Pitting edema	Other
		Low back pain	Fever	Nausea/ Vomiting	Dysuria	Frequency	Oliguria	Hypertension	Pitting edema	Other
Glomerular diseases	IgA nephropathy^[1]^[2] (Berger nephropathy)		+	-	-	-	+	+	+	-	-	Biopsy: IgA deposited in a diffuse granular pattern in the mesangium	Biopsy
	Hereditary nephritis^[3]^[4] (Alport syndrome)	-	-	-	-	-	-	+	-	Cataract Hearing loss	Pyuria Red cell casts Cylindrical casts	Biopsy: Monoclonal antibodies directed against alpha-3 (IV), alpha-4 (IV), and alpha-5 (IV) chains of typ-e IV collagen	Genetic analysis
	Post-streptococcal glomerulonephritis^[5]^[6]	+/-	+	-	-	+	+	+	+	Edema Anemia Increased Blood Pressure	Urine samples for protein and blood	Biopsy Irregularly thin and attenuated GBM Splitting of GBM Scarring Immunoglobulin G and C3 in a diffuse granular pattern Starry sky pattern	Biopsy
	Focal segmental glomerular sclerosis^[7]^[8]^[9]	-	-	-	-	-	-	+	+	Nephrotic syndrome ESRD Pleural effusion Ascites Abdominal pain	Urinalysis reveals large amounts of protein, along with hyaline and broad waxy casts Hepatitis B or C infection Anti-neutrophil cytoplasmic antibody titers, serum protein electrophoresis	Biopsy Segmental solidification in the perihilar region and peripheral areas, especially the tubular pole Coarsely granular deposits -of IgM and C3	Biopsy
	Rapidly progressive glomerulonephritis^[10]^[11]^[12]	+	+	+	-	-	-	+	-	Abdominal pain Painful cutaneous nodules Migratory poly arthropathy Sinusitis Cough Hemoptysis.	Low iron Eosinophilia Increased serum creatinine level Eleated LDH and CPK Proteinuria	Biopsy: Diffuse, proliferative, necrotizing glomerulonephritis with crescent formation	Biopsy
	Lupus nephritis^[13]^[14]	-	+	-	-	-	-	+	+	Foamy dark urine Weight gain	Hematuria Pyuria Proteinuria Cellular casts Low iron	Biopsy, Different pathologies, CLICK HERE for more information.	Biopsy
	Fabry disease	-	-	-	-	-	-	+	+	-	Hematuria Proteinuria	Biopsy	Biopsy
Disease		Low back pain	Fever	Nausea/ Vomiting	Dysuria	Frequency	Oliguria	Hypertension	Pitting edema	Other	Lab Findings	Diagnosis method	Gold standard
Tubulointerstitial diseases^[15]^[16]^[17]		+	+	+	–	–	–	–	–	Rash	Eosinophilia Eosinophiluria Isosthenuria	Biopsy: Edema and infiltration by mononuclear cells, (principally lymphocytes) Eosinophils are present, often in large numbers.	Renal biopsy
Nephrolithiasis^[18]^[19]		+	±	+	±	±	±	–	–	Radiating pain to groin	Hypercalciuria Hyperoxaluria Hypocitraturia Hyperuricemia Hyperuricosuria	Ultrasound: Hydronephrosis +/- Abdominal CT scan without contrast	Abdominal CT scan without contrast
Reflux nephropathy (hydronephrosis)		+	+	-	-	-	-	-	+	Abdomen pain Chest pain Shortness of breath	Elevated WBC count Elevated BUN Hyperkalemia	Ultrasound: Hydronephrosis +/- Biopsy: Kidney scar	–
Malignancy	Renal cell carcinoma (RCC)^[20]^[21]	-	-	-	-	-	-	±	±	Flank mass	Anemia Hematuria	Both CT and MRI may be used to detect neoplastic masses that may define renal cell carcinoma or metastasis of the primary cancer. CT scan and use of intravenous (IV) contrast is generally used for work-up and follow-up of patients with renal cell carcinoma. The histological pattern of renal cell carcinoma depends whether it is papillary, chromophobe or collecting duct renal cell carcinoma.	–
	Nephroblastoma (Wilms tumor)^[22]^[23]	-	-	-	-	-	-	-	-	Abdominal pain	Anemia Hematuria	Ultrasound is the best initial diagnostic study used in cases suspected with Wilms tumor.^[24] Doppler ultrasonography can help to detect invasion of renal vein and IVC by the tumor.^[25] Findings on CT scan:^[26] Heterogeneous soft-tissue density masses Abdominal lymph nodes and contralateral involvement Biopsy: Primitive tubules and glomeruli are often seen comprised of neoplastic cells. Spindled cell stroma surrounding abortive tubules and glomeruli is characteristic. The stroma may include: Striated muscle cartilage bone Fat tissue Fibrous tissue.	Biopsy
	Bladder cancer^[27]^[28]^[29]	-	-	-	-	±	±	-	-	Suprapubic pain	Anemia Hematuria	Ultrasound, CT scan, Biopsy	Biopsy
	Prostate cancer^[30]^[31]	±	-	-	-	±	±	-	-	-	Anemia Hematuria	Ultrasound, CT scan, Biopsy	Biopsy
Disease		Low back pain	Fever	Nausea/ Vomiting	Dysuria	Frequency	Oliguria	Hypertension	Pitting edema	Other	Lab Findings	Diagnosis method	Gold standard
Familial diseases	Polycystic kidney disease^[32]^[33]	+	-	-	-	-	-	+	+	Palpable mass in the flank Palpable abdominal mass in the lumbar quadrant Palpable nodular hepatomegaly	Hypocitraturia in 65% on patients Hyperuricemia in 20% of patients Hyperoxaluria in 20% of patients Low urine pH Hematuria (microscopic or macroscopic) Proteinuria usually less than 1 g/day	Ultrasound: Unilateral or bilateral cysts CT: Hyperdense appearance, Septations Calcifications Genetic testing demonstrates: Frame insertions/deletions Non-canonical splice site alterations Combined missense changes Biopsy: Interstitial fibrosis Tubular atrophy Thickening and lamellation of tubular basement membranes	Ultrasound
Vascular diseases	Renal vein thrombosis^[34]^[35]	+	+	+	-	-	-	-	-	Asymptomatic Abdominal pain Acute in onset	Elevation in serum lactate dehydrogenase Cholesterol levels for hyper-cholesterolemia Albumin levels for hypoalbuminemia Serum complement levels	Ultrasound Venography	Renal venography: Gold standard
	Wegner's granulomatosis polyangiitis^[36]^[37]^[38]^[39]	-	-	-	-	-	+/-	+	+	URTI CNS involvement Ophthalmic involvement	Proteinuria Microscopic hematuria RBC casts	CT chest: Multiple lung nodules Consolidation Ground-glass opacities. Biopsy: Subendothelial edema Microthrombosis, and Degranulation of neutrophils.	Biopsy
	Henoch-Schönlein purpura^[40]^[41]	-	-	-	-	-	+/-	+/-	+	Abdominal pain Rash Hematuria	Proteinuria Microscopic hematuria RBC casts	Biopsy: IgA deposited in a diffuse granular pattern in the mesangium	Renal biopsy, and clinical syndrome
Disease		Low back pain	Fever	Nausea/ Vomiting	Dysuria	Frequency	Oliguria	Hypertension	Pitting edema	Other	Lab Findings	Diagnosis method	Gold standard
Lower urinary tract diseases	Benign prostatic hyperplasia	+/-	-	-	+	+	-	-	-	Nocturia Other voiding symptoms Slow urinary stream Splitting or spraying of the urinary stream Intermittent urinary stream Hesitancy Straining to void Terminal dribbling	Urinalysis to rule out UTI Elevated BUN/Cr High PSA values	Urine cytology to screen for bladder cancer Biopsy to rule out cancer	Biopsy
Lower urinary tract diseases	Urolithiasis^[42]^[43]^[44]	+	+/-	+	+	+	+	-	-	Flank Groin pain	Urine analysis High Cr	Abdominppelvic CT scan without contrast	Abdominppelvic CT scan without contrast
Disease		Low back pain	Fever	Nausea/ Vomiting	Dysuria	Frequency	Oliguria	Hypertension	Pitting edema	Other	Lab Findings	Diagnosis method	Gold standard
Infectious diseases	Pyelonephritis^[45]^[46]	+	+	+	+	+	+	-	-	Delirium Headache	Positive leukocyte esterase test and nitrite test. Blood/urine cultures	CT and ultrasound: Enlarged kidneys Round swollen kidneys Hypodense appearance Abscesses may not be present	-
	Cystitis^[47]^[48]	-	-	-	+	+	+	-	-	Dyspareunia Supra pubic tenderness	Pyuria: > 5-10 WBC/hpf or 27 WBC/microliter Positive leukocyte esterase test and nitrite test. Positive urine/blood cultures	Ultrasound: Presence of a gas in the bladder wall. Also help to detect the presence of a tumor or a stone.	Urine culture
	Prostatitis^[49]^[50]	-	+	-	+	+	+	-	-	Body aches	Increased leukocytes (>10 per high power field) on CBC Bacteria seen on urine culture Elevated C-reactive protein Transiently elevated PSA (prostate specific antigen) levels	Ultrasound: Focal hypoechoic region located in the peripheral part of the prostate CT scan: Edema of the prostate gland with diffuse enlargement,.	-
	Urethritis^[51]^[52]	-/-	+	-	+	+	+	-	-	Urethral discharge	Mucoid, mucopurulent, or purulent discharge Gram stain of urethral secretions demonstrating ≥2 WBC per field Positive leukocyte esterase test.	CT scan: Diffuse, circumferential urothelial wall thickening and contrast-enhancement Periureteric or perinephric fat stranding.	Urine culture
Urogenital trauma	Inserted bladder or ureteral catheters	-	-	-	+	+	+	-	-	History of truma	Hematuria	Retrograde Urethrography	Retrograde Urethrography

Lower abdominal mass can be classified to the gynecological and non-gynecological causes. Bladder cancer in the advanced cases can present as a bladder mass. Below table discusses lower abdominal mass causes:

References

↑ Donadio JV, Grande JP (2002). "IgA nephropathy". N Engl J Med. 347 (10): 738–48. doi:10.1056/NEJMra020109. PMID 12213946.
↑ Suzuki H, Kiryluk K, Novak J, Moldoveanu Z, Herr AB, Renfrow MB; et al. (2011). "The pathophysiology of IgA nephropathy". J Am Soc Nephrol. 22 (10): 1795–803. doi:10.1681/ASN.2011050464. PMID 21949093.
↑ McCarthy PA, Maino DM (2000). "Alport syndrome: a review". Clin Eye Vis Care. 12 (3–4): 139–150. PMID 11137428.
↑ Bodziak KA, Hammond WS, Molitoris BA (1994). "Inherited diseases of the glomerular basement membrane". Am J Kidney Dis. 23 (4): 605–18. PMID 8154501.
↑ Yoshizawa N, Yamakami K, Fujino M, Oda T, Tamura K, Matsumoto K, Sugisaki T, Boyle MD (July 2004). "Nephritis-associated plasmin receptor and acute poststreptococcal glomerulonephritis: characterization of the antigen and associated immune response". J. Am. Soc. Nephrol. 15 (7): 1785–93. PMID 15213266.
↑ Oda T, Yoshizawa N, Yamakami K, Tamura K, Kuroki A, Sugisaki T, Sawanobori E, Higashida K, Ohtomo Y, Hotta O, Kumagai H, Miura S (September 2010). "Localization of nephritis-associated plasmin receptor in acute poststreptococcal glomerulonephritis". Hum. Pathol. 41 (9): 1276–85. doi:10.1016/j.humpath.2010.02.006. PMID 20708459.
↑ Kwoh C, Shannon MB, Miner JH, Shaw A (2006). "Pathogenesis of nonimmune glomerulopathies". Annu Rev Pathol. 1: 349–74. doi:10.1146/annurev.pathol.1.110304.100119. PMID 18039119.
↑ Reidy K, Kaskel FJ (March 2007). "Pathophysiology of focal segmental glomerulosclerosis". Pediatr. Nephrol. 22 (3): 350–4. doi:10.1007/s00467-006-0357-2. PMC 1794138. PMID 17216262.
↑ D'Agati VD, Fogo AB, Bruijn JA, Jennette JC (2004). "Pathologic classification of focal segmental glomerulosclerosis: a working proposal". Am J Kidney Dis. 43 (2): 368–82. PMID 14750104.
↑ Couser WG (1998). "Pathogenesis of glomerular damage in glomerulonephritis". Nephrol Dial Transplant. 13 Suppl 1: 10–5. PMID 9507491.
↑ Atkins RC, Nikolic-Paterson DJ, Song Q, Lan HY (1996). "Modulators of crescentic glomerulonephritis". J Am Soc Nephrol. 7 (11): 2271–8. PMID 8959617.
↑ Jennette JC (March 2003). "Rapidly progressive crescentic glomerulonephritis". Kidney Int. 63 (3): 1164–77. doi:10.1046/j.1523-1755.2003.00843.x. PMID 12631105.
↑ Schwartz N, Goilav B, Putterman C (September 2014). "The pathogenesis, diagnosis and treatment of lupus nephritis". Curr Opin Rheumatol. 26 (5): 502–9. doi:10.1097/BOR.0000000000000089. PMC 4221732. PMID 25014039.
↑ Giannico G, Fogo AB (2013). "Lupus nephritis: is the kidney biopsy currently necessary in the management of lupus nephritis?". Clin J Am Soc Nephrol. 8 (1): 138–45. doi:10.2215/CJN.03400412. PMID 22977215.
↑ Baker, R. J.; Pusey, C. D. (2004). "The changing profile of acute tubulointerstitial nephritis". Nephrology Dialysis Transplantation. 19 (1): 8–11. doi:10.1093/ndt/gfg464. ISSN 0931-0509.
↑ Kelly C, Tomaszewski J, Neilson E. Immunopathogenic mechanisms of tubulointerstitial injury. In: Tisher C, Brenner B, eds, Renal Pathology: With Clinical and Functional Correlations, 2nd Edn., Vol. 1. J. B. Lippincott & Co, Philadelphia, PA, 1994; 699–722
↑ Dharmarajan TS, Yoo J, Russell RO, Boateng YA. Acute post streptococcal interstitial nephritis in an adult and review of the literature. Int Urol Nephrol 1999; 31:145
↑ Hochreiter W, Knoll T, Hess B (February 2003). "[Pathophysiology, diagnosis and conservative therapy of non-calcium kidney calculi]". Ther Umsch (in German). 60 (2): 89–97. doi:10.1024/0040-5930.60.2.89. PMID 12649987.
↑ Trinchieri A (February 2013). "Diet and renal stone formation". Minerva Med. 104 (1): 41–54. PMID 23392537.
↑ Cohen HT, McGovern FJ (2005). "Renal-cell carcinoma". N Engl J Med. 353 (23): 2477–90. doi:10.1056/NEJMra043172. PMID 16339096.
↑ Leveridge MJ, Bostrom PJ, Koulouris G, Finelli A, Lawrentschuk N (June 2010). "Imaging renal cell carcinoma with ultrasonography, CT and MRI". Nat Rev Urol. 7 (6): 311–25. doi:10.1038/nrurol.2010.63. PMID 20479778.
↑ Jolly RD, Stellwagen E, Babul J, Vodkaĭlo LV, Titov VL, Moldomusaev DM, Maianskiĭ AN (November 1975). "Mannosidosis of Angus Cattle: a prototype control program for some genetic diseases". Adv Vet Sci Comp Med. 19 (23): 1–21. PMID 1978.
↑ Stefanowicz J, Sierota D, Balcerska A, Stoba C (2004). "[Wilms' tumour of unfavorable histology--results of treatment with the SIOP 93-01 protocol at the Gdańsk centre. Preliminary report]". Med Wieku Rozwoj (in Polish). 8 (2 Pt 1): 197–200. PMID 15738594.
↑ Hartman DS, Sanders RC (April 1982). "Wilms' tumor versus neuroblastoma: usefulness of ultrasound in differentiation". J Ultrasound Med. 1 (3): 117–22. PMID 6152936.
↑ De Campo JF (1986). "Ultrasound of Wilms' tumor". Pediatr Radiol. 16 (1): 21–4. PMID 3003660.
↑ Cahan LD (1985). "Failure of encephalo-duro-arterio-synangiosis procedure in moyamoya disease". Pediatr Neurosci. 12 (1): 58–62. PMID 4080660.
↑ Pons F, Orsola A, Morote J, Bellmunt J (2011). "Variant forms of bladder cancer: basic considerations on treatment approaches". Curr Oncol Rep. 13 (3): 216–21. doi:10.1007/s11912-011-0161-4. PMID 21360040.
↑ Metts MC, Metts JC, Milito SJ, Thomas CR (June 2000). "Bladder cancer: a review of diagnosis and management". J Natl Med Assoc. 92 (6): 285–94. PMC 2640522. PMID 10918764.
↑ Rom M, Kuehhas FE, Djavan B (2007). "New findings in bladder and prostate cancer: highlights of the 22nd annual congress of the European association of urology, march 21-24, 2007, berlin, Germany". Rev Urol. 9 (4): 214–9. PMC 2199502. PMID 18231618.
↑ Chung SD, Liu SP, Lin HC (2013). "Association between prostate cancer and urinary calculi: a population-based study". PLoS ONE. 8 (2): e57743. doi:10.1371/journal.pone.0057743. PMC 3581486. PMID 23451265.
↑ Rom M, Kuehhas FE, Djavan B (2007). "New findings in bladder and prostate cancer: highlights of the 22nd annual congress of the European association of urology, march 21-24, 2007, berlin, Germany". Rev Urol. 9 (4): 214–9. PMC 2199502. PMID 18231618.
↑ Gabow PA (July 1993). "Autosomal dominant polycystic kidney disease". N. Engl. J. Med. 329 (5): 332–42. doi:10.1056/NEJM199307293290508. PMID 8321262.
↑ Adeva M, El-Youssef M, Rossetti S, Kamath PS, Kubly V, Consugar MB, Milliner DM, King BF, Torres VE, Harris PC (January 2006). "Clinical and molecular characterization defines a broadened spectrum of autosomal recessive polycystic kidney disease (ARPKD)". Medicine (Baltimore). 85 (1): 1–21. doi:10.1097/01.md.0000200165.90373.9a. PMID 16523049.
↑ U. Kuhlmann, J. Steurer, A. Bollinger, G. Pouliadis, J. Briner & W. Siegenthaler (1981). "[Incidence and clinical significance of thromboses and thrombo-embolic complications in nephrotic syndrome patients]". Schweizerische medizinische Wochenschrift. 111 (27–28): 1034–1040. PMID 7268357. Unknown parameter |month= ignored (help)
↑ F. Llach, S. Papper & S. G. Massry (1980). "The clinical spectrum of renal vein thrombosis: acute and chronic". The American journal of medicine. 69 (6): 819–827. PMID 7446547. Unknown parameter |month= ignored (help)
↑ Pagnoux C (2016). "Updates in ANCA-associated vasculitis". Eur J Rheumatol. 3 (3): 122–133. doi:10.5152/eurjrheum.2015.0043. PMID 27733943.
↑ Lee KS, Kim TS, Fujimoto K, Moriya H, Watanabe H, Tateishi U, Ashizawa K, Johkoh T, Kim EA, Kwon OJ (2003). "Thoracic manifestation of Wegener's granulomatosis: CT findings in 30 patients". Eur Radiol. 13 (1): 43–51. doi:10.1007/s00330-002-1422-2. PMID 12541109.
↑ Kallenberg CG, Heeringa P, Stegeman CA (2006). "Mechanisms of Disease: pathogenesis and treatment of ANCA-associated vasculitides". Nat Clin Pract Rheumatol. 2 (12): 661–70. doi:10.1038/ncprheum0355. PMID 17133251.
↑ Jennette JC, Falk RJ (November 1997). "Small-vessel vasculitis". N. Engl. J. Med. 337 (21): 1512–23. doi:10.1056/NEJM199711203372106. PMID 9366584.
↑ Jennette JC, Falk RJ (November 1997). "Small-vessel vasculitis". N. Engl. J. Med. 337 (21): 1512–23. doi:10.1056/NEJM199711203372106. PMID 9366584.
↑ Chen JY, Mao JH (February 2015). "Henoch-Schönlein purpura nephritis in children: incidence, pathogenesis and management". World J Pediatr. 11 (1): 29–34. doi:10.1007/s12519-014-0534-5. PMID 25557596.
↑ Hochreiter W, Knoll T, Hess B (February 2003). "[Pathophysiology, diagnosis and conservative therapy of non-calcium kidney calculi]". Ther Umsch (in German). 60 (2): 89–97. doi:10.1024/0040-5930.60.2.89. PMID 12649987.
↑ Flannigan R, Choy WH, Chew B, Lange D (June 2014). "Renal struvite stones--pathogenesis, microbiology, and management strategies". Nat Rev Urol. 11 (6): 333–41. doi:10.1038/nrurol.2014.99. PMID 24818849.
↑ Pereira DJ, Schoolwerth AC, Pais VM (March 2015). "Cystinuria: current concepts and future directions". Clin. Nephrol. 83 (3): 138–46. PMID 25685869.
↑ Pereira DJ, Schoolwerth AC, Pais VM (March 2015). "Cystinuria: current concepts and future directions". Clin. Nephrol. 83 (3): 138–46. PMID 25685869.
↑ Rosen DA, Hooton TM, Stamm WE, Humphrey PA, Hultgren SJ (2007). "Detection of intracellular bacterial communities in human urinary tract infection". PLoS Med. 4 (12): e329. doi:10.1371/journal.pmed.0040329. PMC 2140087. PMID 18092884.
↑ Franco AV (2005). "Recurrent urinary tract infections". Best Pract Res Clin Obstet Gynaecol. 19 (6): 861–73. doi:10.1016/j.bpobgyn.2005.08.003. PMID 16298166.
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↑ John N. Krieger, Ulrich Dobrindt, Donald E. Riley & Eric Oswald (2011). "Acute Escherichia coli prostatitis in previously health young men: bacterial virulence factors, antimicrobial resistance, and clinical outcomes". Urology. 77 (6): 1420–1425. doi:10.1016/j.urology.2010.12.059. PMID 21459419. Unknown parameter |month= ignored (help)
↑ Sharp VJ, Takacs EB, Powell CR (2010). "Prostatitis: diagnosis and treatment". Am Fam Physician. 82 (4): 397–406. PMID 20704171.
↑ McNagny SE, Parker RM, Zenilman JM, Lewis JS (1992). "Urinary leukocyte esterase test: a screening method for the detection of asymptomatic chlamydial and gonococcal infections in men". J. Infect. Dis. 165 (3): 573–6. PMID 1538163.
↑ Brill JR (2010). "Diagnosis and treatment of urethritis in men". Am Fam Physician. 81 (7): 873–8. PMID 20353145.

Template:WH Template:WS

[pmid12213946-1] Donadio JV, Grande JP (2002). "IgA nephropathy". N Engl J Med. 347 (10): 738–48. doi:10.1056/NEJMra020109. PMID 12213946.

[pmid21949093-2] Suzuki H, Kiryluk K, Novak J, Moldoveanu Z, Herr AB, Renfrow MB; et al. (2011). "The pathophysiology of IgA nephropathy". J Am Soc Nephrol. 22 (10): 1795–803. doi:10.1681/ASN.2011050464. PMID 21949093.

[pmid11137428-3] McCarthy PA, Maino DM (2000). "Alport syndrome: a review". Clin Eye Vis Care. 12 (3–4): 139–150. PMID 11137428.

[pmid8154501-4] Bodziak KA, Hammond WS, Molitoris BA (1994). "Inherited diseases of the glomerular basement membrane". Am J Kidney Dis. 23 (4): 605–18. PMID 8154501.

[pmid15213266-5] Yoshizawa N, Yamakami K, Fujino M, Oda T, Tamura K, Matsumoto K, Sugisaki T, Boyle MD (July 2004). "Nephritis-associated plasmin receptor and acute poststreptococcal glomerulonephritis: characterization of the antigen and associated immune response". J. Am. Soc. Nephrol. 15 (7): 1785–93. PMID 15213266.

[pmid20708459-6] Oda T, Yoshizawa N, Yamakami K, Tamura K, Kuroki A, Sugisaki T, Sawanobori E, Higashida K, Ohtomo Y, Hotta O, Kumagai H, Miura S (September 2010). "Localization of nephritis-associated plasmin receptor in acute poststreptococcal glomerulonephritis". Hum. Pathol. 41 (9): 1276–85. doi:10.1016/j.humpath.2010.02.006. PMID 20708459.

[pmid18039119-7] Kwoh C, Shannon MB, Miner JH, Shaw A (2006). "Pathogenesis of nonimmune glomerulopathies". Annu Rev Pathol. 1: 349–74. doi:10.1146/annurev.pathol.1.110304.100119. PMID 18039119.

[pmid17216262-8] Reidy K, Kaskel FJ (March 2007). "Pathophysiology of focal segmental glomerulosclerosis". Pediatr. Nephrol. 22 (3): 350–4. doi:10.1007/s00467-006-0357-2. PMC 1794138. PMID 17216262.

[pmid14750104-9] D'Agati VD, Fogo AB, Bruijn JA, Jennette JC (2004). "Pathologic classification of focal segmental glomerulosclerosis: a working proposal". Am J Kidney Dis. 43 (2): 368–82. PMID 14750104.

[pmid9507491-10] Couser WG (1998). "Pathogenesis of glomerular damage in glomerulonephritis". Nephrol Dial Transplant. 13 Suppl 1: 10–5. PMID 9507491.

[pmid8959617-11] Atkins RC, Nikolic-Paterson DJ, Song Q, Lan HY (1996). "Modulators of crescentic glomerulonephritis". J Am Soc Nephrol. 7 (11): 2271–8. PMID 8959617.

[pmid12631105-12] Jennette JC (March 2003). "Rapidly progressive crescentic glomerulonephritis". Kidney Int. 63 (3): 1164–77. doi:10.1046/j.1523-1755.2003.00843.x. PMID 12631105.

[pmid25014039-13] Schwartz N, Goilav B, Putterman C (September 2014). "The pathogenesis, diagnosis and treatment of lupus nephritis". Curr Opin Rheumatol. 26 (5): 502–9. doi:10.1097/BOR.0000000000000089. PMC 4221732. PMID 25014039.

[pmid22977215-14] Giannico G, Fogo AB (2013). "Lupus nephritis: is the kidney biopsy currently necessary in the management of lupus nephritis?". Clin J Am Soc Nephrol. 8 (1): 138–45. doi:10.2215/CJN.03400412. PMID 22977215.

[BakerPusey2004-15] Baker, R. J.; Pusey, C. D. (2004). "The changing profile of acute tubulointerstitial nephritis". Nephrology Dialysis Transplantation. 19 (1): 8–11. doi:10.1093/ndt/gfg464. ISSN 0931-0509.

[16] Kelly C, Tomaszewski J, Neilson E. Immunopathogenic mechanisms of tubulointerstitial injury. In: Tisher C, Brenner B, eds, Renal Pathology: With Clinical and Functional Correlations, 2nd Edn., Vol. 1. J. B. Lippincott & Co, Philadelphia, PA, 1994; 699–722

[17] Dharmarajan TS, Yoo J, Russell RO, Boateng YA. Acute post streptococcal interstitial nephritis in an adult and review of the literature. Int Urol Nephrol 1999; 31:145

[pmid12649987-18] Hochreiter W, Knoll T, Hess B (February 2003). "[Pathophysiology, diagnosis and conservative therapy of non-calcium kidney calculi]". Ther Umsch (in German). 60 (2): 89–97. doi:10.1024/0040-5930.60.2.89. PMID 12649987.

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[pmid16523049-33] Adeva M, El-Youssef M, Rossetti S, Kamath PS, Kubly V, Consugar MB, Milliner DM, King BF, Torres VE, Harris PC (January 2006). "Clinical and molecular characterization defines a broadened spectrum of autosomal recessive polycystic kidney disease (ARPKD)". Medicine (Baltimore). 85 (1): 1–21. doi:10.1097/01.md.0000200165.90373.9a. PMID 16523049.

[34] U. Kuhlmann, J. Steurer, A. Bollinger, G. Pouliadis, J. Briner & W. Siegenthaler (1981). "[Incidence and clinical significance of thromboses and thrombo-embolic complications in nephrotic syndrome patients]". Schweizerische medizinische Wochenschrift. 111 (27–28): 1034–1040. PMID 7268357. Unknown parameter |month= ignored (help)

[35] F. Llach, S. Papper & S. G. Massry (1980). "The clinical spectrum of renal vein thrombosis: acute and chronic". The American journal of medicine. 69 (6): 819–827. PMID 7446547. Unknown parameter |month= ignored (help)

[pmid27733943-36] Pagnoux C (2016). "Updates in ANCA-associated vasculitis". Eur J Rheumatol. 3 (3): 122–133. doi:10.5152/eurjrheum.2015.0043. PMID 27733943.

[pmid12541109-37] Lee KS, Kim TS, Fujimoto K, Moriya H, Watanabe H, Tateishi U, Ashizawa K, Johkoh T, Kim EA, Kwon OJ (2003). "Thoracic manifestation of Wegener's granulomatosis: CT findings in 30 patients". Eur Radiol. 13 (1): 43–51. doi:10.1007/s00330-002-1422-2. PMID 12541109.

[pmid17133251-38] Kallenberg CG, Heeringa P, Stegeman CA (2006). "Mechanisms of Disease: pathogenesis and treatment of ANCA-associated vasculitides". Nat Clin Pract Rheumatol. 2 (12): 661–70. doi:10.1038/ncprheum0355. PMID 17133251.

[pmid93665842-39] Jennette JC, Falk RJ (November 1997). "Small-vessel vasculitis". N. Engl. J. Med. 337 (21): 1512–23. doi:10.1056/NEJM199711203372106. PMID 9366584.

[pmid9366584-40] Jennette JC, Falk RJ (November 1997). "Small-vessel vasculitis". N. Engl. J. Med. 337 (21): 1512–23. doi:10.1056/NEJM199711203372106. PMID 9366584.

[pmid25557596-41] Chen JY, Mao JH (February 2015). "Henoch-Schönlein purpura nephritis in children: incidence, pathogenesis and management". World J Pediatr. 11 (1): 29–34. doi:10.1007/s12519-014-0534-5. PMID 25557596.

[pmid126499872-42] Hochreiter W, Knoll T, Hess B (February 2003). "[Pathophysiology, diagnosis and conservative therapy of non-calcium kidney calculi]". Ther Umsch (in German). 60 (2): 89–97. doi:10.1024/0040-5930.60.2.89. PMID 12649987.

[pmid24818849-43] Flannigan R, Choy WH, Chew B, Lange D (June 2014). "Renal struvite stones--pathogenesis, microbiology, and management strategies". Nat Rev Urol. 11 (6): 333–41. doi:10.1038/nrurol.2014.99. PMID 24818849.

[pmid25685869-44] Pereira DJ, Schoolwerth AC, Pais VM (March 2015). "Cystinuria: current concepts and future directions". Clin. Nephrol. 83 (3): 138–46. PMID 25685869.

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[pmid18092884-46] Rosen DA, Hooton TM, Stamm WE, Humphrey PA, Hultgren SJ (2007). "Detection of intracellular bacterial communities in human urinary tract infection". PLoS Med. 4 (12): e329. doi:10.1371/journal.pmed.0040329. PMC 2140087. PMID 18092884.

[pmid16298166-47] Franco AV (2005). "Recurrent urinary tract infections". Best Pract Res Clin Obstet Gynaecol. 19 (6): 861–73. doi:10.1016/j.bpobgyn.2005.08.003. PMID 16298166.

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[49] John N. Krieger, Ulrich Dobrindt, Donald E. Riley & Eric Oswald (2011). "Acute Escherichia coli prostatitis in previously health young men: bacterial virulence factors, antimicrobial resistance, and clinical outcomes". Urology. 77 (6): 1420–1425. doi:10.1016/j.urology.2010.12.059. PMID 21459419. Unknown parameter |month= ignored (help)

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[pmid1538163-51] McNagny SE, Parker RM, Zenilman JM, Lewis JS (1992). "Urinary leukocyte esterase test: a screening method for the detection of asymptomatic chlamydial and gonococcal infections in men". J. Infect. Dis. 165 (3): 573–6. PMID 1538163.

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@@ Line 48: / Line 48: @@
 | style="background: #F5F5F5; padding: 5px;" | -
 | style="background: #F5F5F5; padding: 5px;" | '''Biopsy:'''
-IgA deposited in a diffuse granular patte-rn in the mesangium
+[[IgA]] deposited in a diffuse [[Granular cell|granular]] pattern in the [[mesangium]]
 | style="background: #F5F5F5; padding: 5px;" |Biopsy
 *
@@ Line 70: / Line 70: @@
 * Cylindrical [[casts]]
 | style="background: #F5F5F5; padding: 5px;" |'''Biopsy:'''
-* Monoclonal antibodies directed against alpha-3 (IV), alpha-4 (IV), and alpha-5 (IV) chains of typ-e IV collagen
+* [[Monoclonal antibodies]] directed against alpha-3 (IV), alpha-4 (IV), and alpha-5 (IV) chains of [[Type-IV collagen|typ-e IV collage]]<nowiki/>n
 | style="background: #F5F5F5; padding: 5px;" |Genetic analysis
 |-
@@ Line 83: / Line 83: @@
 | style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" |
-* Edema
+* [[Edema]]
-* Anemia
+* [[Anemia]]
-* Increased Blood Pressure
+* Increased [[Blood pressure|Blood Pressure]]
 | style="background: #F5F5F5; padding: 5px;" |
-* Urine samples for protein and blood
+* Urine samples for [[protein]] and [[blood]]
 | style="background: #F5F5F5; padding: 5px;" |
 '''Biopsy'''
-* Irregularly thin and attenuated GBM
+* Irregularly thin and attenuated [[GBM]]
-* Splitting of GBM
+* Splitting of [[GBM]]
 * Scarring
-* Immunoglobulin G and C3 in a diffuse granular pattern
+* [[Immunoglobulin G]] and [[C3 disease|C3]] in a diffuse [[Granule cell|granular]] pattern
-* Starr-y sky pattern
+* Starry sky pattern
 | style="background: #F5F5F5; padding: 5px;" |Biopsy
 |-
@@ Line 107: / Line 107: @@
 | style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" |
-* Nephrotic syndrome
+* [[Nephrotic syndrome]]
-* ESRD
+* [[ESRD]]
-* Pleural effusion
+* [[Pleural effusion]]
-* Ascites
+* [[Ascites]]
-* Abdominal pain
+* [[Abdominal pain]]
 **
 | style="background: #F5F5F5; padding: 5px;" |
-* Urinalysis reveals large amounts of protein, along with hyaline and broad waxy casts
+* [[Urinalysis]] reveals large amounts of protein, along with [[hyaline]] and broad waxy casts
-* Hepatitis B or C infection
+* [[Hepatitis B]] or [[Hepatitis C|C]] infection
-* Antineutrophil cytoplasmic antibody titers, serum protein electrophoresis
+* [[Anti-neutrophil cytoplasmic antibody]] titers, [[serum protein electrophoresis]]
 | style="background: #F5F5F5; padding: 5px;" |'''Biopsy'''
-* Segmental solidification in the perihilar region and  peripheral areas, specially the tubular pole
+* Segmental solidification in the perihilar region and  peripheral areas, especially the [[tubular]] pole
-* Coarsely granular deposits -of IgM and C3
+* Coarsely [[Granule cell|granular]] deposits -of [[Immunoglobulin M|IgM]] and [[C3 glomerular disease|C3]]
 | style="background: #F5F5F5; padding: 5px;" |Biopsy
 |-
@@ Line 134: / Line 134: @@
 * Abdominal pain
 * Painful cutaneous nodules
-* Migratory polyarthropathy
+* Migratory poly arthropathy
-* Sinusitis
+* [[Rhinosinusitis|Sinusitis]]
-* Cough
+* [[Cough]]
-* Hemoptysis.
+* [[Hemoptysis]].
 | style="background: #F5F5F5; padding: 5px;" |
-* Low iron
+* Low [[iron]]
-* Eosinophilia
+* [[Eosinophilia]]
-* Increased serum creatinine level
+* Increased serum [[creatinine]] level
-* Eleated LDH and CPK
+* Eleated [[Lactate dehydrogenase|LDH]] and [[Creatine kinase|CPK]]
-* Proteinuria
+* [[Proteinuria]]
 | style="background: #F5F5F5; padding: 5px;" | Biopsy:
-* Diffuse, proliferative, necrotizing glomerulonephritis with cresc-ent formation
+* Diffuse, proliferative, necrotizing [[Glomerular disease|glomerulonephritis]] with [[Glomerular disease|crescent]] formation
 | style="background: #F5F5F5; padding: 5px;" |Biopsy
 |-
@@ Line 165: / Line 165: @@
 * [[Proteinuria]]
 * Cellular casts
-* Low iron
+* Low [[iron]]
 | style="background: #F5F5F5; padding: 5px;" | Biopsy,
-* Different pathologies, [[Lupus nephritis|CLICK HERE]] for more- information.
+* Different pathologies, [[Lupus nephritis|CLICK HERE]] for more information.
 | style="background: #F5F5F5; padding: 5px;" |Biopsy
 |-
@@ Line 181: / Line 181: @@
 | style="background: #F5F5F5; padding: 5px;" | -
 | style="background: #F5F5F5; padding: 5px;" |
-* Hematuria
+* [[Hematuria]]
-* Proteinuria
+* [[Proteinuria]]
 | style="background: #F5F5F5; padding: 5px;" | Biopsy
 | style="background: #F5F5F5; padding: 5px;" | Biopsy
@@ Line 216: / Line 216: @@
 * [[Isosthenuria]]
 | style="background: #F5F5F5; padding: 5px;" |Biopsy:
-* [[Edema]] and infiltration by mononuclear cells, (principally lymphocytes)
+* [[Edema]] and infiltration by [[Monocyte|mononuclear cells]], (principally lymphocytes)
 * [[Eosinophils]] are present, often in large numbers.
 | style="background: #F5F5F5; padding: 5px;" |Renal biopsy
@@ Line 238: / Line 238: @@
 * [[Hyperuricosuria]]
 | style="background: #F5F5F5; padding: 5px;" |
-* Hydronephrosis +/- in sonography
+* Ultrasound: [[Hydronephrosis]] +/-
-* Abdominal CT scan without contrast
+* [[Computed tomography|Abdominal CT scan]] without contrast
-| style="background: #F5F5F5; padding: 5px;" |Abdominal CT scan without contrast
+| style="background: #F5F5F5; padding: 5px;" |Abdominal [[Computed tomography|CT scan]] without contrast
 |-
 | colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Reflux nephropathy|Reflux nephropathy (hydronephrosis)]]
@@ Line 258: / Line 258: @@
 * Elevated [[WBC]] count
 * Elevated [[BUN]]
-* Hyperkalemia
+* [[Hyperkalemia]]
 | style="background: #F5F5F5; padding: 5px;" |
-* Ultrasound: Hydronephrosis +/-
+* Ultrasound: [[Hydronephrosis]] +/-
-* Biopsy: Kidney scar
+* Biopsy: [[Kidney]] scar
 | style="background: #F5F5F5; padding: 5px;" |–
 |-
@@ Line 277: / Line 277: @@
 | style="background: #F5F5F5; padding: 5px;" |±
 | style="background: #F5F5F5; padding: 5px;" |
-* Flank mass
+* [[Flanks|Flank]] mass
 | style="background: #F5F5F5; padding: 5px;" |
-* Anemia
+* [[Anemia]]
-* Hematuria
+* [[Hematuria]]
 | style="background: #F5F5F5; padding: 5px;" |
 * Both [[CT]] and [[MRI]] may be used to detect [[neoplastic]] masses that may define renal cell carcinoma or metastasis of the primary cancer. [[CT]] scan and use of intravenous (IV) contrast is generally used for work-up and follow-up of patients with [[Renal cell carcinoma|renal cell carcinom]]<nowiki/>a.
@@ Line 296: / Line 296: @@
 | style="background: #F5F5F5; padding: 5px;" | -
 | style="background: #F5F5F5; padding: 5px;" |
-* Abdominal pain
+* [[Abdominal pain]]
 | style="background: #F5F5F5; padding: 5px;" |
 * [[Anemia]]
@@ Line 329: / Line 329: @@
 * [[Anemia]]
 * [[Hematuria]]
-| style="background: #F5F5F5; padding: 5px;" |Ultrasound, CT scan, Biopsy
+| style="background: #F5F5F5; padding: 5px;" |[[Ultrasound]], [[Computed tomography|CT scan]], Biopsy
 | style="background: #F5F5F5; padding: 5px;" |Biopsy
 |-
@@ Line 345: / Line 345: @@
 * [[Anemia]]
 * [[Hematuria]]
-| style="background: #F5F5F5; padding: 5px;" |Ultrasound, CT scan, Biopsy
+| style="background: #F5F5F5; padding: 5px;" |[[Ultrasound]], [[Computed tomography|CT scan]], Biopsy
 | style="background: #F5F5F5; padding: 5px;" |Biopsy
 |-
@@ Line 386: / Line 386: @@
 | style="background: #F5F5F5; padding: 5px;" |Ultrasound:
 * Unilateral or bilateral [[cysts]]
-CT:
+[[CT-scans|CT]]:
 * Hyperdense appearance,
 * Septations
@@ Line 399: / Line 399: @@
 * Tubular atrophy
 * Thickening and lamellation of tubular basement membranes
-* Microcysts
+| style="background: #F5F5F5; padding: 5px;" |[[Ultrasound]]
-| style="background: #F5F5F5; padding: 5px;" |Ultrasound
 |-
 | rowspan="3" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Vascular anomaly|Vascular diseases]]
@@ Line 454: / Line 453: @@
 | style="background: #F5F5F5; padding: 5px;" |
 * Asymptomatic
-* Abdominal pain
+* [[Abdominal pain]]
 * Acute in onset
 | style="background: #F5F5F5; padding: 5px;" |
-* Elevation in serum lactate dehydrogenase
+* Elevation in serum [[lactate dehydrogenase]]
-* Cholesterol levels for hypercholesterolemia
+* [[Cholesterol]] levels for hyper-cholesterolemia
-* Albumin levels for hypoalbuminemia
+* [[Albumin]] levels for hypoalbuminemia
-* Serum complement levels
+* Serum [[complement]] levels
 | style="background: #F5F5F5; padding: 5px;" |
-* Ultrasound,
+* [[Ultrasound]]
-* Venography
+* [[Venography]]
 | style="background: #F5F5F5; padding: 5px;" |'''Renal venography:''' Gold standard
 |-
@@ Line 476: / Line 475: @@
 | style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" |
-* URTI
+* [[Upper respiratory tract infection|URTI]]
-* CNS involvement
+* [[CNS]] involvement
-* Ophthalmic involvement
+* [[Ophthalmic]] involvement
 | style="background: #F5F5F5; padding: 5px;" |
-* Proteniuria
+* [[Proteinuria]]
-* Microscopic hematuria
+* Microscopic [[hematuria]]
-* RBC casts
+* [[RBC casts]]
-| style="background: #F5F5F5; padding: 5px;" | CT chest:
+| style="background: #F5F5F5; padding: 5px;" | [[Computed tomography|CT]] chest:
 * Multiple [[Pulmonary nodule|lung nodules]]
 * [[Consolidation (medicine)|Consolidation]]
@@ Line 505: / Line 504: @@
 | style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" |
-* Abdominal pain
+* [[Abdominal pain]]
-* Rash
+* [[Rash]]
-* Hematuria
+* [[Hematuria]]
 | style="background: #F5F5F5; padding: 5px;" |
-* Proteniuria
+* [[Proteinuria]]
-* Microscopic hematuria
+* Microscopic [[hematuria]]
-* RBC casts
+* [[Urinary casts|RBC casts]]
 | style="background: #F5F5F5; padding: 5px;" |Biopsy:
-IgA deposited in a diffuse granular pattern in the mesangium
+[[Immunoglobulin A|IgA]] deposited in a diffuse [[Granule cell|granular]] pattern in the [[mesangium]]
 | style="background: #F5F5F5; padding: 5px;" |Renal biopsy, and clinical syndrome
 |-
@@ Line 543: / Line 542: @@
 | style="background: #F5F5F5; padding: 5px;" | -
 | style="background: #F5F5F5; padding: 5px;" |
-* Nocturia
+* [[Nocturia]]
 * Other voiding symptoms
 ** Slow urinary stream
-** Splitting or spraying of the urinary stream
+** Splitting or spraying of the [[Urinary system|urinary]] stream
 ** Intermittent urinary stream
 ** Hesitancy
@@ Line 552: / Line 551: @@
 ** Terminal dribbling
 | style="background: #F5F5F5; padding: 5px;" |
-* Urinalysis to rule out UTI
+* Urinalysis to rule out [[Urinary tract infection|UTI]]
-* Elevated BUN/Cr
+* Elevated [[Blood urea nitrogen|BUN]]/[[Creatinine|Cr]]
-* High PSA values
+* High [[Prostate specific antigen|PSA]] values
 | style="background: #F5F5F5; padding: 5px;" |
 * Urine cytology to screen for bladder cancer
@@ Line 569: / Line 568: @@
 | style="background: #F5F5F5; padding: 5px;" | -
 | style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" |Flank, groin pain
 | style="background: #F5F5F5; padding: 5px;" |
-* Urine analysis
+* [[Flanks|Flank]]
+* [[Groin]] pain
+| style="background: #F5F5F5; padding: 5px;" |
+* [[Urine|Urine analysis]]
-* High Cr
+* High [[Creatinine|Cr]]
-| style="background: #F5F5F5; padding: 5px;" |Abdominppelvic CT scan without contrast
+| style="background: #F5F5F5; padding: 5px;" |Abdominppelvic [[Computed tomography|CT scan]] without contrast
-| style="background: #F5F5F5; padding: 5px;" |Abdominppelvic CT scan without contrast
+| style="background: #F5F5F5; padding: 5px;" |Abdominppelvic [[Computed tomography|CT scan]] without contrast
 |-
 ! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Disease

Bladder cancer differential diagnosis: Difference between revisions

Revision as of 16:33, 5 February 2019

Overview

Differential Diagnosis

References

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