Non small cell lung cancer differential diagnosis: Difference between revisions

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__NOTOC__
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{{Non small cell lung cancer}}
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Non_small_cell_lung_cancer]]
{{CMG}}{{AE}}{{MV}}
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==Overview==
==Overview==
Non-small cell lung cancer must be differentiated from other diseases that cause chronic [[cough]], [[weight loss]], [[hemoptysis]], and [[dyspnea]] among adults such as [[tuberculosis]], pulmonary fungal disease, lung abscess, and secondary [[metastases]].<ref name="pmid24455507">{{cite journal| author=Bhatt M, Kant S, Bhaskar R| title=Pulmonary tuberculosis as differential diagnosis of non-small cell lung cancer | journal=South Asian J Cancer | year= 2012 | volume= 1 | issue= 1 | pages= 36-42 | pmid=24455507 | doi=10.4103/2278-330X.96507 | pmc=PMC3876596 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24455507  }}</ref><ref name="pmid22242302">{{cite journal| author=Kamiya K, Yoshizu A, Misumi Y, Hida N, Okamoto H, Yoshida S| title=[Lung abscess which needed to be distinguished from lung cancer; report of a case]. | journal=Kyobu Geka | year= 2011 | volume= 64 | issue= 13 | pages= 1204-7 | pmid=22242302 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22242302  }} </ref><ref name="pmid24008649">{{cite journal| author=Matsuoka T, Uematsu H, Iwakiri S, Itoi K| title=[Chronic eosinophilic pneumonia presenting as a solitary nodule, suspicious of lung cancer;report of a case]. | journal=Kyobu Geka | year= 2013 | volume= 66 | issue= 10 | pages= 941-3 | pmid=24008649 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24008649  }} </ref>
Non-small cell lung cancer must be differentiated from other diseases that cause chronic [[cough]], [[weight loss]], [[hemoptysis]], and [[dyspnea]] among adults such as [[tuberculosis]], [[Fungal pneumonia|pulmonary fungal disease]], [[lung abscess]], and secondary [[metastases]].


==Differential Diagnosis==
==Differential Diagnosis==
*The table below summarizes the findings that differentiate non small cell lung cancer from other conditions that cause  chronic [[cough]], [[weight loss]], [[hemoptysis]], and [[dyspnea]].<ref name="pmid24455507">{{cite journal| author=Bhatt M, Kant S, Bhaskar R| title=Pulmonary tuberculosis as differential diagnosis of lung cancer. | journal=South Asian J Cancer | year= 2012 | volume= 1 | issue= 1 | pages= 36-42 | pmid=24455507 | doi=10.4103/2278-330X.96507 | pmc=PMC3876596 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24455507  }} </ref><ref name="pmid22242302">{{cite journal| author=Kamiya K, Yoshizu A, Misumi Y, Hida N, Okamoto H, Yoshida S| title=[Lung abscess which needed to be distinguished from lung cancer; report of a case]. | journal=Kyobu Geka | year= 2011 | volume= 64 | issue= 13 | pages= 1204-7 | pmid=22242302 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22242302  }} </ref><ref name="pmid24008649">{{cite journal| author=Matsuoka T, Uematsu H, Iwakiri S, Itoi K| title=[Chronic eosinophilic pneumonia presenting as a solitary nodule, suspicious of lung cancer;report of a case]. | journal=Kyobu Geka | year= 2013 | volume= 66 | issue= 10 | pages= 941-3 | pmid=24008649 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24008649  }} </ref>
*The table below summarizes the findings that differentiate non small cell lung cancer from other conditions that cause  chronic [[cough]], [[weight loss]], [[hemoptysis]], and [[dyspnea]].<ref name="pmid24455507">{{cite journal| author=Bhatt M, Kant S, Bhaskar R| title=Pulmonary tuberculosis as differential diagnosis of lung cancer. | journal=South Asian J Cancer | year= 2012 | volume= 1 | issue= 1 | pages= 36-42 | pmid=24455507 | doi=10.4103/2278-330X.96507 | pmc=PMC3876596 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24455507  }} </ref><ref name="pmid22242302">{{cite journal| author=Kamiya K, Yoshizu A, Misumi Y, Hida N, Okamoto H, Yoshida S| title=[Lung abscess which needed to be distinguished from lung cancer; report of a case]. | journal=Kyobu Geka | year= 2011 | volume= 64 | issue= 13 | pages= 1204-7 | pmid=22242302 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22242302  }} </ref><ref name="pmid24008649">{{cite journal| author=Matsuoka T, Uematsu H, Iwakiri S, Itoi K| title=[Chronic eosinophilic pneumonia presenting as a solitary nodule, suspicious of lung cancer;report of a case]. | journal=Kyobu Geka | year= 2013 | volume= 66 | issue= 10 | pages= 941-3 | pmid=24008649 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24008649  }} </ref>


{| style="border: 0px; font-size: 90%; margin: 3px; width: 1000px" align=center
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| valign="top" |
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! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Differential Diagnosis}}
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Differential Diagnosis}}
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! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Differentiating Features}}
! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Differentiating Features}}
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"|'''[[Pulmonary tuberculosis]]'''
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Pulmonary tuberculosis]]'''
|style="padding: 5px 5px; background: #F5F5F5;"| Chronic [[cough]], [[weight loss]], [[hemoptysis]], nocturnal diaphoresis, [[dyspnea]]
| style="padding: 5px 5px; background: #F5F5F5;" | Chronic [[cough]], [[weight loss]], [[hemoptysis]], nocturnal diaphoresis, [[dyspnea]]
|style="padding: 5px 5px; background: #F5F5F5;"|In pulmonary tuberculosis, differentiating features include: resolution (or decrease in size) after medical therapy, patients age is usually younger, [[hemoptisis]] is an early feature,  and CXR anatomical predilection for upper lobes
| style="padding: 5px 5px; background: #F5F5F5;" |In pulmonary tuberculosis, differentiating features include: resolution (or decrease in size) after medical therapy, patients age is usually younger, [[hemoptisis]] is an early feature,  and CXR anatomical predilection for upper lobes
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"|'''[[Lung abscess]]'''
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Lung abscess]]'''
|style="padding: 5px 5px; background: #F5F5F5;"|Chronic [[cough]], [[weight loss]], [[hemoptysis]], and [[dyspnea]]
| style="padding: 5px 5px; background: #F5F5F5;" |Chronic [[cough]], [[weight loss]], [[hemoptysis]], and [[dyspnea]]
|style="padding: 5px 5px; background: #F5F5F5;"|In lung abscess, differentiating features include:  acute or subacute onset, CXR anatomical predilection for upper lobes,  and  usually resolve with [[antibiotic]]
| style="padding: 5px 5px; background: #F5F5F5;" |In lung abscess, differentiating features include:  acute or subacute onset, CXR anatomical predilection for upper lobes,  and  usually resolve with [[antibiotic]]
|-
|-
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"|'''[[Pneumonia]]'''
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Pneumonia]]'''
|style="padding: 5px 5px; background: #F5F5F5;"|[[Cough]], [[fatigue]], and [[dyspnea]]
| style="padding: 5px 5px; background: #F5F5F5;" |[[Cough]], [[fatigue]], and [[dyspnea]]
|style="padding: 5px 5px; background: #F5F5F5;"|In pneumonia, differentiating features include: high grade fever, good response to antibiotics, acute onset, predilection on CXR is consolidation, laboratory markers indicate infection
| style="padding: 5px 5px; background: #F5F5F5;" |In pneumonia, differentiating features include: high grade fever, good response to antibiotics, acute onset, predilection on CXR is consolidation, laboratory markers indicate infection
|-
|-
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"|'''[[Fungal infection]]'''
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Fungal infection]]'''
|style="padding: 5px 5px; background: #F5F5F5;"|Chronic [[cough]], [[weight loss]], [[hemoptysis]], and [[dyspnea]]
| style="padding: 5px 5px; background: #F5F5F5;" |Chronic [[cough]], [[weight loss]], [[hemoptysis]], and [[dyspnea]]
|style="padding: 5px 5px; background: #F5F5F5;"|In fungal infection, differentiating features include: CXR findings (air-cresecent sign), no response to antibioitcs, and  mimcs tuberculosis
| style="padding: 5px 5px; background: #F5F5F5;" |In fungal infection, differentiating features include: CXR findings (air-cresecent sign), no response to antibioitcs, and  mimcs tuberculosis
|-
|-
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"|'''[[Chronic eosinophilic pneumonia]]'''
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Chronic eosinophilic pneumonia]]'''
|style="padding: 5px 5px; background: #F5F5F5;"|Chronic [[cough]], [[weight loss]], [[hemoptysis]], and [[dyspnea]]
| style="padding: 5px 5px; background: #F5F5F5;" |Chronic [[cough]], [[weight loss]], [[hemoptysis]], and [[dyspnea]]
|style="padding: 5px 5px; background: #F5F5F5;"|In chronic eosinophilic pneumonia , differentiating features include:  parasite infection or medication exposure, and  increased serum [[IgE]] levels
| style="padding: 5px 5px; background: #F5F5F5;" |In chronic eosinophilic pneumonia , differentiating features include:  parasite infection or medication exposure, and  increased serum [[IgE]] levels
|}
|}


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Latest revision as of 19:34, 19 February 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Overview

Non-small cell lung cancer must be differentiated from other diseases that cause chronic cough, weight loss, hemoptysis, and dyspnea among adults such as tuberculosis, pulmonary fungal disease, lung abscess, and secondary metastases.

Differential Diagnosis

Differential Diagnosis Similar Features Differentiating Features
Pulmonary tuberculosis Chronic cough, weight loss, hemoptysis, nocturnal diaphoresis, dyspnea In pulmonary tuberculosis, differentiating features include: resolution (or decrease in size) after medical therapy, patients age is usually younger, hemoptisis is an early feature, and CXR anatomical predilection for upper lobes
Lung abscess Chronic cough, weight loss, hemoptysis, and dyspnea In lung abscess, differentiating features include: acute or subacute onset, CXR anatomical predilection for upper lobes, and usually resolve with antibiotic
Pneumonia Cough, fatigue, and dyspnea In pneumonia, differentiating features include: high grade fever, good response to antibiotics, acute onset, predilection on CXR is consolidation, laboratory markers indicate infection
Fungal infection Chronic cough, weight loss, hemoptysis, and dyspnea In fungal infection, differentiating features include: CXR findings (air-cresecent sign), no response to antibioitcs, and mimcs tuberculosis
Chronic eosinophilic pneumonia Chronic cough, weight loss, hemoptysis, and dyspnea In chronic eosinophilic pneumonia , differentiating features include: parasite infection or medication exposure, and increased serum IgE levels

References

  1. Bhatt M, Kant S, Bhaskar R (2012). "Pulmonary tuberculosis as differential diagnosis of lung cancer". South Asian J Cancer. 1 (1): 36–42. doi:10.4103/2278-330X.96507. PMC 3876596. PMID 24455507.
  2. Kamiya K, Yoshizu A, Misumi Y, Hida N, Okamoto H, Yoshida S (2011). "[Lung abscess which needed to be distinguished from lung cancer; report of a case]". Kyobu Geka. 64 (13): 1204–7. PMID 22242302.
  3. Matsuoka T, Uematsu H, Iwakiri S, Itoi K (2013). "[Chronic eosinophilic pneumonia presenting as a solitary nodule, suspicious of lung cancer;report of a case]". Kyobu Geka. 66 (10): 941–3. PMID 24008649.


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