MyMedR

Papilliferous keratoameloblastoma is an extremely rare variant of ameloblastoma, a benign odontogenic tumor, with only seven cases reported in the English language literature. This variant presents with the metaplastic transformation of stellate reticulum-like cells to the extent of forming papillary structures exhibiting superficial keratinization of varying thickness. This paper describes the pathognomonic macroscopic features of this tumor observed during gross examination under the stereo zoom microscope that differentiate it from the other odontogenic tumors which have not been explored in the previously documented cases. Also, in this paper, a detailed comparison of the macroscopic features observed under the stereo zoom microscope during gross examination with the microscopic features of the histologic section has been described proving to be useful in the histological differential diagnosis of the keratinizing variants of ameloblastoma.

Matched MeSH terms: Diagnosis, Differential

Fulltext Addison's disease presenting with hyperpigmentation

Tong CV, Ooi XY

BMJ Case Rep, 2021 Aug 17;14(8).

PMID: 34404673 DOI: 10.1136/bcr-2021-245610

Matched MeSH terms: Diagnosis, Differential

A typical clinical manifestation of atypical underlying diagnosis: Questions

B N, Cj NA, Mk AM, I MI

Pediatr Nephrol, 2023 Nov;38(11):3611-3613.

PMID: 37160460 DOI: 10.1007/s00467-023-05962-6

Matched MeSH terms: Diagnosis, Differential

Cervicofacial actinomycosis: a key consideration in cases of submandibular swelling

Cheng XL, Abu Hassan NI, Ng DC

BMJ Case Rep, 2023 Dec 09;16(12).

PMID: 38087483 DOI: 10.1136/bcr-2023-258129

Matched MeSH terms: Diagnosis, Differential

Leiomyoma of the incisive papilla region: a case report

Ng KH, Siar CH, Abdul Latif H

Ann Dent, 1992;51(1):29-31.

PMID: 1632624

Leiomyomas are benign neoplasms of smooth muscle origin. They represent rare entities in the oral cavity. A case arising from the incisive papilla region of a 3-month-old infant is described and the histogenesis as well as the biologic potential of this tumor are discussed.

Matched MeSH terms: Diagnosis, Differential

Some observations on differential diagnosis in the tropics

Kanagarayer K

Malayan Medical Journal, 1930;5:36-8.

Matched MeSH terms: Diagnosis, Differential

A rare cause of left ventricular outflow tract mass in infancy: Cardiac papillary fibroelastoma

Haranal M, Febrianti Z, Latiff HA, Rahman SA, Sivalingam S

Asian Cardiovasc Thorac Ann, 2021 Oct;29(8):816-818.

PMID: 33641433 DOI: 10.1177/0218492321998500

Primary cardiac tumors are one of the rare causes of intracardiac masses in pediatric population. Cardiac papillary fibroelastomas are benign cardiac tumors with predilection for valvular endocardium, and the presentation is dictated by the cardiac structure involved and the tumor characteristics. We report an infant with cardiac papillary fibroelastoma manifesting as an asymptomatic left ventricular outflow tract mass. This case is being presented to emphasize the rare occurrence of cardiac papillary fibroelastoma in pediatric population and to be cognizant of this entity when considering differential diagnosis of intracardiac masses in this subgroup.

Matched MeSH terms: Diagnosis, Differential

High Accuracy of a Simplified, Practical Algorithm in Differentiating Crohn's Disease from Intestinal Tuberculosis

Hilmi IN, Nik Muhamad Affendi NA, Shahrani S, Thalha AM, Leow AH, Khoo XH

Dig Dis, 2023;41(4):581-588.

PMID: 36702102 DOI: 10.1159/000529238

BACKGROUND: The differentiation between intestinal tuberculosis (ITB) and Crohn's disease (CD) remains a challenge, particularly in areas where tuberculosis is highly prevalent. Previous studies have identified features that favour one diagnosis over the other. The aim of the study was to determine the accuracy of a standardized protocol in the initial diagnosis of CD versus ITB.

METHODS: All patients with suspected ITB or CD were prospectively recruited. A standardized protocol was applied, and the diagnosis was made accordingly. The protocol consists of history and examination, ileocolonoscopy with biopsies, and tuberculosis workup. The diagnosis of probable ITB was made based on at least one positive finding. All other patients were diagnosed as probable CD. Patients were treated either with anti-tubercular therapy or steroids. Reassessment was then carried out clinically, biochemically, and endoscopically. In patients with suboptimal response, the treatment was either switched or escalated depending on the reassessment.

RESULTS: 164 patients were recruited with final diagnosis of 30 (18.3%) ITB and 134 (81.7%) CD. 1 (3.3%) out of 30 patients with ITB was initially treated as CD. 16 (11.9%) out of 134 patients with CD were initially treated as ITB. The initial overall accuracy for the protocol was 147/164 (89.6%). All patients received the correct diagnosis by 12 weeks after reassessment.

CONCLUSION: In our population, most patients had CD rather than ITB. The standardized protocol had a high accuracy in differentiating CD from ITB.

Matched MeSH terms: Diagnosis, Differential

Fulltext Understanding hyperemesis gravidarum

Loh KY, Sivalingam N

Med J Malaysia, 2005 Aug;60(3):394-9; quiz 400.

PMID: 16379204

Nausea and vomiting are common in early pregnancy affecting 70-80 percent of pregnant mothers. In a majority of women vomiting begins between 4-7 weeks of pregnancy. Nausea and vomiting are usually mild and self-limiting, however some of the mothers have a more profound course which lead to hyperemesis gravidarum. Careful clinical evaluation is necessary to exclude underlying medical illnesses or non pregnancy related causes of severe vomiting. Hyperemesis gravidarum poses health risk to both mother and baby, therefore prompt treatment should be initiated without delay. Non pharmacotherapy such as dietary modification and emotional support are useful. Pharmacotherapy with antiemetics, pyridoxine, methylprednisolone are effective and relatively safe. Severe hyperemesis with dehydration and electrolyte imbalance may need hospitalisation for electrolyte and fluid replacement.

Matched MeSH terms: Diagnosis, Differential

Fulltext A rare case of chondrosarcoma of the clavicle

Amalourde A, Vinayaga P, Naveed N, Jamal A, Looi LM, Sengupta S

Med J Malaysia, 2004 Dec;59 Suppl F:60-2.

PMID: 15941166 MyJurnal

Although all types of tumour and tumour-like conditions have been described to occur in the clavicle, they only contribute to less then 0.5% of all skeletal tumours. The incidence of primary chondrosarcoma of the clavicle is extremely rare. To our knowledge it has not been reported in Malaysia. We would like to highlight the possibility of chondrosarcoma as a differential diagnosis for a clavicular lesion.

Matched MeSH terms: Diagnosis, Differential

Fulltext Practical way of creating differential diagnoses through an expanded VITAMINSABCDEK mnemonic

Zabidi-Hussin ZA

Adv Med Educ Pract, 2016;7:247-8.

PMID: 27217805 DOI: 10.2147/AMEP.S106507

Having an organized, structured thinking process is critical in medicine. It is through this thinking process that enables one to go through the method of history-taking, which will eventually lead to making a definitive diagnosis and all other processes that follow. The use of mnemonic has been found to be useful for this purpose. The mnemonic VITAMINSABCDEK, is a convenient and practical way to assist in expanding the differential diagnoses and covers all possible causes of an illness. It is also easy to remember, as the vitamins whose letters are represented in this mnemonic cover the entire range of vitamins known.

Matched MeSH terms: Diagnosis, Differential

Missed subdiaphragmatic mass in medial left epigastrium: tumour or foreign body?

Maurer HJ

J R Soc Med, 1993 Aug;86(8):481.

PMID: 8078052

Matched MeSH terms: Diagnosis, Differential

Thymolipoma

Majid AA

Aust N Z J Surg, 1992 Jan;62(1):74-6.

PMID: 1731742

Although the diagnosis of thymolipoma has improved with the introduction of computerized tomography (CT), variations in CT appearance are still being described; this paper describes a case which resembled a lipoma. The CT features of thymolipoma are discussed with special reference to the differential diagnosis. Surgical excision should be considered for patients who are found to exhibit a fatty intrathoracic mass on CT.

Matched MeSH terms: Diagnosis, Differential

Advanced extrauterine pregnancy mimicking intra-uterine fetal death: case reports

Glew SS, Sivanesaratnam V

Aust N Z J Obstet Gynaecol, 1989 Nov;29(4):450-1.

PMID: 2631682

Two cases of late second trimester extrauterine pregnancy are presented--intraabdominal pregnancy in one and an ampullary pregnancy in another. In the former the diagnosis was made only after attempts at induction of labour for fetal death with prostaglandins failed and in the latter only at laparotomy. The diagnostic and surgical problems encountered are discussed.

Matched MeSH terms: Diagnosis, Differential

Fulltext Benign Lymphoepithelial Cyst: An Unusual Cause of Parotid Swelling in Two Immunocompetent Patients

Thong HK, Athar PPSH, Mustaffa WMW

Open Access Maced J Med Sci, 2019 Jul 15;7(13):2142-2145.

PMID: 31456841 DOI: 10.3889/oamjms.2019.577

BACKGROUND: Lymphoepithelial cysts, which are benign and slow-growing tumours, usually involve the head and neck regions. Benign lymphoepithelial cysts (BLECs) are the most common cause of parotid swelling in human immunodeficiency virus (HIV)-positive patients and are less common in immunocompetent patients.

CASE PRESENTATION: Here, we present two cases of immunocompetent patients with long-standing, progressively enlarging parotid swelling. Postoperative histopathological examination of these patients revealed features of BLEC.

CONCLUSION: Wide surgical excision is the gold standard for treatment and recurrences is rare. These cases are of particular interest because of the rarity of BLEC in HIV-negative patients and highlight an important differential diagnosis of parotid swelling.

Matched MeSH terms: Diagnosis, Differential

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