Differential Diagnosis for Scapula Region Swelling in a 58-year-old Leukemia Patient
- Single most likely diagnosis:
- Chloroma (or Granulocytic Sarcoma): This is a solid tumor composed of immature granulocytic cells, often associated with acute myeloid leukemia (AML). The scapula region swelling could be due to a chloroma, given the patient's history of leukemia.
- Other Likely diagnoses:
- Metastatic disease: Leukemia patients are at increased risk of developing secondary malignancies, and the scapula region could be a site for metastasis.
- Hematoma or bleeding: Leukemia patients often have coagulopathy or thrombocytopenia, increasing the risk of bleeding or hematoma formation in the scapula region.
- Infection or abscess: Immunocompromised patients, such as those with leukemia, are more susceptible to infections, which could cause swelling in the scapula region.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Spinal epidural abscess or hematoma: Although less likely, these conditions can cause neurological deficits and are medical emergencies requiring prompt attention.
- Pathologic fracture: Weakened bones due to leukemia or metastatic disease could lead to pathologic fractures, which might present with swelling in the scapula region.
- Rare diagnoses:
- Ewing's sarcoma: A rare malignant bone tumor that could cause swelling in the scapula region, although it is more common in younger patients.
- Lymphoma: Although less likely, lymphoma could cause swelling in the scapula region, especially if it involves the bone or soft tissues.
- Amyloidosis: A rare condition characterized by the deposition of amyloid proteins in various tissues, including the skin and soft tissues, which could cause swelling in the scapula region.