Differential Diagnosis for Splenomegaly with Periportal, Retroperitoneal, Thoracic Lymphadenopathy
- Single Most Likely Diagnosis
- Lymphoma (Hodgkin's or Non-Hodgkin's): This is the most likely diagnosis due to the combination of splenomegaly and widespread lymphadenopathy involving multiple regions, which is a common presentation for lymphoma.
- Other Likely Diagnoses
- Chronic Lymphocytic Leukemia (CLL): CLL can cause splenomegaly and lymphadenopathy, although the lymphadenopathy might not always be as widespread as in lymphoma.
- Chronic Myeloid Leukemia (CML): CML can lead to splenomegaly, and while lymphadenopathy is less common, it can occur, especially in advanced stages.
- Sarcoidosis: Although more commonly associated with pulmonary symptoms, sarcoidosis can cause lymphadenopathy and, less frequently, splenomegaly.
- Do Not Miss Diagnoses
- Tuberculosis: While less common in some regions, tuberculosis can cause splenomegaly and lymphadenopathy, and missing this diagnosis could have significant consequences due to its treatability and potential for severe outcomes if left untreated.
- HIV/AIDS: Infection with HIV can lead to splenomegaly and lymphadenopathy due to either the virus itself or opportunistic infections, making it crucial not to miss this diagnosis due to its implications for treatment and prognosis.
- Rare Diagnoses
- Castleman Disease: A rare disorder that can cause lymphadenopathy and, in some cases, splenomegaly, often presenting with systemic symptoms.
- Lymphangiomatosis: A rare condition characterized by the abnormal growth of lymphatic vessels, which can lead to lymphadenopathy and splenomegaly, among other symptoms.
- Kaposi's Sarcoma: Although primarily known for its cutaneous manifestations, Kaposi's sarcoma can involve lymph nodes and the spleen, especially in immunocompromised patients.
- Histoplasmosis or other fungal infections: In endemic areas, these infections can cause splenomegaly and lymphadenopathy, and while rare, they are important to consider due to their treatability.