Differential Diagnosis for Right Hip Pain, Right Lung Mass, Anemia, Leukocytosis, and Thrombocytosis

• Single Most Likely Diagnosis
  • Multiple Myeloma: This diagnosis is likely due to the combination of anemia refractory to blood transfusions, bone pain (right hip pain), and elevated blood cell counts (leukocytosis and thrombocytosis). Multiple myeloma can also lead to lung masses due to extramedullary plasmacytomas. The disease's impact on bone marrow can explain the refractory anemia and abnormal blood cell counts.
• Other Likely Diagnoses
  • Metastatic Cancer: A primary cancer (e.g., lung, breast, or prostate) with metastasis to the bone (causing hip pain) and possibly affecting the bone marrow (leading to anemia, leukocytosis, and thrombocytosis) is a plausible explanation. The lung mass could be the primary site or a metastasis.
  • Lymphoma: Both Hodgkin's and non-Hodgkin's lymphoma can present with systemic symptoms, anemia, abnormal blood cell counts, and masses in various parts of the body, including the lungs and bones.
• Do Not Miss Diagnoses
  • Sickle Cell Disease with Sickle Cell Crisis and Secondary Lung Involvement: Although less likely given the lung mass, sickle cell disease can cause anemia, bone pain, and leukocytosis. A lung mass could be due to secondary complications like infarction or infection.
  • Osteomyelitis or Bone Infection with Hematogenous Spread: An infection in the bone (osteomyelitis) could cause hip pain and, if it spreads to the blood, could lead to systemic symptoms, anemia, and abnormal blood counts. A lung mass could be an abscess or infected embolus.
• Rare Diagnoses
  • Langerhans Cell Histiocytosis (LCH): This rare disorder can cause bone lesions (leading to hip pain), anemia, and abnormal blood cell counts. Lung involvement is possible, especially in the form of pulmonary Langerhans cell histiocytosis.
  • Erdheim-Chester Disease: A rare form of histiocytosis that can affect multiple systems, including bones (causing pain), lungs (leading to masses or nodules), and the hematopoietic system (resulting in anemia and abnormal blood cell counts).