Differential Diagnosis
- Single most likely diagnosis
- Anxiety disorder: The patient's extreme health anxiety and history of convincing herself of severe illnesses (e.g., metastatic melanoma) without concrete evidence suggest that her symptoms may be exacerbated or entirely caused by anxiety. The lack of systemic symptoms such as fever, weight loss, and the presence of movable and non-tender lymph nodes also point towards a benign cause.
- Other Likely diagnoses
- Benign melanocytic nevus with reactive lymphadenopathy: The mole in the belly button area could be a benign nevus, and the lymph nodes could be reacting to minor irritations or infections, which are common and not indicative of metastatic disease.
- Irritable Bowel Syndrome (IBS): The patient's description of IBS-type symptoms, including diarrhea that is sometimes greasy and flaky, aligns with IBS, a common condition that can cause significant distress but is not life-threatening.
- Night sweats due to anxiety or hormonal changes: Night sweats can be caused by various factors, including anxiety, hormonal fluctuations, or sleep disorders, and do not necessarily indicate a serious underlying condition.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Metastatic melanoma: Although the patient's conviction about having metastatic melanoma might be driven by anxiety, it is crucial to rule out this potentially deadly diagnosis through a thorough examination and, if necessary, a biopsy of the mole and lymph nodes.
- Lymphoma: Enlarged lymph nodes, even if movable and non-tender, could potentially be a sign of lymphoma, a type of cancer that affects the immune system.
- Tuberculosis or other infectious diseases: These conditions can cause lymphadenopathy (enlarged lymph nodes) and night sweats, among other symptoms, and require prompt diagnosis and treatment.
- Rare diagnoses
- Neuroendocrine tumors: These rare tumors can cause a variety of symptoms, including flushing, diarrhea, and lymphadenopathy, but are much less common than other conditions listed here.
- Carcinoid syndrome: A rare condition caused by a neuroendocrine tumor that can lead to symptoms such as diarrhea, flushing, and wheezing, but typically presents with more systemic and severe symptoms than those described by the patient.