Differential Diagnosis for Pruritus plus Mediastinal Adenopathy
Single Most Likely Diagnosis
- Hodgkin Lymphoma: This condition is known for causing pruritus (itching) in a significant portion of patients, along with mediastinal adenopathy (enlargement of lymph nodes in the mediastinum), which is a common presentation, especially in the nodular sclerosis subtype.
Other Likely Diagnoses
- Non-Hodgkin Lymphoma: While less commonly associated with pruritus compared to Hodgkin lymphoma, certain subtypes of non-Hodgkin lymphoma can present with both pruritus and mediastinal adenopathy.
- Sarcoidosis: This autoimmune disease can cause both pruritus and mediastinal adenopathy, although the pruritus is more commonly associated with skin lesions.
- Lymphoma-associated conditions: Certain conditions that predispose to or are associated with lymphoma, such as immunodeficiency states, can also present with these symptoms.
Do Not Miss Diagnoses
- Lymphomatoid Papulosis: A rare condition that can mimic lymphoma but is generally benign, it can cause pruritus and occasionally mediastinal adenopathy.
- Castleman Disease: A rare disorder that can cause lymphadenopathy, including mediastinal adenopathy, and systemic symptoms, which might include pruritus in some cases.
Rare Diagnoses
- Cutaneous T-cell Lymphoma (e.g., Mycosis Fungoides/Sézary Syndrome): These conditions can cause severe pruritus and, in advanced stages, may involve lymph nodes, including those in the mediastinum.
- Kimura Disease: A rare, chronic inflammatory disorder that can cause lymphadenopathy and eosinophilia, and might be associated with pruritus, although it is more commonly associated with swelling in the head and neck region.
- Angioimmunoblastic T-cell Lymphoma: A rare and aggressive form of non-Hodgkin lymphoma that can present with systemic symptoms, including pruritus, and lymphadenopathy.