Differential Diagnosis
- Single most likely diagnosis
- Lymphoma (Hodgkin's or Non-Hodgkin's): The presence of palpable lymph nodes, particularly in the elbow, and fullness under the ribs that worsens with sitting and laying down, could indicate lymphoma. The symptoms of anxiety and IBS-type diarrhea could be related to the stress of the underlying condition or could be a paraneoplastic syndrome.
- Other Likely diagnoses
- Sarcoidosis: This condition can cause lymphadenopathy and abdominal symptoms, and it can also cause gastrointestinal symptoms like diarrhea. The worsening of symptoms with position could be related to the location of affected lymph nodes.
- Inflammatory bowel disease (IBD): While IBD primarily causes gastrointestinal symptoms, it can also cause extraintestinal manifestations like lymphadenopathy and anxiety. The fullness under the ribs could be related to an enlarged spleen, which can occur in IBD.
- Mononucleosis: Caused by Epstein-Barr virus, this condition can lead to lymphadenopathy, splenomegaly (which could cause fullness under the ribs), and gastrointestinal symptoms. However, it's more common in younger individuals.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Tuberculosis: Although less common in some regions, TB can cause lymphadenopathy, abdominal symptoms, and systemic symptoms like anxiety. It's crucial to consider TB due to its potential severity and the need for specific treatment.
- Lymph node metastasis from an underlying cancer: The presence of palpable lymph nodes, especially if they are hard, fixed, or rapidly growing, necessitates a thorough investigation for an underlying malignancy, which could be life-threatening if not identified and treated promptly.
- Rare diagnoses
- Castleman disease: A rare disorder that involves an overgrowth of cells in the lymph nodes, which can cause lymphadenopathy, systemic symptoms, and sometimes gastrointestinal symptoms.
- Kaposi's sarcoma: Although rare and more commonly associated with immunocompromised states, it can cause lymphadenopathy and gastrointestinal symptoms, including diarrhea.