Differential Diagnosis for 39-year-old with Hemoptysis and Unintentional Weight Loss
Single Most Likely Diagnosis
- Lung Cancer: Given the patient's history of tobacco use, age, and symptoms of hemoptysis and unintentional weight loss, lung cancer is a highly likely diagnosis. The presence of a cavitary lesion and extensive lymphadenopathy on CT chest further supports this diagnosis.
Other Likely Diagnoses
- Tuberculosis (TB): The patient's symptoms of hemoptysis, weight loss, and cavitary lesion are consistent with TB, especially in the context of immunosuppression from methamphetamine use. Lymphadenopathy is also a common finding in TB.
- Infectious Diseases (e.g., pneumonia, abscess): The presence of a cavitary lesion and consolidation on CT chest suggests an infectious process, which could be related to the patient's immunosuppressed state from methamphetamine use.
- Sarcoidosis: Although less likely, sarcoidosis could present with lymphadenopathy and pulmonary symptoms, including hemoptysis and weight loss.
Do Not Miss Diagnoses
- Wegener's Granulomatosis (Granulomatosis with Polyangiitis): This autoimmune disorder can present with hemoptysis, weight loss, and cavitary lesions, and is often associated with renal and sinus involvement. Missing this diagnosis could lead to delayed treatment and poor outcomes.
- Lymphoma: Although less common, lymphoma could present with lymphadenopathy, weight loss, and pulmonary symptoms, including hemoptysis. Delayed diagnosis could result in poor prognosis.
Rare Diagnoses
- Histoplasmosis: This fungal infection can cause pulmonary symptoms, including hemoptysis and weight loss, especially in immunosuppressed individuals. However, it is less common than other diagnoses on this list.
- Cystic Fibrosis: Although typically diagnosed in childhood, cystic fibrosis can present in adulthood with pulmonary symptoms, including hemoptysis and weight loss. However, this diagnosis is unlikely given the patient's age and lack of other suggestive symptoms.