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​Symptoms and Signs – Differential Diagnosis of Mallory-Weiss Tear
• Arteriovenous malformations
• Esophageal or gastric varices
• Esophagitis/esophageal ulcers (peptic or pill induced)
• Gastric erosions
• Gastric or duodenal ulcer
• Neoplasms (usually gastric)
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​Symptoms and Signs – Differential Diagnosis of Mastitis
• Breast abscess
• Granulomatous mastitis can be a manifestation of systemic disease, including sarcoidosis, Wegener’s granulomatosis, giant cell arteritis, polyarteritis nodosa, tuberculosis, and syphilis
• Inflammatory breast cancer
• Mastitis as a symptom of hyperprolactinemia or galactorrhea
• Other cancers; 3% of women diagnosed with breast cancer are lactating
• Plugged lactiferous ducts
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​Symptoms and Signs – Differential Diagnosis of Mediastinal Masses or Widening on Chest Radiograph
• Achalasia
• Carcinoma: lungs, esophagus
• Esophageal diverticula
• Hiatal hernia
• Lymphoma: Hodgkin’s disease and non-Hodgkin’s lymphoma
• Prominent pulmonary outflow tract: pulmonary hypertension,
• Sarcoidosis
• Vascular: aortic aneurysm, ectasia or tortuosity of aorta or otherthoracic vessels
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Symptoms and Signs – Differential Diagnosis of pulmonary embolism, right-to-left shunts
• Leukemias
• Lymphadenopathy caused by silicosis and other pneumoconioses
• Pneumomediastinum
• Trauma: mediastinal hemorrhage
• Infections: TB, viral (rare), Mycoplasma (rare), fungal, tularemia
• Substernal thyroid
• Thymoma
• Teratoma
• Bronchogenic cyst
• Pericardial cyst
• Neurofibroma, neurosarcoma, ganglioneuroma
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​Symptoms and Signs – Differential Diagnosis of Acute Mediastinitis
• Cardiothoracic surgery (median sternotomy) (e.g., CABG, valve replacement, other types of cardiothoracic surgery)
• Esophageal perforation
• Esophagogastroduodenoscopy, esophageal dilation, esophagealvariceal sclerotherapy, nasogastric tube, Sengstaken-Blakemore tube, endotracheal intubation, esophageal surgery, paraesophageal surgery, transesophageal echocardiography, anterior stabilization of cervical vertebral bodies
• Head and neck infections (e.g., tonsillitis, pharyngitis, parotitis, epiglottitis, odontogenic)
• Iatrogenic
• Infections originating at another site (e.g., TB; pneumonia; pancreatitis; osteomyelitis of sternum, clavicle, ribs)
• Spontaneous perforation (e.g., emesis, carcinoma)
• Swallowed foreign bodies
• Trauma
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