The fear of lymphadenopathy: Does it portend sarcoidosis or lymphoma? Consultant. University of Virginia School of Medicine. Management of spontaneous pneumothorax: British thoracic society pleural disease guideline 2010. Unilateral pulmonary hilar tumor mass: is it always lung cancer? Maedica. Toma CL, Dumitrache-Rujinski S, Belaconi IN, et al. Pulmonary sarcoidosis: typical and atypical manifestations at high-resolution CT with pathologic correlation. Bronchoscopic techniques in diagnosis and staging of lung cancer. Missed lung cancer: when, where, and why? Diagn Interv Radiol. Approach to unequal hilum on chest X-ray. Heart failure may also lead to hilar adenopathy. Other causes: Castleman disease is a condition characterized by abnormal lymph tissue.In the United States, histoplasmosis is common in the Ohio and Mississippi River Valleys, with coccidioidomycosis more common in the southwestern states. Other infections: Infections such as mycobacteria, viral infections such as infectious mononucleosis, berylliosis, tularemia, histoplasmosis, and coccidioidomycosis can lead to enlarged lymph nodes in this region.Drug reactions are also a relatively common cause of hilar adenopathy. The hilar lymph node enlargement with sarcoidosis is usually symmetric in contrast to other common causes. Sarcoidosis is the most common cause of bilateral hilar lymph node enlargement, especially in young adults. Inflammation: Conditions such as sarcoidosis, amyloidosis, and silicosis can cause hilar lymphadenopathy.Tuberculosis: Worldwide, tuberculosis is one of the most common causes of hilar adenopathy in children.Lymphoma and other mediastinal tumors may also lead to enlarged hilar lymph nodes as well. Other cancers: Metastatic breast cancer can lead to hilar lymphadenopathy both due to the spread of the cancer to this region and due to involved lymph nodes.Lung cancer: Lung cancer is the most common cause of unequal hilar regions in adults, both due to the presence of a tumor and to the presence of involved lymph nodes.Increased pulmonary blood flow: Conditions such as cyanotic congenital heart disease (heart defects present at birth which cause a blue tinge to the skin due to a reduced oxygen content) can result in increased pulmonary blood flow.PAH may occur as a primary disease (not secondary to another problem) or as a secondary problem which in turn is caused most often by chronic obstructive pulmonary disease (COPD). Pulmonary arterial hypertension (PAH): This is an elevated pressure in the pulmonary arteries.Pulmonary venous hypertension (elevated pressure in the pulmonary veins): Pulmonary venous hypertension may occur due to medical conditions such as heart failure and heart valve problems such as mitral stenosis and mitral regurgitation.Possible causes of enlarged hilar lymph nodes (lymphadenopathy) are discussed below. Tumors and lymphadenopathy: Cancers such as lung cancers and lymphomas, as well as cancer that has spread to this region from other parts of the body (metastatic cancer) can cause masses in this region.
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