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CT scan of the chest showing bilateral lymphadenopathy in the mediastinum due to sarcoidosis. Bilateral hilar lymphadenopathy is a bilateral enlargement of the lymph nodes of pulmonary hila. It is a radiographic term for the enlargement of mediastinal lymph nodes and is most commonly identified by a chest x-ray.
Löfgren syndrome is a type of acute sarcoidosis, [1] an inflammatory disorder characterized by swollen lymph nodes in the chest, tender red nodules on the shins, fever and arthritis. [2] It is more common in women than men, and is more frequent in those of Scandinavian , Irish , African and Puerto Rican heritage.
Lymphadenopathy of an inflammatory type (the most common type) is lymphadenitis, [1] producing swollen or enlarged lymph nodes. In clinical practice, the distinction between lymphadenopathy and lymphadenitis is rarely made and the words are usually treated as synonymous .
Even when erythema nodosum is absent, it is believed that the combination of hilar lymphadenopathy and ankle periarthritis can be considered as a variant of Löfgren syndrome. [72] Enthesitis also occurs in about one-third of patients with acute sarcoid arthritis, mainly affecting the Achilles tendon and heels. [ 72 ]
In active pulmonary TB, infiltrates or consolidations and/or cavities are often seen in the upper lungs with or without mediastinal or hilar lymphadenopathy. [1] However, lesions may appear anywhere in the lungs. In HIV and other immunosuppressed persons, any abnormality may indicate TB or the chest X-ray may even appear entirely normal. [1]
Least invasive modality, uses the esophagus to access mediastinal lymph nodes, excellent for station 5, 7, 8 lymph nodes. Useful for station 2L and 4L, L adrenal, celiac lymph node Cannot reliably access right sided paratracheal lymph node stations 2 R and 4R; accurate discrimination of primary hilar tumors and involved lymph nodes is important
Micrograph of a primary mediastinal large B-cell lymphoma, a cause of mediastinal lymphadenopathy. H&E stain. Mediastinal lymphadenopathy or mediastinal adenopathy is an enlargement of the mediastinal lymph nodes.
Similarly, the presence of contralateral hilar adenopathy frequently, though not uniformly, includes patients in the limited-disease category. [13] [14] The traditional TNM classification system is preferred over the 2-stage system when surgery is the recommended treatment option. [4]