CXR Case 019

There is bilateral hilar lymphadenopathy

* The lung fields are otherwise clear*

Bilateral hilar lymphadenopathy should always be further investigated, as lymphoma (primarily Hodgkin’s) is an important cause.

Differentials include: sarcoidosis, silicosis and tuberculosis.

Up to half of patients with Hodgkin’s lymphoma have radiographic evidence of lymphadenopathy on plain CXR at the time of clinical presentation and about 85% on CT, which would be the next investigation of choice.

*The clear lung fields should not put clinicians of the possibility of TB or sarcoidosis*