CXR Case 019
30 year old female presents with night sweats, weight loss and a cough
Describe and interpret this CXR
CHEST X-RAY INTERPRETATION
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*
Prof Fraser Brims Curtin Medical School, acute and respiratory medicine specialist, immediate care in sport doc, ex-Royal Navy, academic| Top 100 CXR | Google Scholar | ICIS Course ANZ