Bilateral hilar lymphadenopathy explained

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.

Causes

The following are causes of BHL:^[1]

• Sarcoidosis^[2]
• Infection
  • Tuberculosis^[2]
  • Fungal infection^[2]
  • Mycoplasma
  • Intestinal Lipodystrophy (Whipple's disease)^{[3] [4]}
• Malignancy
  • Lymphoma^[2]
  • Carcinoma
  • Mediastinal tumors
• Inorganic dust disease
  • Silicosis^{[5] [6] [7]}
  • Berylliosis^[7]
• Extrinsic allergic alveolitis
  • Such as bird fancier's lung
• Less common causes also exist:
  • Eosinophilic granulomatosis with polyangiitis
  • Human immunodeficiency virus
  • Extrinsic allergic alveolitis
  • Adult-onset Still's disease^[8]

Notes and References

1. Book: M. Longmore . I. Wilkinson . T. Turmezei . CK. Cheug . Oxford Handbook of Clinical Medicine 7th Edition. Oxford University Press. 2007. United States, New York. 978-0-19-856837-7. 179.
2. Criado . E. Sánchez. M. Ramírez. J. Arguis. P. De Caralt. TM. Perea. RJ. Xaubet. A. Pulmonary sarcoidosis: typical and atypical manifestations at high-resolution CT with pathologic correlation. Radiographics. 30 . 6. 1567–1586 . October 2010. 21071376. 10.1148/rg.306105512. free.
3. Urbanksi . G. Rivereau. P. Artru. L. Fenollar. F. Raoult. D. Puéchal. X. Whipple disease revealed by lung involvement: a case report and literature review. Chest. 141 . 6. 1595–1598. June 2012. 22670021. 10.1378/chest.11-1812.
4. Book: Beers, Mark. The Merck Manual. registration. 2006. 9780911910186 .
5. Suwatanapongched . T. Gierada. DS. CT of thoracic lymph nodes. Part II: diseases and pitfalls. The British Journal of Radiology. 79 . 948. 999–1000. December 2006. 16641412. 10.1259/bjr/82484604.
6. Leung . CC. Yu. IT. Chen. W. Silicosis. The British Journal of Radiology. 379 . 9830. 2008–2018. May 2012. 22534002. 10.1016/S0140-6736(12)60235-9. 208793253.
7. Chong . S. Lee. KS. Chung. MJ. Han. J. Kwon. OJ. Kim. TS. Pneumoconiosis: comparison of imaging and pathologic findings. Radiographics. 26 . 1. 59–77. January–February 2006. 16418244. 10.1148/rg.261055070.
8. Owlia . MB. Mehrpoor. G. Adult-onset Still's disease: a review. Indian Journal of Medical Sciences. 63 . 5. 207–221 . May 2009. 19584494. 10.4103/0019-5359.53169. free .