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Hilar Lymphadenopathy


Presentation

  • Classical radiographic features of patients presenting with silicosis are diffuse interstitial shadowing with subsequent enlargement of hilar nodes, sometimes with "eggshell" calcification.[ncbi.nlm.nih.gov]
  • We here report a 5-year-old boy who presented with cough and bilateral hilar lymphadenopathy with a family history of sarcoidosis. The laboratory investigations did not confirm this diagnosis.[ncbi.nlm.nih.gov]
  • Here, we present a case report of SHML causing isolated hilar lymphadenopathy with complete remission for more than 6 years, after a short course of high dose steroid (dexamethasone 20 mg daily for 3 days).[ncbi.nlm.nih.gov]
  • A 9-year-old boy with a history of atopic dermatitis presented with a 4-month history of an asymptomatic papular eruption. This was predominantly perioral in distribution with lesser involvement of the neck, arms and trunk.[ncbi.nlm.nih.gov]
  • An 18-year-old boy presented with a rare association of a thyroid tubercular abscess and bilateral symmetrical hilar lymphadenopathy.[ncbi.nlm.nih.gov]
Hodgkin's Disease
  • Kaplan ‏ عرض مقتطف - 1980 Hodgkin's disease Henry S.[books.google.com]
  • Diffuse lung involvement, on the other hand, carries a graver prognosis Five-year Survival Rates for Hodgkin Lymphoma Stages I and II 90% Stage III 84% Stage IV 65% Hodgkin Disease.[learningradiology.com]
  • Cancer 1959; 12;164-82 4..Hyman GA, Sommers SC, the development of Hodgkin’s disease and lymphoma during anticonvulsant therapy. Blood 1966; 28; 416-27. 5. Gams RA, Neal JA, Conrad FG. Hydantoin-induced pseudo-pseudolymphoma.[priory.com]
Eye Pain
  • A 56-year-old woman consulted an ophthalmologist due to right eye pain in September 2012. She was diagnosed with right-sided iritis and glaucoma.[ci.nii.ac.jp]

Workup

  • History is particularly important along with a careful physical examination as it helps to direct the workup. Laboratory testing assists in confirming and denying possible diagnoses.[pediatriceducation.org]
Mediastinal Mass
  • EBUS-TBNA was successfully performed to obtain samples from 161 lymph nodes and mediastinal masses. EBUS-TBNA was diagnostic for 119 of 128 patients (93.0%) for all disease categories.[ncbi.nlm.nih.gov]
  • RESULTS: In 101 patients, EBUS-TBNA was successfully performed to obtain samples from 225 lymph nodes, 7 lung masses, 1 mediastinal mass and 2 esophageal masses. 63 malignant tumors and 38 benign diseases were confirmed.[ncbi.nlm.nih.gov]
  • mass with healed pulmonary tuberculosis ( Clin Med Res 2010;8:99 ) Women who cooked over wood fires, with primary nodal anthracosis identified as a cause of FDG PET/CT positive mediastinal lymphadenopathy ( Respiratory Medicine Case Reports 2013;10:48[pathologyoutlines.com]
  • mass may produce chest pain, cough or shortness of breath Pruritus Nodal pain, especially if preceded by drinking alcohol may occur in less than 10% of patients but is characteristic of Hodgkin lymphoma Rarely, hemoptysis Rarely, back or bone pain Imaging[learningradiology.com]
Chest X-Ray Abnormal
  • On a chest X-ray, abnormalities of these structures are represented by a change in position, size and/or density. Hilar enlargement Hilar enlargement may be unilateral or bilateral, symmetrical or asymmetrical.[radiologymasterclass.co.uk]
X-Ray Abnormal
  • On a chest X-ray, abnormalities of these structures are represented by a change in position, size and/or density. Hilar enlargement Hilar enlargement may be unilateral or bilateral, symmetrical or asymmetrical.[radiologymasterclass.co.uk]
Penicillium
  • Penicillium marneffei, Pneumocystis pneumonia, Pulmonary aspergillosis, Mucormycosis) and mycobacterial infections (Mycobacterium tuberculosis, Non-tuberculous Mycobacteria), lymphoma, as well as AIDS related disease in children with AIDS.[books.google.com]

Treatment

  • Different treatment modalities have been tried with variable responses, however, there is no consensus on the best modality of treatment.[ncbi.nlm.nih.gov]
  • Sarcoidosis developing in the course of a preexisting neoplasm is rare, but must be considered in order to establish a proper diagnosis and withhold unnecessary treatment.[ncbi.nlm.nih.gov]
  • After a six-month of anti-tubercular treatment (ATT), the boy showed clinical and bacteriological improvement. The thyroid scan with Technetium 99 (Tc 99) and the chest skiagram also became normal.[ncbi.nlm.nih.gov]
  • Multidisciplinary contributions on medical treatment, radiation oncology, and surgery and anesthesia are included. Highlights include new material on minimally invasive procedures and thoroughly updated diagnostic and treatment information.[books.google.com]
  • Excellent photographs (X-ray and CT imaging) reveal the common imaging features of different diseases in different stages of treatment.[books.google.com]

Prognosis

  • Patterns of Anatomic Distribution 280 Clinical Staging Classification 340 Radiotherapy 366 Chemotherapy 442 Selection of Optimal Treatment 478 Chapter 10 Chapter 11 Chapter 12 Chapter 13 Historical Aspects 15 Etiology and Epidemiology 16 Pathology 52 Prognosis[books.google.com]
  • Prognostically, mediastinal node enlargement worsens prognosis but only minimally.[learningradiology.com]
  • […] and larger sized tumors, and led to poor prognosis.[journals.plos.org]
  • The prognosis of Löfgren syndrome is good, with complete resolution with or without treatment within 6 months to 2 years. It is usual to repeat chest X-rays from time to time until the lymphadenopathy has fully resolved.[dermnetnz.org]
  • Prognosis [ 1, 15 ] Although many patients have sarcoidosis which resolves spontaneously, a significant proportion of patients have chronic or progressive disease with resultant morbidity.[patient.info]

Etiology

  • The Nature of the Immunologic Defect 236 Patterns of Anatomic Distribution 280 Clinical Staging Classification 340 Radiotherapy 366 Chemotherapy 442 Selection of Optimal Treatment 478 Chapter 10 Chapter 11 Chapter 12 Chapter 13 Historical Aspects 15 Etiology[books.google.com]
  • There could be autoimmune etiology like SLE, rheumatoid arthritis and immunocompromise like AIDS.[medhelp.org]
  • Benign hyperplasia, Langerhans cell histiocytosis. lymphadenopathy Enlarged lymph nodes, follicular hypertrophy, swollen lymph glands Hematology Enlargement of lymph nodes of any etiology; the differential diagnostic considerations are multiple and divided[medical-dictionary.thefreedictionary.com]
  • Treatment In order for the hilar adenopathy to disappear, the treatment has to be concentrated on the underlying etiology.[hellomrdoctor.com]
  • A differential of possible etiologies can be broken up into three different categories: Inflammation (sarcoidosis, silicosis) Neoplasm (lymphoma, metastases, bronchogenic carcinoma) Infection (tuberculosis, histoplasmosis, infectious mononucleosis) An[med-ed.virginia.edu]

Epidemiology

  • […] the Immunologic Defect 236 Patterns of Anatomic Distribution 280 Clinical Staging Classification 340 Radiotherapy 366 Chemotherapy 442 Selection of Optimal Treatment 478 Chapter 10 Chapter 11 Chapter 12 Chapter 13 Historical Aspects 15 Etiology and Epidemiology[books.google.com]
  • Department of Health, Republic of South Africa (1999) Epidemiological comments, vol 1, no. 2. Notifiable medical conditions, June 1999 Google Scholar 19.[link.springer.com]
  • He has since completed further training in emergency medicine, clinical toxicology, clinical epidemiology and health professional education.[lifeinthefastlane.com]
  • Barrier Epidemiology of adult Still's disease: estimate of the incidance by a retrospective study in West France Ann Rheum Dis, 54 (1995), pp. 587-590 [14] A. Kraus, O. Alarcon-Segovivia Fever adult onset Still's disease.[reumatologiaclinica.org]
  • Epidemiology Sarcoidosis occurs worldwide, with a prevalence of about 4.7-64 in 100,000, and an incidence of 1.0-35.5 in 100,000 per year [ 1 ]. The highest rates are reported in northern European/Scandinavian and African-American individuals.[patient.info]
Sex distribution
Age distribution

Pathophysiology

  • On conclusion, the pathophysiology of phenytoin-induced lymphadenopathy is incompletely understood. It can require careful pathological scrutiny to differentiate it from monoclonal cell expansion.[priory.com]
  • The pathophysiology of sarcoidosis is similar to that of other interstitial lung diseases, with main features including decreased lung compliance, and decreased lung volumes and capacities.[aafp.org]

Prevention

  • J Thorac Oncol 2011;6:1345-1349 When it comes to staging known lung cancer, EBUS / EUS looks equal or superior to mediastinoscopy, and (if it becomes standard care) could prevent thousands of unnecessary mediastinoscopies and thoracotomies.[pulmccm.org]
  • Prevention Although sarcoidosis cannot be prevented, some preventative measures may reduce complications. For example: Influenza vaccination. Osteoporosis prophylaxis (steroid usage).[patient.info]
  • […] samples are often required. 27 The REMEDY trial, 21 the only prospective study of EBUS-TBNA in patients with IMHL requiring pathological confirmation, demonstrated high sensitivity (92%) and cost-effectiveness of EBUS-TBNA as a first-line investigation, preventing[bmjopenrespres.bmj.com]
  • Health care services aimed at preventing health problems or maintaining health are provided. 9. Patient-focused care is provided by working with health care professionals, including those from other disciplines. Medical Knowledge 10.[pediatriceducation.org]
  • Treatment The goals of treatment for sarcoidosis include resolving inflammatory lesions that are interfering with organ function, preventing pulmonary fibrosis and diminishing symptoms. 3 If the patient presents with stage 1 or stage 2 disease with normal[aafp.org]

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