Causes of Bilateral Hilar Lymphadenopathy

Sometimes you may come across a chest x-ray which shows Bilateral Hilar Lymphadenopathy (BHL), so what differential needs to be considered.

Here are the differential diagnoses to be considered in such cases.

There is a clinical tip here. If there is SYMMETRICAL BHL, consider SARCOIDOSIS unless proved otherwise.

BILATERAL HILAR LYMPHADENOPATHY

Sarcoidosis *

Infections

  • Tuberculosis *
  • Mycoplasma
  • Fungal Infections
    • Histoplasmosis
    • Coccidiodomycosis

Malignancy

  • Lymphoma *
  • Primary or Secondary Carcinomas
  • Mediastinal tumors

Organic Dust Exposure

  • Silicosis
  • Berylliosis

Hypersensitivity Pneumonitis

Langerhan’s Cell Histiocytosis (Histiocytosis X)

* Common causes of BHL

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