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Chest x-ray shows bulky hila, may be due to lymph node enlargement or vascular dysfunction, PFT normal, no cold or cough, breathlessness. Indications?

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Hello, My mother's chest x XXXXXXX shows both the hila look bulky may be due to lymph node enlargement or vascular disfunction..all other findings are normal..PFT was done and came back normal...she has no cold and cough..she has shortness of breath for one day...she had never asthma....what dows it indicate? Do we need to do any further test?
Posted Tue, 17 Jul 2012 in Lung and Chest disorders
 
 
Answered by Dr. Gyanshankar Mishra 4 hours later
Hi,
Thanks for posting the query on XXXXXXX
After going through your query, I would like to comment the following:

1. Your mother seems to be having complaint of breathlessness and hilar adenopathy on chest xray.

2. In view of the clinical symptom, a HRCT scan of the thorax is definitely indicated for the hilar adenopathy. Causes like malignancy, tuberculosis, sarcoidosis etc. needs to be ruled out.

3. If hilar adenopathy is found then focus elsewhere in the body also needs to be searched for. In addition bronchoscopic TBNA/ CT guided FNAC of the mediastinal lymph node is an option for delineating the cause of adenopathy.

4. Also a detailed clinical evaluation by a Pulmonologist is required.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Above answer was peer-reviewed by
 
Follow-up: Chest x-ray shows bulky hila, may be due to lymph node enlargement or vascular dysfunction, PFT normal, no cold or cough, breathlessness. Indications? 11 hours later
First of all my mother has just one day shortness of breath -
Secondly, does bulky hila indicates hilar adenopathy?
Can an mri scan detect all these abnormalities as she already had three Ct scan - one for CT angio in 2004 -one for abdomen and pelvis in 2008 and most likely she had one for head in 2009/10 I can not exactly sure about the last one, so this time we want a mri - will it be helpful to diagnose?
Thanks.
 
 
Answered by Dr. Gyanshankar Mishra 17 hours later
Hi,
Thanks for posting the follow up.

In absence of any clinical symptoms, I would suggest a wait and watch policy. If symptoms do not subside or symptoms increase than eventhough an mri can pick up mediastinal adenopathy, CT thorax is better at picking it up.

Also bulky hila on chest xray not always indicated hilar adenopathy and sometimes prominent broncho vascular markings or rotation of the film leads to such appearance.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Above answer was peer-reviewed by
 
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