swollen hilum lymph node

When I had a routine chest xray prior to a heart cath a node was seen enlarged directl adjacent to the pulminary artery.  A CT with contrast was done and showed a lymph node enlargement.  I was put on a regiment of antibiotics and re'CT'ed after about 2 weeks.  The second CT show the node had shrunk by a small amout, but a second node was seen very slightly enlarged.  I have seen a thoracic surgeon that recommends a wait 3 months and see approach, where my pulmonologest feels that a biopsy should be done now.  I need help

[PaulMD]

Hi.

The need to do a biopsy would depend on the level of suspicion of your doctors.  If your pulmonologist is highly suspicious of these nodes turning out to be a major problem (such as that of a malignancy) then it is best to have these nodes biopsied as soon as possible.  Causes of this would include chronic infections (such as TB), occupational disorders (silicosis, asbestosis), or malignancy (lung cancer, lymphoma, etc.).

A bronchoscopy with bronchial washings or lymph node biopsy can also be employed to ascertain the diagnosis.

Again, ask your pulmonologist about his or her level of suspicion for these findings and have the appropriate course of action done.

Regards and God bless.