Hilar and Mediastinal adenopathy

Please help me understand my CT scan results as I can not get in to see the Pulmonary Specialist for 2 weeks:

Findings: Images through the lungs demonstrate no suspicious pulmonary nodules. There are small prevascular and pretraceal nodes. Bilateral hilar nodes are seen measuring 10 and 17 mm. Subcarinal nodes are seen as well measuring 2.9 centimeters. No pleural or pericardial effusion. images of the upper portion of the abdomen demonstrate no evidence of splenomegaly. Adrenal glands appear normal. Patient status post cholecystectomy.

Impression: There are hilar and mediastinal adenopathy noted as described above.The differential diagnosis includes both reative, inflammatory and malignant etiologies. Clinical correlation is suggested. Followup examination may be indicated. I see no cardiac enlargement. No pleural or pericardial effusion noted.

Help Please - Thank you
Jayla

[Dr Sharma]

Hi there. Localized adenopathy should prompt a search for adjacent precipitating lesion and examination of other nodal areas to rule out generalized lymphadenopathy. 3 to 4 weeks period of observation is acceptable if the clinical picture is benign. Excisional biopsy of the most abnormal node will enable the pathologist to determine the diagnosis. The causes for lymphadenopathy may be obvious like sore throat and tender cervical lymph nodes, other serious illnesses like lymphoma, AIDS, or metastatic cancer. Like your report mentions these enlarged lymph nodes can be a common symptom of infectious and malignant disease. Reactive causes are infection acute bacterial or viral, chronic like tuberculous lymphadentis. Infectious mononucleosis,, toxoplasmosis, etc. Tumoral lymphadenopathy includes primary like hodgkin’s and non-hodgkin lymphoma, secondary including metastasis. There could be autoimmune etiology like SLE, rheumatoid arthritis and immunocompromise like AIDS. The causes of bilateral hilar lymphadenopathy are tuberculosis, sacrcoidosis, extrinsic allergic alveolitis, malignancy like lymphoma, carcinoma organic dust like silicosis. Your pulmonologist and pathologist would need to do a thorough assessment to discern the pathology. Hope this helps. Take care.