BILATERAL HILAR ADENOPATHY: ITS SIGNIFICANCE AND MANAGEMENT

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Abstract
Bilateral hilar adenopathy is due to a number of different conditions, both benign and malignant, some of which require specific therapy. Tuberculosis, often a cause of unilateral hilar adenopathy, is seldom a cause of bilateral enlargement. Sarcoidosis is one of the most frequent causes of the condition. In 100 cases of lymphoma there were 9 cases of bilateral enlargement of the hilar nodes. Because rapid regression of hilar nodes occurs spontaneously in some benign conditions, similar regression following X-ray therapy cannot be considered valid "proof" that the patient is suffering from Hodgkin''s disease. X-ray therapy should be used only in cases of histologically proved malignant disease. Erythema nodosum and articular symptoms are frequently associated with bilateral enlargement of the hilar lymph nodes. When bilateral hilar adenopathy is accompanied by erythema nodosum it is unlikely to be attributable to a malignant disease. The prognosis in bilateral hilar adenopathy is dependent upon the specific cause and is often very hopeful. Treatment should be directed at the specific cause of the condition.