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Each of your lungs has a region known as the “hilum.” The hilum is a wedge-shaped area near the center of each lung that opens up to allow for the arteries, veins and bronchi to connect. Hilar lymphadenopathy occurs when the lymph nodes that are located on the hila become enlarged.
When diagnosing hilar lymphadenopathy, doctors may distinguish between it being bilateral or unilateral, meaning it either affects both hila or just one hilum. Below, we will share a breakdown of hilar lymphadenopathy including the symptoms, diagnosis and treatment options.
Understanding Hilar Lymphadenopathy
In order to understand hilar lymphadenopathy, it is important to first have some basic understanding of the anatomy of the lungs as well as the lymphatic system. The hilum (hila plural) is an area located on each lung that connects the lung to its supporting structures. This is where the tubes that connect your windpipe to your lungs (or bronchi) and blood vessels connect.
The lymphatic system helps to maintain fluid balance in the body and support immune function. One important part of the lymphatic system is the lymph nodes. The lymph nodes are small glands that store important immune cells and help to clear out unneeded cells such as damaged cells and cancer cells.
The hila of the lungs have lymph nodes located on them that are prone to certain abnormalities, with hilar lymphadenopathy being one of them. Hilar lymphadenopathy is simply an abnormality of disease of the lymph nodes that are located on the hila. This is usually characterized by an enlargement of the lymph node.
Common Causes of Hilar Lymphadenopathy
There are several other conditions that could potentially cause hilar lymphadenopathy. The lymph nodes can become enlarged for several different reasons. Hilar lymphadenopathy is simply one instance of the lymph nodes becoming enlarged or showing abnormalities. Some common causes of hilar lymphadenopathy include infections, sarcoidosis and cancers.
Infections
Viral, bacterial and fungal infections can all cause the lymph nodes to swell, leading to hilar lymphadenopathy. When an infection is detected by the immune system, more blood cells will rush to the area of infection to help fight off the source. When the blood cells rush to the area, they can cause swelling of the lymph nodes. For this reason, infections affecting the lungs can cause hilar lymphadenopathy.
Sarcoidosis
Diagnosis of sarcoidosis is given when inflammatory cells called granulomas grow in the body. Hilar lymphadenopathy and sarcoidosis often occur together. The cause of sarcoidosis is not known but it may be related to an immune response to infection, foreign chemicals or dust causing an abnormal immune reaction in the body.
Cancers
Cancers such as lymphomas and lung cancers can sometimes cause hilar lymphadenopathy. Advanced cancers may spread to the lymph nodes causing enlargements and abnormalities like hilar lymphadenopathy. Cancers that affect the lungs are most likely to lead to hilar lymphadenopathy.
Symptoms of Hilar Lymphadenopathy
Some common symptoms of hilar lymphadenopathy include:
- Cough
- Chest pain
- Shortness of breath
- Fatigue
- Night sweats
The prognosis for someone who has hilar lymphadenopathy varies depending on the underlying cause of the condition. For example, if hilar lymphadenopathy is only caused by a mild infection, treating the infection may be as simple as taking some antibiotics. Whereas if the underlying cause is cancer treatment may be more complex.
Lymph node enlargement is sometimes mild and normal while other times it may be a sign of something more serious. Small, isolated lymph nodes that are enlarged are often not a serious cause for concern. Whereas multiple enlarged nodes may indicate a need for further testing.
Diagnostic Tests for Hilar Lymphadenopathy
To diagnose hilar lymphadenopathy, your doctor will likely need to do some type of imaging scan to get a good look at the structures of your lungs. Common imaging tests that may be used to look for hilar lymphadenopathy include:
- Chest x-ray
- CT scan with contrast
- PET scan
- Lymph node biopsy
Treatment for hilar lymphadenopathy will vary depending on the underlying cause. If the cause is an infection, your doctor may prescribe antibiotics for the infection. Sometimes corticosteroids are prescribed for inflammatory conditions like sarcoidosis. If the underlying cause is cancer, then chemotherapy or radiation may be recommended.
Imaging scans are vital in diagnosing hilar lymphadenopathy and determining the underlying cause to ensure proper treatment.
Is Hilar Lymphadenopathy Dangerous?
How dangerous this condition is depends on the underlying cause. When treating hilar lymphadenopathy, your doctor will focus on determining and treating the underlying cause of it since there isn’t a direct treatment for hilar lymphadenopathy itself.
Some of the conditions that lead to hilar lymphadenopathy can lead to complications if left untreated. For example, certain infections will require treatment with antibiotics in order to prevent them from spreading and worsening. Sarcoidosis can sometimes go away on its own but can lead to dangerous complications in some instances. If hilar lymphadenopathy is caused by cancer, it is important to work closely with a skilled provider to determine the best treatment approach.
Approaches to Managing Hilar Lymphadenopathy
Treatment options for hilar lymphadenopathy will depend on the underlying cause. There are some cases when hilar lymphadenopathy may resolve on its own but this isn’t always the case. It is important to determine the true cause with your provider in order to treat it accordingly. You may have to take steps to manage symptoms through medication and lifestyle changes.
Making certain lifestyle adjustments can help to support your overall health as well as your lung health and keep you feeling your best. Avoid lung-damaging exposure to things like cigarette smoke, harmful pollutants and chemicals to keep your lungs healthy. If you have a viral and bacterial infection, follow your doctor’s treatment recommendations and take time to rest until the infection resolves. Following a healthy diet and exercise plan will keep you feeling your best and ensure that your lungs stay strong and healthy.
The Role of Lifestyle Medicine in Hilar Lymphadenopathy Management
The doctors at UCF Health use Lifestyle Medicine as a holistic approach to treating patients. The lifestyle medicine doctors at UCF Health strive to identify the underlying cause of the condition, rather than just treating symptoms. Working with a lifestyle medicine doctor when dealing with hilar lymphadenopathy can help ensure that the true underlying cause is identified, helping to treat the condition so you can fully heal.
Conclusion
Hilar lymphadenopathy is a problem in the lungs that causes hilar lymph nodes to become enlarged or show abnormalities. Some cases of hilar lymphadenopathy are more serious than others. Ultimately, it is very important to determine the underlying cause of hilar lymphadenopathy and treat it accordingly.
Working closely with your doctor is essential in determining the true cause of hilar lymphadenopathy in order to determine how serious of a case it is and what type of treatment is most fitting. The Lifestyle Medicine doctors at UCF Health use a holistic approach in determining the true causes of diseases, rather than just treating symptoms. Schedule a visit today to determine a diagnosis and start a unique treatment plan.