Differential Diagnosis for Bilateral Hilar Lymphadenopathy and Erythema Nodosum
- Single Most Likely Diagnosis
- Sarcoidosis: This is the most likely diagnosis due to the combination of bilateral hilar lymphadenopathy (BHL) and erythema nodosum, which are both common manifestations of sarcoidosis. Sarcoidosis is a systemic granulomatous disease that can affect multiple organs, including the lungs and skin.
- Other Likely Diagnoses
- Lymphoma: Both Hodgkin's and non-Hodgkin's lymphoma can cause BHL and may be associated with skin manifestations like erythema nodosum.
- Tuberculosis: Although less common, tuberculosis can cause BHL and erythema nodosum, especially in endemic areas.
- Inflammatory bowel disease (IBD): IBD, such as Crohn's disease or ulcerative colitis, can be associated with both BHL and erythema nodosum, although this is less common.
- Do Not Miss Diagnoses
- Lymphangitic carcinomatosis: This is a rare but potentially life-threatening condition where metastatic cancer spreads to the lymphatic vessels in the lungs, causing BHL. It's crucial to rule out malignancy, especially in patients with a history of cancer.
- Histoplasmosis: This fungal infection can cause BHL and may be associated with erythema nodosum, particularly in immunocompromised patients.
- Rare Diagnoses
- Berylliosis: A rare occupational disease caused by exposure to beryllium, which can lead to BHL and skin manifestations.
- Other granulomatous diseases: Such as granulomatosis with polyangiitis (formerly known as Wegener's granulomatosis) or eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome), which can cause BHL and skin lesions, although these are less common.