Differential Diagnosis for Bilateral Hilar Lymphadenopathy
- Single Most Likely Diagnosis
- Sarcoidosis: This is the most common cause of bilateral hilar lymphadenopathy, characterized by non-caseating granulomas in lymph nodes and other organs. It often presents with respiratory symptoms, skin lesions, and eye involvement.
- Other Likely Diagnoses
- Lymphoma (Hodgkin's and non-Hodgkin's): Both types can cause bilateral hilar lymphadenopathy, although it's more common in Hodgkin's lymphoma. Symptoms may include fever, night sweats, weight loss, and fatigue.
- Tuberculosis: Although more commonly associated with unilateral lymphadenopathy, tuberculosis can cause bilateral hilar lymphadenopathy, especially in immunocompromised patients. Symptoms include cough, fever, weight loss, and night sweats.
- Histoplasmosis: This fungal infection can cause bilateral hilar lymphadenopathy, particularly in endemic areas. Symptoms may include fever, cough, and fatigue.
- Do Not Miss Diagnoses
- Lymphangitic Carcinomatosis: Metastatic cancer to the lungs can cause bilateral hilar lymphadenopathy. It's crucial to identify this condition early, as it significantly affects treatment and prognosis.
- Wegener's Granulomatosis: Now known as Granulomatosis with Polyangiitis (GPA), this condition can cause bilateral hilar lymphadenopathy, along with renal and sinus involvement. It's essential to diagnose GPA promptly due to its potential for severe organ damage.
- Rare Diagnoses
- Castleman Disease: A rare lymphoproliferative disorder that can cause bilateral hilar lymphadenopathy, often accompanied by systemic symptoms like fever and weight loss.
- Kimura Disease: A rare, chronic inflammatory disorder that can cause bilateral hilar lymphadenopathy, typically accompanied by eosinophilia and IgE elevation.
- Silicosis: A occupational lung disease caused by inhalation of silica particles, which can lead to bilateral hilar lymphadenopathy, especially in individuals with a history of exposure.