From the Guidelines

Yes, mediastinal lymphadenopathy can cause perihilar atelectasis.

Mediastinal lymphadenopathy can lead to compression or obstruction of the airways, resulting in perihilar atelectasis 1.
The compression or obstruction can cause a decrease in lung volume, leading to atelectasis, which is a common finding in patients with mediastinal lymphadenopathy 1.

Patients with mediastinal lymphadenopathy may present with symptoms such as cough, dyspnea, and chest pain, which can be related to the underlying cause of the lymphadenopathy, such as lung cancer or lymphoma 1.
The presence of perihilar atelectasis can further exacerbate these symptoms, making it essential to diagnose and manage the underlying condition promptly.

Imaging studies, such as CT scans, can help diagnose mediastinal lymphadenopathy and perihilar atelectasis 1.
The size and texture of the lymph nodes, as well as the presence of FDG activity on PET/CT, can provide valuable information for diagnosis and management 1.

The management of mediastinal lymphadenopathy and perihilar atelectasis depends on the underlying cause and may involve a multidisciplinary approach, including surgery, radiation therapy, and medical therapy 1.
In some cases, the treatment of the underlying condition can lead to resolution of the perihilar atelectasis, improving symptoms and quality of life.

From the Research

Mediastinal lymphadenopathy refers to the enlargement of lymph nodes in the mediastinum, which can be caused by various conditions, including infections, inflammatory diseases, and malignancies 2, 3.
Perihilar atelectasis is a condition characterized by the collapse of lung tissue in the perihilar region, which can be caused by various factors, including obstructive airway diseases, infections, and malignancies.
There is evidence to suggest that mediastinal lymphadenopathy can cause perihilar atelectasis, particularly in cases where the enlarged lymph nodes compress or obstruct the airways, leading to lung collapse 4.
A study published in 2020 reported a case of diffuse large B-cell lymphoma arising from the lesion of chronic lobar atelectasis, which highlights the potential for mediastinal lymphadenopathy to contribute to the development of perihilar atelectasis 4.

The exact mechanisms by which mediastinal lymphadenopathy causes perihilar atelectasis are not fully understood, but it is thought that the enlargement of lymph nodes can lead to compression or obstruction of the airways, resulting in lung collapse 5, 4.
There is also evidence to suggest that conditions such as chronic obstructive pulmonary disease (COPD) and pulmonary arterial hypertension (PAH) can contribute to the development of both mediastinal lymphadenopathy and perihilar atelectasis 6, 5.
The presence of pleural and pericardial effusions has also been associated with mediastinal lymphadenopathy and perihilar atelectasis, suggesting a possible pathophysiological mechanism involving increased lymphatic flow caused by right heart failure 5.

The diagnosis of mediastinal lymphadenopathy and perihilar atelectasis typically involves imaging modalities such as computed tomography (CT) and positron emission tomography (PET) scans 2, 3.
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has also been used to diagnose mediastinal lymphadenopathy and perihilar atelectasis, particularly in cases where lymphoma is suspected 4.