Widening of the hilum

Introduction The hilar is wider than normal. The center of the inner side of the lung has an elliptical depression called the hilar, which is the place where the main bronchus, pulmonary artery, pulmonary veins, and bronchial arteries, veins, lymphatic vessels, and nerves enter and exit. There is an oblong depression in the middle of the longitudinal plane, called the hilum. The upper part of the right hilum consists of branches of the right upper pulmonary artery and the pulmonary veins, the lower part consists of the right lower pulmonary artery, and the left hilar consists of branches of the left pulmonary artery and the superior pulmonary vein. On the posterior anterior chest image, the left hilum is slightly higher than the right hilum, the lateral thoracic image, the right hilar is mostly in the front, and the left hilar is in the posterior. It increases, decreases, and other abnormal changes suggest lesions.

Cause

Lung cancer can cause widening of the hilar.

an examination

Imaging studies can be diagnosed.

Differential diagnosis

Differential diagnosis of hilar widening:

1, increased hilar shadow: common in pulmonary edema, lung enlargement accompanied by thickening of the lung texture, careful observation of the phenomenon of floc doping in the blurred lung texture. Focal type: about 20%, characterized by lesions confined to one side or both sides of a lung field. In the bilateral middle and upper lung fields, the shadow distribution is more asymmetrical, and in the lower lung field, the distribution is mostly symmetric. Most of the shadows are clouds of varying sizes and uneven density, sometimes fused into a cotton mass, with blurred edges and no restriction by the leaf gap. Diffuse type: about 55%, characterized by a wide range of lesions, more common in the two lungs, the lower field, or spread to the upper, middle and lower fields. The flaky floc density is high, sometimes it is melted into a cotton lumps, mostly in the middle and inner zones.

"Butterfly" shadow: refers to the chest X-ray showing the thickening and blurring of the lungs and the butterfly-like shadow centered on the hilum. It is the clinical manifestation of lung malaria.

2. Pulmonary malaria refers to the damage of the malaria parasite to the lungs. The body may be infected with Plasmodium with or without typical malaria systemic symptoms and obvious respiratory symptoms such as cough, cough, shortness of breath, wheezing or chest pain. Its clinical manifestations include malaria asthma, bronchitis, pneumonia, pulmonary edema, and acute respiratory distress syndrome (ARDS). Pulmonary malaria is a manifestation of pulmonary systemic damage of malaria parasites, and its incubation period is comparable to that of malaria infection. The number of malaria and ovarian malaria is 10 to 20 days, the malaria is 70 to 80 days, and the falciparum malaria is 10 to 14 days.

3, mediastinal shadow: the mediastinal shadows on both sides widened, the above mediastinum is obvious, because the inflammation involving the surrounding pleura caused the contours on both sides to be blurred. The lateral chest radiograph has an increased density behind the sternum. The outline of the trachea and aortic arch is blurred. An abscess is formed, and a prominent arc shadow can be seen on one side or both sides of the mediastinum, and the trachea and esophagus are displaced by pressure. There may also be signs of mediastinal emphysema, abscess and fluid level, pleural effusion, and liquid pneumothorax. Esophageal lipiodol or organic iodine imaging can confirm the perforation of the esophagus, esophageal bronchospasm or esophageal pleural palsy. Computed tomography can detect early mediastinal inflammation caused by severe deep neck infection.

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