Answer:
Dear
Toni,
High-resolution
CT scan of the chest may be indicated.
A prominent
hilar shadow on the chest x-ray of a non-smoker suggests sarcoidosis,
pulmonary hypertension or lymphoma.
Other
considerations include tuberculosis or a fungal infection, while lung
cancer is an unlikely diagnosis.
However,
in some cases the isolated x-ray abnormality is not significant for
any disease.
To evaluate
it further, a CT-scan and an electrocardiogram would be needed, and
they may suggest the need for a bronchoscopy and a biopsy of any solid
lesion.
Sputum
examination may not be reliable, and blood tests cannot provide a
definitive diagnosis.
Skin
testing for tuberculosis would be significant if the test was positive,
provided it was known to be negative previously.
A chest
x-ray showning a hilar prominence may suggest sarcoidosis.
Sarcoidosis
(an interstitial lung disease) is a rare disease that results from
inflammation.
Ninety
percent of the cases of sarcoidosis are found in the lungs and is
called pulmonary sarcoidosis.
Sarcoidosis
constitutes 2% of interstitial lung disease.
It may
be suggested a high-resolution CT scan for further investigation.
Sarcoidosis
is usually asymptomatic, which means there are no outward signs that
the person has the disease.
This
is why so many cases of sarcoidosis are discovered by chance during
a routine x-ray.
When
symptoms appear, the most common are:
- Respiratory
(complications with breathing)
- Ophthalmological (pertaining to the eye)
- Dermatological (pertaining to the skin).
A person
may experience shortness of breath (dyspnea), a dry cough that persists,
skin rashes (either erythema nodosum or other types of rashes), or
inflammation in the eye.
Sometimes,
a person with sarcoidosis complains of "feeling sick" and
may experience fever or weight loss.
Sarcoidosis can affect nearly any organ, with the possible exception
of the adrenal gland.
Skin
lesions, or granulomas that develop on the skin, occur in about 25%
of cases of Sarcoidosis .
Most
skin lesions are harmless, although they can cause scarring and disfigurement.
One type,
lupus pernio, develops on the face and can leave scars. Another type,
erythrema nodosum, develops on the legs and is quite painful.
