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What is a Hilum? My brother's x-ray showed "a mild asymmetry…

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What is a Hilum? ...

What is a Hilum?

Doctor's Assistant: What are all the symptoms you're experiencing (e.g. loss of appetite, fever, rash)?

My brother's x-ray showed "a mild asymmetry the size and density of the right hilum. This finding is concerning for the underlying mass. The trachea is in the midline." What does this mean?

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

There are bullet fragments in his chest from an old bullet wound where he was shot in an attack about 38 years ago.

Doctor's Assistant: How long have you been dealing with the issue? In general, how has your health been lately?

It stated with what they thought was whooping cough about two weeks ago. They gave him medicine for the cough, which didn't do any good so they ordered the chest x-ray.

Submitted: 8 months ago.Category: Medical
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Answered in 17 minutes by:
11/22/2017
Doctor: Dr. D. Love, Doctor replied 8 months ago
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19,750
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
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Hello from JustAnswer. This is Dr. Love.

A hilum refers to a specific location in an organ at which blood vessels, nerves, and other structures enter that organ. There are actually many organs in the body that have a hilum, not just the lungs. Other organs that have a hilum include the kidneys, the liver, and the spleen.

In the lungs, not only do the blood vessels enter the lung at the hilum, but the airway also enters each lung at the hilum. There are also many other structures that are also located at the hilum of the lung, and the primary other structure are a number of different lymph nodes.

When there is asymmetry of the hilum on one side compared to the other, a common cause is because of enlargement of the lymph nodes in that area, particularly after a recent infection. Lymph node enlargement can occur as a response to infection in the lung, just like lymph nodes elsewhere in the body. However, it is also possible to get asymmetry from a mass in this area, either that has arisen in the airway or that is in the lymph node.

The fact that the trachea is in the midline (which is where it is supposed to be) indicates that whatever is causing the asymmetry of the hilum is not pushing the trachea out of position.

A plain chest x-ray is not able to separate the various structures that occur in the hilum. A CT scan is better able to distinguish the various anatomic structures. If the doctor thinks that the asymmetry is due to lymph node enlargement from a recent infection, then the doctor may simply repeat the chest x-ray after some time for recovery. But another option is to perform a CT scan.

If I can provide any additional information, please let me know.

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Doctor: Dr. D. Love, Doctor replied 8 months ago

Please let me know if I can provide any further assistance.

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