What causes Dense Hilum Sign in lungs on chest radiography?
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Answer:
Dense Hilum Sign: Unilateral increase in hilar density compared to the contralateral side due to pathological processes such as hilar mass (e.g., lung cancer, lymphoma), enlarged hilar lymph nodes, enlarged pulmonary vessels, or superimposed airspace disease (e.g., pneumonia in superior segment of lower lobe).
Why is it called so?:
Named for the increased radiographic density (whiteness) observed at one pulmonary hilum, making it appear denser or more opaque than the normal symmetric contralateral hilum on frontal chest radiograph. The term Dense Hilum Sign emphasizes the focal increase in hilar opacity on the radiographic image.
Pathophysiology:
The sign develops when a mass, lymphadenopathy, or airspace opacity located at the hilum or in the lung anterior/posterior to it (e.g., superior segment) superimposes on the normal hilar vascular structures during the posteroanterior projection, resulting in asymmetric increased opacity while the hilum overlay sign may be lost.
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