tag:blogger.com,1999:blog-12660458.post111722831054947352..comments2023-09-01T10:33:09.297-04:00Comments on Pulmonary Roundtable: Enlarged hilar lymph nodesUnknownnoreply@blogger.comBlogger6125tag:blogger.com,1999:blog-12660458.post-14850390070577842442008-02-23T20:40:00.000-05:002008-02-23T20:40:00.000-05:00Did anyone ever test the Radon Gas levels in her h...Did anyone ever test the Radon Gas levels in her home. i presented with the same symptoms and have now mitigated our home and am doing much better. simple. basic. Deadly Radon Gas.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-12660458.post-37402451185339670922007-10-01T03:06:00.000-04:002007-10-01T03:06:00.000-04:00Don't forget to rule out Lofgren's! It presents v...Don't forget to rule out Lofgren's! It presents very similarly to Sarcoid. Although, the high ACE levels would suggest Sarcoid, I would want to also check the serum Ca++ level to furthur indicate sarcoid. I would assume Sarcoid but, don't forget about Lofgrens!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-12660458.post-1117292008968145972005-05-28T10:53:00.000-04:002005-05-28T10:53:00.000-04:00I would also try and get tissue. Sarcoid would be...I would also try and get tissue. Sarcoid would be up there on my list. Mesenteric TB can present with large retroperitoneal adenopathy, abdominal pain and even small ascites. Fever is not always present. Lymphoma would also be a concern.Baleeirohttps://www.blogger.com/profile/03993066135160692535noreply@blogger.comtag:blogger.com,1999:blog-12660458.post-1117281463341177142005-05-28T07:57:00.000-04:002005-05-28T07:57:00.000-04:00I missed the statement that her abdominal pain had...I missed the statement that her abdominal pain had resolved. Given her current lack of symptoms, I agree that watchful waiting is appropriate. If her abdominal symptoms return or worsen, than I would re-image to see if there were any nodes that were new or increasing in size. If so, I would still obtain a biopsy. Sarcoid can cause bowel obstruction due to mesenteric LAD, but it's not the norm, and I would really hate to miss a treatable lympoma. That said, she's feeling well wihtout treatment and, as stated in my first post, the lack of associated findings makes my suspicion of lympoma pretty low.Jeff Hhttps://www.blogger.com/profile/01209432708535732499noreply@blogger.comtag:blogger.com,1999:blog-12660458.post-1117230203347193602005-05-27T17:43:00.000-04:002005-05-27T17:43:00.000-04:00I agree that sarcoid is so far up the list that I ...I agree that sarcoid is so far up the list that I might get TBBx's to confirm it and then follow.<BR/>I have recently seen a case of sarcoid involving the mesenteric nodes to such an extent that the patient required surgery for an SBO. In my opinion, biopsy of the abdominal nodes would be uneccessary of the TBBX confirms the sarcoid diagnosis.<BR/>Once diagnosed, I would just follow symptoms and sprio/DLCO and if stable, would not treat with steroids.<BR/>For me, the fibrosis on HRCT does not remove sarcoid from the top 10 things on the list. Sarcoid causes fibrosis oftentimes, as ya'll know, and it's presence might be the explanation for the low DLCO.Jenningshttps://www.blogger.com/profile/04930453447603683057noreply@blogger.comtag:blogger.com,1999:blog-12660458.post-1117229258007212352005-05-27T17:27:00.000-04:002005-05-27T17:27:00.000-04:00Ok-first, as I'm assuming that the contrast-enhanc...Ok-first, as I'm assuming that the contrast-enhanced CT of the chest and the HRCT were done within a short time frame, the "stable" hilar LAD doesn't mean much. <BR/><BR/>It all started sounding like sarcoid-mild restriction, hilar LAD, otherwise asymptomatic, elevated ACE, but then the presence of lower lobe "fibrotic" areas and the abdominal LAD may be red flags for something else. Sarcoid can cause enlarged abdominal lymph nodes, but would not be typical. <BR/><BR/>On the other hand, if someone had diffuse chest and abdominal LAD associated to a malignancy, particularly a lymphoma, or an infectious disease for that matter, I would expect some symptoms. <BR/><BR/>So, I suppose this is one of those cases of sarcoid where I'd fall on the conservative side and get tissue. In this case, I'd want surgical or core from an abdominal node first, as this could always be incidental sarcoid in a patient with lymphoma. Still, in the end, sarcoid is number one on my list.Jeff Hhttps://www.blogger.com/profile/01209432708535732499noreply@blogger.com