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Dense hilum sign

Case contributed by Henry Knipe
Diagnosis almost certain

Presentation

Cough for a few weeks.

Patient Data

Age: 60 years
Gender: Male
x-ray

Right hilum is dense and enlarged compared to the left. Elevated right hemidiaphragm suggests volume loss or phrenic nerve palsy. 

ct

Superior segment right lower lobe mass extends to the hilum.

Right hilar and subcarinal lymphadenopathy.

Right adrenal mass.

Case Discussion

The CT findings almost certainly represent a metastatic lung cancer, but the patient did not want any further investigation or treatment and the histology is unknown. 

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