Dense hilum sign

Last revised by Dr Ian Bickle on 30 Apr 2021

The dense hilum sign suggests a pathological process at the hilum or in the lung anterior or posterior to the hilum. Malignancy, especially lung cancer, should be suspected.

Radiographic features

On a well-centered chest posteroanterior (PA) radiograph the density of the hilum is comparable on both sides. In the absence of calcification or adenopathy, the hila should appear of equal density and be symmetric.

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Cases and figures

  • Case 1
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  • Case 2: lung cancer
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  • Case 3: on right
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  • Case 4: lung cancer on left
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