Luis Antonio Sosa MD, Presenter: Nothing to Disclose

Kaushik S. Shahir MD, Abstract Co-Author: Nothing to Disclose

Lawrence R. Goodman MD, Abstract Co-Author: Nothing to Disclose

To illustrate the multiple causes of increased density of the hilum on the frontal chest X-ray with lateral radiograph and CT chest correlation.

The dense hilum sign was described by Benjamin Felson and often indicates and abnormality in the hilum itself or in the lung in front or behind it. The importance of this sign is that it may be present serious pathology like cancer but can also be present in benign processes or anatomical variants. There are multiple causes of increased density in the hilum: vascular, bronchial or parenchymal pathologies. Projectional artifacts may occasionally contribute.  

The asymmetric increased density of the hilum may be an overlooked radiographic sign. In the presence of this sign, further investigation with lateral radiograph or contrast CT chest is required. This presentation revisits the various possibilities that cause this sign. This would be contrasted with hilum convergence and hilum overlying.

Sosa, L, Shahir, K, Goodman, L, Dense Hilum Sign: An Important Sign with Multiple Meanings.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9008968.html