Bilateral Hilar Adenopathy in Amyloidosis

To the Editor: Bilateral hilar adenopathy can be an important roentgenographic feature of amyloidosis. Failure to appreciate this fact initially led to diagnostic uncertainty in the case recorded below. A 47-year-old white housewife entered the hospital for investigation of malaise. Physical findings were normal. Chest roentgenograms demonstrated bilateral hilar adenopathy but no parenchymal or anterior mediastinal disease. We suspected sarcoidosis or lymphoma. Surprisingly, however, scalene-lymph-node biopsy showed amyloid. Did the woman have amyloidosis alone, or did she have another primary illness? That question seemed answered when subsequent hepatic and hilar-lymph-node biopsies also displayed amyloid as the only histologic aberration. Nine., No extract is available for articles shorter than 400 words.