The hilum is the wedge-shaped area on the inner (mediastinal) surface of each lung where the bronchi, blood vessels, nerves and lymphatics enter and leave. It is the 'doorway' of the lung through which the lung root passes. On the right the main bronchus lies highest at the back, while on the left the pulmonary artery is highest.
| Location | Middle of the mediastinal surface of each lung, at about the level of T5-T7 vertebrae; the pulmonary ligament hangs down from its lower edge. |
|---|---|
| Parts |
|
| Nerve Supply | Pulmonary plexus |
| Blood Supply | Pulmonary arteries; Bronchial arteries |
| Venous drainage |
|
| Lymphatic drainage |
|
Provides the entry and exit point for all structures passing between the lung and the mediastinum.
Enlarged hilar lymph nodes are visible on chest X-ray and CT; bilateral enlargement is classic for sarcoidosis, while one-sided enlargement raises concern for lung cancer, tuberculosis or lymphoma. Central tumours often arise near the hilum. Hilar node sampling by endobronchial ultrasound is central to staging lung cancer.
Enlargement of the lymph nodes at the hilum from sarcoidosis, infection, lymphoma or cancer spread. It is often found on chest imaging.
A tumour arising near the hilum in a main or lobar bronchus. It may cause cough, haemoptysis and collapse of lung beyond the tumour.
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