Correct!
5. All of the above

The thoracic CT scan shows left hilar enlargement secondary to a hilar mass. The mass appears to be unilateral. The differential diagnosis of a hilar mass is large but includes malignant causes such as lung cancer or lymphoma or benign causes such as tuberculosis, fungal disease or sarcoidosis. An incidental finding is that the patient has had bilateral augmentation mammoplasties.

Serologic testing for coccidioidomycosis and histoplasmosis were negative and a serum angiotensin converting enzyme level was normal. She returned to Iowa in May but continued to have cough and chest heaviness. A repeat thoracic CT scan was performed (Figure 2).

Figure 2. Repeat CT scan in lung windows (A-D) and soft tissue windows (E-H).

Which of the following is/are true? (Click on the correct answer to proceed to the third of seven pages)

1. The calcium present in the left hilar region excludes a malignant cause
2. The lack of bilateral hilar enlargement excludes sarcoidosis for all practical purposes
3. There is now definite lung involvement on the left
4. 1 and 3
5. All of the above

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