Enlarged lymph node shadow in the lung suggests the possibility of inflammation, tuberculosis and tumor. If inflammation is present, clinical findings may include cough, coughing, high fever, chest pain, and even blood in the sputum. In case of tuberculosis, polymorphic changes in the lung may be seen, including plaques, exudates, proliferation, nodules, calcifications, pleural thickening, and cavity formation. These changes are accompanied by enlargement of pulmonary lymph nodes, suggesting the possibility of tuberculosis. If the lung lymph nodes are enlarged due to tumor, it is necessary to distinguish between central type lung cancer or peripheral type lung cancer. Central type lung cancer may present with enlarged hilar lymph nodes, accompanied by obstructive pneumonia and pulmonary atelectasis. Clinically, irritating dry cough, blood in sputum, chest pain, accompanied by progressive body wasting can be seen, and fiberoptic bronchoscopy can further clarify the pathological cell nature of central type lung cancer. If the lymph node enlargement caused by peripheral type lung cancer is mainly manifested by chest pain, chest CT can suggest the diagnosis. Therefore, swollen lymph nodes in the hilar lung suggest inflammation, tuberculosis, or tumor, and enhanced CT of the chest can be given to further clarify the diagnosis if necessary.