Miliary pattern on radiographs are attributed always to
tuberculosis even though the differential diagnoses of miliary
pattern is very wide. This pattern is most commonly caused by
infectious diseases and rarely by malignancies. Primary lung
cancers presenting with miliary shadows is extremely rare.
Here we report a case of 50-year old female, presenting with
15 days of symptoms and CXR PA view showing bilateral diffuse
miliary nodules. HRCT Chest confirmed the miliary pattern
and also showed a mass in left lower lobe. Microbiological tests
for tuberculosis and fungal infections were negative. CECT
Chest gave impression of left lower lobe suspected malignant
lung mass with pulmonary metastasis. Malignancy was
confirmed by CT guided FNAC as Adenocarcinoma lung. PET
scan didnot reveal metastasis in other organs.
CONCLUSION :
Miliary pattern does not always indicate tuberculosis and other
possibilities should be evaluated.