Miliary Pattern - Chest Radiology
• Miliary opacities are scattered, small (1 -4 mm) nodules
• Diffusely distributed throughout the lungs
• Named after the millet seed
• Indicates hematogenous spread of a disease process or (rarely) diffuse inhalational injury
Differential Diagnosis of Miliary Opacities:
• Infectious
- Mycobacterium: Tuberculosis, NTB
- Endemic fungi: Histo, blasto, coccidio
- Select Bacteria: Nocardia, zoonotic infections, meliodosis, rarely typical pneumonia pathogens
- Viral: VZV, CMV, varicella
- Disseminated Parasites: Strongy, schisto
• Malignancy: Lymphoma, Mesothelioma, Miliary mets (thyroid, melanoma, renal)
• Infiltrative / Granulomatous: Amyloid, Sarcoidosis, HSP
• Inhalation: Pneumoconiosis, Vaping
By @PulmPEEPs
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