CTICasesMiliary Pulmonary Metastases from Lung Adenocarcinoma
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Imaging findings
Sequential chest CT scans demonstrate progress of previously treated lung adenocarcinoma, showing multiple bilateral, diffuse, randomly distributed micronodules (miliary pattern) throughout both lungs without significant interlobular septal thickening. Some of the nodules directly abut the pleural surfaces.
Key takeaways
A miliary or random pattern of micronodules is classically seen in hematogenous infections (tuberculosis, fungal infections) or metastatic disease from thyroid, renal, or breast primaries. Although uncommon, primary lung adenocarcinoma can present with hematogenous miliary metastases, which can show dramatic response to targeted therapies like tyrosine kinase inhibitors (e.g., erlotinib/Tarceva).
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