CTICasesMiliary Tuberculosis with Ghon Complex
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Imaging findings
Frontal chest x-ray shows innumerable bilateral diffuse nodules in a miliary pattern. Initial CT for trauma revealed peribronchial nodules, classic distribution to posterior segments of the left upper lobe, some bronchial wall thickening, and enhancing lymphadenopathy. The follow-up CT demonstrates classic bilateral diffuse miliary distribution of nodules everywhere (central, perivisceral, pleural), with calcification within a nodule and hilar lymph nodes, potentially representing a Ghon complex.
Key takeaways
Innumerable diffuse nodules on chest x-ray often indicate a miliary pattern. The presence of calcified nodules and hilar lymphadenopathy can suggest a Ghon complex in the context of tuberculosis, even if initial imaging was called "tree-in-bud" (which this was clarified not to be). This is a classic presentation of tuberculosis in an immigrant population.
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