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



#Miliary #Pattern #Chest #Radiology #differential #diagnosis #pulmonary #CXR #clinical #CT