Miliary opacities (lungs)
Citation, DOI, disclosures and article data
Citation:
Gaillard F, Yu Y, Altadill A, et al. Miliary opacities (lungs). Reference article, Radiopaedia.org (Accessed on 03 Mar 2025) https://doi.org/10.53347/rID-1679
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rID:
1679
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Disclosures:
At the time the article was created Frank Gaillard had no recorded disclosures.
View Frank Gaillard's current disclosures
Last revised:
Disclosures:
At the time the article was last revised Yoshi Yu had no financial relationships to ineligible companies to disclose.
View Yoshi Yu's current disclosures
Revisions:
34 times, by
20 contributors -
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Systems:
Sections:
Tags:
Synonyms:
- Differential of miliary pulmonary opacities
- Miliary nodules
- Miliary nodule
- Miliary opacity
- Miliary nodular opacities
- Miliary opacities (lung)
- Miliary opacities
- Miliary pattern
- Miliary pattern (lungs)
The term miliary opacities refers to innumerable, small 1-4 mm pulmonary nodules scattered throughout the lungs. It is useful to divide these patients into those who are febrile and those who are not.
Additionally, some miliary opacities are very dense, narrowing the differential - see multiple small hyperdense pulmonary nodules.
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Pathology
Etiology
The causes can be broadly subgrouped dependent on whether or not the patient is febrile.
Afebrile
- infection
- tuberculosis (often febrile but may be afebrile)
-
fungal (often febrile)
- immunocompromised or elderly patients may be afebrile
- healed varicella pneumonia
- miliary metastases
- others
- sarcoidosis: miliary sarcoidosis 8
- pneumoconioses
- pulmonary hemosiderosis
- BCGosis
- hypersensitivity pneumonitis
- Langerhans cell histiocytosis (LCH)
- multifocal micronodular pneumocyte hyperplasia (MMPH)
- diffuse pulmonary meningotheliomatosis 9
-
pulmonary alveolar proteinosis
- small acinar opacities can mimic a miliary pattern 6
Febrile
- infection
- tuberculosis
- fungal
- viral pneumonitis
- nocardiosis
- salmonella
- melioidosis - occasionally described although not in radiology literature 10
- hypersensitivity pneumonitis (mild fever if any)
History and etymology
The term miliary is derived from the millet seed, a term used to describe a group of small-seeded species of cereal crops or grains, widely grown around the world for food and fodder 5.
See also
Quiz questions
References
- 1. Umeoka S, Koyama T, Miki Y et-al. Pictorial review of tuberous sclerosis in various organs. Radiographics. 28 (7): e32. doi:10.1148/rg.e32 - Pubmed citation
- 2. Mccook TA, Kirks DR, Merten DF et-al. Pulmonary alveolar proteinosis in children. AJR Am J Roentgenol. 1981;137 (5): 1023-7. AJR Am J Roentgenol (abstract) - Pubmed citation
- 3. Collins J, Stern EJ. Chest radiology, the essentials. Lippincott Williams & Wilkins. (2007) ISBN:0781763142. Read it at Google Books - Find it at Amazon
- 4. Roche CJ, O'keeffe DP, Lee WK et-al. Selections from the buffet of food signs in radiology. Radiographics. 22 (6): 1369-84. doi:10.1148/rg.226025521 - Pubmed citation
- 5. Andreu J, Mauleón S, Pallisa E et-al. Miliary lung disease revisited. Curr Probl Diagn Radiol. 2003;31 (5): 189-97. Pubmed citation
- 6. Voloudaki AE, Tritou IN, Magkanas EG et-al. HRCT in miliary lung disease. Acta Radiol. 1999;40 (4): 451-6. Pubmed citation
- 7. McGuinness G, Naidich DP, Jagirdar J et-al. High resolution CT findings in miliary lung disease. J Comput Assist Tomogr. 1992;16 (3): 384-90. Pubmed citation
- 8. Taki M, Ikegami N, Konishi C, Nakao S, Funazou T, Ariyasu R, Yoshida M, Nakagawa K, Morita K, Hee Hwang M, Yoshimura C, Wakayama T, Nishizaka Y. Pulmonary Sarcoidosis Presenting with Miliary Opacities. Internal medicine (Tokyo, Japan). 54 (19): 2483-6. doi:10.2169/internalmedicine.54.4681 - Pubmed
- 9. Jayaschandran V, Gjorgova-Gjeorgjievski S, Siddique H. An uncommon cause of miliary pattern of pulmonary nodules-diffuse pulmonary meningotheliomatosis. (2017) Respirology case reports. 5 (4): e00238. doi:10.1002/rcr2.238 - Pubmed
- 10 .Tan R, et.al. Melioidosis mimicking miliary tuberculosis. (2019) Forensic science, medicine, and pathology. doi:10.1007/s12024-018-0026-3 - Pubmed
Incoming Links
Articles:
- Pulmonary nodule
- Miliary lung nodules (mnemonic)
- Chest curriculum
- Pulmonary alveolar microlithiasis
- Interstitial lung pattern (radiograph)
- BCGosis
- Varicella pneumonia
- Pulmonary metastases
- Tropical pulmonary eosinophilia
- Vegetable and plant inspired signs
- Disseminated histoplasmosis
- Pulmonary coccidioidomycosis
- Miliary sarcoidosis
- Sarcoidosis (thoracic manifestations)
- Miliary tuberculosis
- Tuberous sclerosis
- Diffuse pulmonary nodules
- Tuberculosis (pulmonary manifestations)
- Pulmonary Langerhans cell histiocytosis
- Primary pulmonary tuberculosis
Cases:
- Adenocarcinoma of the lung with miliary lung metastasis
- Paediatric disseminated tuberculosis
- Miliary tuberculosis
- Pulmonary miliary metastases
- Miliary sarcoidosis
- Miliary nodules from thyroid cancer metastases
- Miliary nodules
- Miliary tuberculosis
- Miliary tuberculosis
- Pulmonary tuberculosis - miliary and endobronchial spread
- Acute miliary histoplasmosis
- Pulmonary sarcoidosis (stage II)
- Sarcoidosis: with miliary involvement
- Metastatic papillary thyroid cancer
- Healed varicella pneumonia
- Miliary tuberculosis
- Miliary tuberculosis
- Miliary tuberculosis
- Miliary tuberculosis
- Miliary tuberculosis
Multiple choice questions:
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