Miliary opacities (lungs)

Last revised by Yoshi Yu ◉ on 1 Jun 2024

Citation, DOI, disclosures and article data

Citation:

Yu Y, Altadill A, Elfeky M, et al. Miliary opacities (lungs). Reference article, Radiopaedia.org (Accessed on 15 Jan 2025) https://doi.org/10.53347/rID-1679

DOI:

https://doi.org/10.53347/rID-1679

Permalink:

https://radiopaedia.org/articles/1679?iframe=true

rID:

1679

Article created:

2 May 2008, Frank Gaillard ◉ ◈

Disclosures:

At the time the article was created Frank Gaillard had no recorded disclosures.

View Frank Gaillard's current disclosures

Last revised:

1 Jun 2024, Yoshi Yu ◉

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 - see full revision history and disclosures

Systems:

Chest

Sections:

Gamuts

Tags:

infectiousdisease

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.

infection
- tuberculosis (often febrile but may be afebrile)
  - miliary tuberculosis
- fungal (often febrile)
  - immunocompromised or elderly patients may be afebrile
- healed varicella pneumonia
miliary metastases
others
- sarcoidosis: miliary sarcoidosis⁸
- pneumoconioses
  - silicosis
  - coal workers pneumoconiosis
- 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.

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

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Miliary opacities (lungs)

Citation, DOI, disclosures and article data

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Pathology

Etiology

Afebrile