Presentation
Patient well. Incidental finding.
Patient Data
Random distribution of miliary pulmonary nodules. No cavitation. No consolidation. No pleural effusion. No lymph node enlargement / calcification.
Pathology (wedge resection)
Multiple parenchymal and subpleural small foci, each up to 2-3mm in size.
Corresponding to minimal cystic change and collections of uniform fusiform to plump cells
EMA+, PR+, vimentin pending, HMB45-, SMA-/+, AE1/3-, synaptophysin-, chromogranin-, melanA- and pigments.
Intervening lung parenchyma, small airways and blood vessels are unremarkable.
Interstitial fibrosis or inflammation, granulomas, alveolar exudates, Langerhans cell infiltrate, organizing pneumonia, and neoplasia not present.
Miliary ground-glass nodules.
Random distribution.
No significant change.
Case Discussion
Miliary pulmonary nodules in a well patient with no known history of malignancy.
The patient went on to have a non-diagnostic endobronchial biopsy.
Diagnosis made on wedge resection.
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