Miliary tuberculosis

Case contributed by A.Prof Frank Gaillard

Presentation

Prior history of breast cancer. Presents with myalgias, arthralgias, weight loss, decreased and appetite.

Patient Data

Age: 70 years
Gender: Female
CT

There is a large right hilar mass predominantly of soft tissue attenuation, however, there are foci of stippled calcification in a circular pattern within it just lateral to the bronchus intermedius. The mass itself encases the right mainstem bronchus as well as right lobar bronchi. There is associated slight narrowing of the encased bronchi.

There is an enlarged right paratracheal lymph node and a calcified node. Significant subcarinal adenopathy is also noted and has displaced the oesophagus to the left. An associated large right pleural effusion is present. 

Additionally, there are innumerable 1-2mm pulmonary nodules distributed in a random pattern. Several larger nodules measuring up to 2 cm in size are noted primarily within all of lobes on the right consistent with tuberculomas. 

IMPRESSION: 

The findings are in keeping with miliary tuberculosis. The large right hilar mass is likely conglomerate adenopathy, however, an underlying mass cannot be excluded.

Case Discussion

Despite the history of malignancy, this demonstrates miliary opacities suggestive of miliary TB rather than metastases. Bronchial wash positive for AFB.

 

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Case information

rID: 6552
Published: 9th Jul 2009
Last edited: 16th Jul 2018
System: Chest
Inclusion in quiz mode: Included

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