Non-small cell lung cancer with miliary metastases

Case contributed by Chia Wei Oh
Diagnosis almost certain

Presentation

One month history of non-productive cough. Non-smoker

Patient Data

Age: 40
Gender: Female

Stellate lesion in right upper lobe measuring approximately 2.5 x 2.5 x 3.0 cm in size. Multiple miliary nodules noted throughout the lungs. Multiple mildly enlarged lymph nodes in left supraclavicular region.

Case Discussion

This young lady was referred by her GP with a chest x-ray that showed a lesion in the right upper lobe with miliary appearance. She was initially investigated for possible TB given her young age, non-smoking history and chest x-ray findings. CT chest was performed. She then went on to have bronchoscopy for tissue diagnosis. Transbronchial biopsy showed non-small cell carcinoma. Bronchoalveolar lavage did not grow any micro-organism. Mycobacterium tuberculosis complex DNA by PCR was not detected.

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