Background
Lung adenocarcinoma (LA) is the most frequent histological subtype of
lung cancer worldwide. This condition is categorized from preinvasive
lesions to metastatic adenocarcinoma (1, 2). Smoking is the most common
responsible risk factor for LA so far along with a family history of
lung cancer, occupational exposure, and genetic mutations. In the early
stages, LA can be asymptomatic while in late stages, non-specific
symptoms such as coughing, weight loss, and hemoptysis can occur (3).
Miliary tuberculosis (TB) is the wide-spreading dissemination of
Mycobacterium tuberculosis through the bloodstream. It can affect single
or several organs and through a hematogenous way to the brain (4).
Miliary TB can present with non-specific manifestations including fever,
weight loss, sweats, and anorexia mimicking other diseases especially
primary and secondary lung cancers. Immune suppression due to cancer,
HIV infection, malnutrition, diabetes, transplantation, and end-stage
renal disease are risk factors for this condition (5).
The miliary pattern in lung imaging can present in miliary TB,
occupational lung diseases, different fungal infections, sarcoidosis,
and metastatic diseases from primary or secondary lung cancers;
therefore, diagnosis cannot be distinguished by CT imaging alone.
Further investigations such as serological and pathological tests are
necessary for diagnosis (6, 7).
In the current article, we are presenting a young man with no prior
medical history or risk factor with metastatic lung adenocarcinoma
mimicking miliary TB in imaging.