TB Miliary Disease

Miliary TB
Historical Xray from 60 years ago from the teaching collection of Dr Lloyd Hawes
Ashley Davidoff
TheCommonVein.net
Miliary TB
CTPA reveals innumerable punctate nodules in a randomly distribution (red arrows). There are areas of groundglass opacity predominantly in a central peribronchial vascular distribution in both lungs. No pneumothorax. Differential of innumerable punctate nodules is consistent with miliary TB.
Courtesy Joseph Cannella,
Dr. Christina LeBedis, MD, MS
Transbronchial Spread of TB with Extensive Tree in Bud Changes Masquerading as Miliary TB
CT Active TB Cavitation and Ipsilateral Transbronchial Spread with Extensive Tree in Bud Pattern 
39-year-old immigrant Vietnamese male presents night sweats fever and cough
CXR shows a cavitating lesion in the apex of the right lung (magnified lower image, right) associated with an ipsilateral micronodular pattern (magnified lower image, left)
Although the right lung has the appearance of a “miliary” pattern, this term is usually referred to the hematogenous spread of the disease
Ashley Davidoff MD TheCommonvein.net 131708cL
CT Active TB Cavitation and Ipsilateral Transbronchial Spread with Extensive Tree in Bud Pattern
39-year-old immigrant Vietnamese male presents night sweats, fever, and cough. CT in the coronal plane of the chest shows a large cavitating lesion in the right upper lobe, with innumerable micronodules dominantly in the right midlung field, and to lesser extent in the right upper lung field. Some micronodules are probably present in the left lower lobe as well. Close to the largest subsegmental consolidation there is a bronchus which shows thickening of its wall.
Although it has the appearance has a “miliary” pattern, this term is usually referred to the hematogenous spread of the disease
Ashley Davidoff MD TheCommonvein.net 135786c
006Lu
CT Active TB Transbronchial Spread with Extensive Tree in Bud Changes
39-year-old immigrant Vietnamese male presents night sweats fever and cough. CT in the axial plane through the mid chest shows innumerable micronodules resulting from transbronchial spread with resultant tree in bud pattern scattered through the right lung (magnified in the right lower image). There are minimal similar changes in the lingula (magnified left lower image)..
Ashley Davidoff MD TheCommonvein.net 135789c 006Lu