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Case of the Week 608


What is the most likely diagnosis?

  • 62 year-old with fever and cough



Axial CT Scan of Chest

  1. Silicosis
  2. Bronchoalveolar cell carcinoma
  3. Miliary tuberculosis
  4. Rheumatoid nodules
  5. Multiple arteriovenous malformations

Additional Image - Close-up of Axial CT Scan of Right Hemithorax

 

Additional Images

 

Close-up of Axial CT Scan of Right Hemithorax


Answer:

3. Miliary tuberculosis

More (Click Discussion Tab)

 

 

Miliary Tuberculosis


General Considerations

  • Widespread hematogenous dissemination of Mycobacterium Tuberculosis
  • So named because the nodules are the size of millet seeds (1-5mm with a mean of 2 mm)
  • Miliary TB represents only 1-3% of all cases of TB
  • Older men, African Americans and pregnant women are susceptible
  • Considered to be a manifestation of primary TB–although clinical appearance of miliary TB may not occur for many years after initial infection
  • When treated, clearing is frequently rapid
    • Miliary TB seldom, if ever, produces calcification
  • Under age 5, there is an increased risk of meningitis

MORE . . .


.

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62 year-old with fever and cough
 
 
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Recognizing the parameters that define a good chest x-ray; avoiding common pitfalls
 
How to recognize the most common arthritides




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LearningRadiology.com
is an award-winning educational website aimed primarily at medical students and radiology residents-in-training, containing  lectures, handouts, images, Cases of the Week, archives of cases, quizzes, flashcards of differential diagnoses and “most commons” lists, primarily in the areas of chest, GI, GU cardiac, bone and neuroradiology.