Pulmonary miliary metastases

Case contributed by Rasha Ragab
Diagnosis certain

Presentation

Cough and chest pain.

Patient Data

Age: 60 years
Gender: Female

Chest

x-ray
  • multiple nodular opacities are seen scattered in both lung fields (miliary pattern)

  • nodular opacity is seen at the left hilum superimposed on the adjacent mediastinum 

  • costophrenic angles are clear

  • cardiac shadow is within normal limit

Findings are in keeping with miliary lung metastatic deposits, proved by CT chest (not shown) and the patient has been discovered to have thyroid cancer and underwent thyroidectomy.

Thyroid gland

ultrasound

Ultrasound of thyroid gland was done revealing a left hypoechoic ill-defined nodule with punctate calcification, classified as (TI-RADS 5).

Case Discussion

The lungs are the second most frequent site of metastatic growth from extra-thoracic malignancies, with secondary pulmonary lesions being detected in 20–54% of cases.

The most common primary tumors to result in pulmonary metastases include breast, colorectal, renal carcinoma, uterine leiomyosarcoma, and head & neck carcinoma.

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