Case 1:
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14 year old female presented with history of weight loss and non productive cough of 2 months duration. Chest radiograph done a month earlier was normal.

Chest Pic

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Answer : Diagnosis : Miliary tuberculosis

Miliary nodules are discrete round or oval lesions of 1-5 mm in diameter, and are usually visible only after they reach 2-3 mm in diameter. Causes of miliary mottling of lung fields are several, of which tuberculosis, fungal diseases (histoplasmosis), malignancy (metastatic, alveolar cell carcinoma, lymphoma), pneumoconiosis, sarcoidosis and interstitial fibrosis (subliminal honeycombing) are common. Rare causes include histiocystosis X, amyloidosis, rheumatoid arthritis, hemosiderosis (due to mitral stenosis). Common radiographic findings in tuberculosis include parenchymal infiltration, fibrotic scars, pleural effusion, hilar and mediastinal lymphadenopathy, and bronchiectasis.

Contribution : Dr Rahul Sachdev, New Delhi, India