Bilateral Miliary Shadowing on Chest X-ray

Amer Saleem; Enson Cherian Thomas; Alexander Wilkinson; Mohammed Azher; Nayyar Saleem

Author(s)

Amer Saleem Department of Respiratory Medicine, Bedford Hospital NHS Trust, Bedford, UK.

Enson Cherian Thomas Department of Respiratory Medicine, Bedford Hospital NHS Trust, Bedford, UK.

Alexander Wilkinson Department of Respiratory Medicine, Bedford Hospital NHS Trust, Bedford, UK.

Mohammed Azher Department of Respiratory Medicine, Bedford Hospital NHS Trust, Bedford, UK.

Nayyar Saleem Department of Respiratory Medicine, Bedford Hospital NHS Trust, Bedford, UK.

Abstract

A patient presented with recent onset of increasing shortness of breath, weight loss and low-grade fever. His chest X-ray revealed bilateral miliary shadowing. He was investigated with CT-scanning of thorax. Later, a biopsy from supra-clavicular node and its immunocytochemistry studies confirmed metastasis from primary lung cancer. Primary lung cancer with miliary pulmonary metastases is a rare happening and is mostly associated with lung adenocarcinoma.

Publication Details

Page(s) 902-903

DOI DOI not available

Published Journal: Journal of College of Physicians and Surgeons--Pakistan : JCPSP, Volume: 23, Issue: 12, Year: 2013

Request the full text from PASTIC

Keywords

Chest X-ray, Miliary mottling, Pulmonary alveolar microlithiasis, Miliary tuberculosis, Pulmonary adenocarcinoma, Miliary metastases

References

Kobayashi M,Takeuchi T,Bandobashi K,Uemura Y,Ogawa Y,Ohtsuki Y .2006 .Diffuse micronodular pulmonary metastasis of lung adenocarcinoma predicts gefitinib response in association with epidermal growth factor receptor mutations. Anticancer Res, 26 : 1621-6.

Kim CS,Lee KN,Lee JH .2003 .Comparison of high-resolution CT findings between miliary metastases and miliary tuberculosis. J Korean Radiol Soc, 48 : 147-52.

Togashi Y,Masago K,Kubo T,Sakamori Y,Kim YH,Hatachi Y .2011 .Association of diffuse, random pulmonary metastases, including miliary metastases, with epidermal growth factor receptor mutations in lung adenocarcinoma. Cancer, 117 : 819-25.

Laack E,Simon R,Regier M,Andritzky B,Tennestedt P,Habermann C .2011 .Miliary never-smoking adenocarcinoma of the lung: strong association with epidermal growth factor receptor exon 19 deletion. J Thorac Oncol, 6 : 199-202.

Park J,Park BB,Kim JY,Lee SH,Lee SI,Kim HY .2004 .Gefitinib (ZD1839) monotherapy as a salvage regimen for previously treated advanced non-small cell lung cancer. Clin Cancer Res, 10 : 4383-8.

Kaneda H,Tamura K,Kurata T,Uejima H,Nakagawa K,Fukuoka M. .2004 .Retrospective analysis of the predictive factors associated with the response and survival benefit of gefitinib in patients with advanced non-small-cell lung cancer. Lung Cancer, 46 : 247-54.

Ando M,Okamoto I,Yamamoto N,Takeda K,Tamura K,Seto T .2006 .Predictive factors for interstitial lung disease, antitumor response, and survival in non-small-cell lung cancer patients treated with gefitinib. J Clin Oncol, 24 : 2549-56.

Shepherd FA,Rodrigues Pereira J,Ciuleanu T,Tan EH,Hirsh V,Thongprasert S .2005 .Erlotinib in previously treated nonsmall-cell lung cancer. N Engl J Med, 353 : 123-32.