Post 09 - Not Miliary TB: High-Density, Variable-Sized Nodules in a Flour-Mill Worker

60-years old non-smoker man working in a traditional flour mill for 30 years presented with breathlessness.

His CT scan showed multiple small, diffuse nodules (Fig. 1) (red arrows) and moderate centrilobular emphysema (green arrow).

He was diagnosed to have miliary tuberculosis and put on treatment and didn't improve.

A closer look at the nodules shows they are high density (arrows in Fig. 2) and they are variable-sized (Fig. 3).

Miliary nodules by definition are 2-3 mm sized randomly distributed nodules - and are same-sized (Fig. 4 - another patient).