# Miliary Lung Lesions Mimicking Tuberculosis: A Case of Metastatic Lung Adenocarcinoma

## TL;DR

A 39-year-old man with miliary lung lesions was initially treated for tuberculosis but later diagnosed with lung cancer, highlighting the need for early tissue testing.

## Contribution

The paper presents a rare case where lung cancer mimicked tuberculosis, emphasizing the importance of biopsy in diagnostic uncertainty.

## Key findings

- Miliary lung lesions were initially misdiagnosed as tuberculosis.
- Biopsy confirmed metastatic lung adenocarcinoma despite TB treatment.
- Early tissue diagnosis is critical in TB-endemic regions for accurate management.

## Abstract

Miliary patterns on chest imaging frequently prompt urgent consideration of disseminated infectious diseases such as tuberculosis (TB), particularly in patients from endemic regions. However, non-infectious aetiologies like metastatic malignancy must also be considered. We report the case of a 39-year-old previously healthy male with miliary pulmonary lesions initially treated empirically for disseminated TB. Despite therapy, his condition deteriorated until biopsy results confirmed metastatic lung adenocarcinoma. This case highlights the diagnostic challenges in TB-endemic regions and underscores the importance of early tissue diagnosis.