Diffuse pulmonary nodules and diagnostic dilemmas: Lung adenocarcinoma masquerading as miliary tuberculosis

Lung adenocarcinoma is the most common subtype of lung cancer, often presenting with nonspecific symptoms. It is rare for adenocarcinoma to mimic miliary tuberculosis, creating a diagnostic challenge. This case report details a 40-year-old male with a 9-month history of dry cough and shortness of breath. Initial chest X-ray demonstrated a miliary pattern of nodular shadows in both lungs and a homogeneous opacity in the middle zone of the left lung. Contrast-enhanced computed tomography (CECT) of the thorax revealed a mass lesion involving the lingular segment of the left upper lobe and diffuse interstitial coarse reticulations with tiny cysts involving both lung parenchyma. A biopsy taken from the left upper lobe lung lesion confirmed the diagnosis of lung adenocarcinoma.