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

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.