![](https://i0.wp.com/radrounds.com/wp-content/uploads/2021/03/miliary_mets.jpeg?resize=696%2C557&ssl=1)
This patient had had a thyroid malignancy treated with surgical excision and radioactive iodine. This scan was obtained as followup. Note the innumerable miliary metastases scattered throughout both lungs. Thyroid cancer is a classical cause of miliary metastases, with other common primaries being pancreatic cancer, breast cancer and melanoma.
Differential diagnosis includes sarcoidosis, miliary TB and silicosis.
References:
1. Primer of diagnostic imaging – Weissleder
2. StatDx.com
Credit: Dr Frank Gaillard