Lung adenocarcinoma presenting as miliary lung metastasis on imaging

Intrapulmonary miliary metastasis is a rare presentation of adenocarcinoma of the lung, characterized by the dissemination of cancer cells throughout the lung parenchyma in different patterns. This case report highlights an unusual presentation of adenocarcinoma of the lung with intrapulmonary miliary metastasis, emphasizing the diagnostic challenges and management considerations. Here, we report a case of a 51-year-old female who presented to the emergency department (ED) with a 2-month history of dry cough, which started after a flu illness and was associated with mild shortness of breath, left-sided chest pain, and miliary nodules on chest imaging. During bronchoscopy, a transbronchial biopsy was taken for further pathological assessment. The results showed histopathological evidence of lung adenocarcinoma.