From confusion to clarity - Transbronchial lung biopsy in diffuse pulmonary miliary nodules

Miliary nodules are randomly distributed, small, and discrete nodules, usually of the size of millet seeds (1-2mm).They can be found along interlobular septa, fissures and pleural surfaces.While tuberculosis remains a common cause of miliary nodules in tuberculous endemic countries, several other diseases can also present with miliary nodular pattern.Other diseases which can present with miliary nodules include metastatic nodules, pneumoconiosis, sarcoidosis and other infections like histoplasma and nocardiosis.It is important to recognize this, and a histologic/microbiologic diagnosis should be established in all cases with miliary nodules.This report presents two cases with miliary nodules on HRCT chest where bronchoscopic biopsy helped confirm the diagnosis.