title: Maintaining sharp focus on a grainy film: miliary pattern in an elderly woman with acute respiratory failure.
abstract: An elderly woman with a history of pulmonary tuberculosis reportedly diagnosed and treated 30 years prior to presentation was found unresponsive at home. Chest imaging revealed innumerable pulmonary nodules worrisome for an infectious process, specifically tuberculosis. The patient deteriorated rapidly and in accordance with her wishes, aggressive interventions were withheld. She died within 48 h from respiratory failure. A limited chest autopsy was performed and revealed the cause of death as lymphangitic spread of cancer from a primary lung adenocarcinoma.
authors.affiliation: College of Medicine, University of Kentucky, Lexington, Kentucky, USA.
authors.forename: Patrick
authors.initials: P
authors.lastname: Hensley
authors.affiliation: Department of Internal Medicine, University of Kentucky, Lexington, Kentucky, USA.
authors.forename: Talal
authors.identifier: http://orcid.org/0000-0001-8249-4128
authors.initials: T
authors.lastname: Hilal
authors.affiliation: Department of Pathology, University of Kentucky, Lexington, Kentucky, USA.
authors.forename: Janna
authors.initials: J
authors.lastname: Neltner
authors.affiliation: Division of Immunology, University of Iowa, Iowa City, Iowa, USA.
authors.forename: Bharat
authors.initials: B
authors.lastname: Kumar
mesh_terms: D000208:Acute Disease; D000230:Adenocarcinoma / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000473:pathology; D000077192:Adenocarcinoma of Lung; D000369:Aged, 80 and over; D001344:Autopsy; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology*; D008175:Lung Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000473:pathology; D011859:Radiography; D012131:Respiratory Insufficiency / Q000209:etiology*; D014391:Tuberculosis, Miliary / Q000000981:diagnostic imaging*