Miliary Pattern

A miliary pattern, as seen on a chest radiograph, refers to the presence of multiple tiny (1–3 mm) nodular opacities scattered diffusely throughout the lung parenchyma (Figure 1). In Stedman’s Medical Dictionary ¹ ,-the word miliary is defined as ‘resembling a millet seed in size.’ The term has its origins in the Sepulchretum ² , a book republished by Jean Jacques Manget (1652–1742) in 1700. The Sepulchretum is a collection of autopsy cases with pathologic descriptions. Manget, a Prussian physician, added several of his own cases to those already published by Theophilus Bonetus (1620–1689) of Geneva. One of Manget’s cases was a 17-year-old lad who had died of tuberculosis (TB). The tubercles throughout the lungs, liver, spleen and mesentery were described by Manget as the size of millet seeds (magnitudine seminum milii) ³ . The seed analogy may relate to Heironymous Frascatorius’ 1546 theory, published in his De Contagione, that ‘imperceptible particles or ‘seminaria, the seeds of disease … could exist outside the body for several years and still infect.’ ⁴ Figure 1 Chest radiograph of patient with miliary tuberculosis. Case courtesy of Dr M. Lesar, Bethesda Naval Hospital https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9781003076568/34c29fd5-5662-4e8f-b58c-badd7fa5d724/content/fig55_1_B.jpg"/>