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Bronchogenic carcinoma usually presents as a mass lesion associated with variable degrees of lung collapse and associated effusion. Although primaries from other sites such as thyroid, choriocarcinoma, and sarcomas may present as miliary mottling, bronchogenic carcinoma presenting this way is uncommon. We present here the case of a 62-year-old housewife, who presented with bilateral miliary shadows on chest radiography and was treated for pulmonary tuberculosis on the basis of history and radiological findings. As the disease advanced, the diagnosis of primary adenocarcinoma of the lung was made.