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case_images: Chest radiograph anteroposterior (AP) view demonstrating multiple innumerable tiny nodules scattered in both lungs fields.
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case_images: A Chest Radiograph (Fig. 1) showed diffuse, innumerable tiny nodules scattered in both lungs, in keeping with military nodules.
case_images: High resolution CT (HRCT) thorax in coronal view showed diffuse discrete innumerable tiny nodules in random distribution scattered in both lungs predominantly at bilateral upper lobes.
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case_images: The contrasted enhanced computed tomography (CECT) chest (Fig. 2) showed diffuse discrete innumerable tiny nodules of random distribution scattered in both lungs, predominantly at bilateral upper lobes.
case_images: (A) Axial CT thorax at the level of left atrium showed a well-defined rounded hypodense lymph node likely suppurative lymph node at right station 11 (arrow). (B) Multiple hypodense cervical lymph node with the largest at left 1b (arrow).
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case_images: Subsequently, CECT of neck and thorax, revealed multiple necrotic lymph nodes at bilateral cervical and mediastinal regions (Fig. 3).
case_images: Coronal view of CT Thorax demonstrating two well-defined rounded hypodense lesions at bilateral suprarenal regions (arrow), likely arising from both adrenal glands. These lesions demonstrated irregular thick enhancing wall which could represent abscess formation.
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case_images: Other findings were two large, well-defined, rounded hypodense lesions at bilateral suprarenal regions, likely arising from both adrenal glands (Fig. 4).
case_images: Haematoxylin & Eosin (H&E) section shows a vague granulomatous inflammation (red arrow) in the background of mixed inflammatory cells (200 x H&E).
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case_images: The diagnosis of disseminated rhinosporidiosis was then made based on the constellation of these findings and histopathology examination (HPE) (Fig. 5, Fig. 6).