Step 1: The image shows miliary tuberculosis, the widespread haematogenous dissemination of Mycobacterium tuberculosis. Step 2: It produces a distinctive pattern of tiny 1 to 5 mm nodular lesions scattered evenly throughout both lung fields. Step 3: These innumerable small spots resemble millet seeds, which gives the disease its name miliary. The same seeding can also involve the liver and spleen. Step 4: This uniform fine micronodular spread differs from the dilated airways of bronchiectasis, the hyperinflation of COPD, or a discrete mass of lung cancer, so the answer is miliary tuberculosis.