Tuberculosis of the lungs is prevalent worldwide, especially in developing coun­tries. Disseminated tuberculosis (TB) is an infection in two or more noncontiguous locations caused by Mycobacterium tuberculosis hematogenous dissemination due to primary infection or reactivation of a latent infection. Miliary tuberculosis also refers to TB that is progressing and widespread. Even if the conventional pathologic or radiologic signs are lacking, it implies a hematogenous spread to numerous organs [8, 9]. Tuberculosis is caused by the small aerobic non-motile bacillus Mycobacterium tuberculosis infecting the lungs (MTB). When patients with an active MTB infection cough, sneeze, or otherwise transmit their saliva, it spreads. Lung cancer is an etiologically complicated disease in which several genes play a role in the pathogenesis of the disease through various routes. Individuals may develop lung cancer when these genes interact with environmental conditions [7]. Tuberculosis must be distinguished from lung cancer to receive proper and timely treatment [10]. According to reports, delaying the identication and treatment of lung cancer often results in a poor outcome and survival rate [7]. However, because lung cancer and tuberculosis are often confused, an invasive biopsy separates the two diseases. Even radiologists with decades of expertise may misdiagnose tuber­culosis and lung cancer utilizing CT imaging data in clinical practice or even miss the diagnosis entirely [11]. Pulmonary nodules are spherical intrapulmonary lesions less than 3cm [12]. In both lung metastases and HDTB, several tiny pulmonary nodules are common. Because the imaging manifestations are so similar, it’s chal­lenging to make a denitive diagnosis [13]. Lung cancer nodules have dened edges and may contain cavities or ground-glass opacity. In hematogenous disseminated tuberculosis, the margins of nodules are not apparent and may show hollow or ground-glass opacity. The CT scan of the patient’s lungs revealed several spherical nodules of various sizes with distinct borders and partial fusion. The intrahepatic bile duct and pancreas were dilated, the pancreatic head was enlarged, and the spleen had several low-density foci. CA19-9 is regarded as a pancreatic cancer marker. Pancreatic and biliary ductal cells and stomach, colon, endometrial, and salivary epithelia produce CA19-9 [14]. CA19-9 is only seen in trace amounts in serum. On the other hand, this signal has low specicity [15]. CA19-9 overexpres­sion has been seen in various benign gastrointestinal illnesses and pancreatic tuber­culosis [16, 17]. CA19-9 levels were dramatically elevated in our patient, who also played a role in the misdiagnosis of the disease. Disseminated tuberculosis, once almost exclusively diagnosed in children or people with immunosuppression, is increasingly detected in adults with no apparent immunological deciency [18, 19]. The majority of these patients come from countries where tuberculosis is prevalent. Patients’ access to the healthcare system is hampered by several circumstances, including a language barrier and frequent relocation, which can lead to a delay in diagnosis and, as a result, disease progression [19, 20].