Adenocarcinoma is the most frequently diagnosed histological subtype of bronchogenic carcinomas in women and nonsmokers, and commonly located peripherally. Pulmonary adenocarcinoma, as other bronchogenic carcinomas, can cause distant metastases. However, miliary lung metastasis is rare and generally bone marrow involvement in pulmonary adenocarcinomas is not expected. Here we report a 71-year-old female pulmonary adenocarcinoma patient with miliary lung metastasis and bone marrow involvement.