| Summary points: | A 66-year-old male presents with flu-like symptoms, shortness of breath, difficulty breathing, and dry cough for 2 weeks. Physical examination, chest radiography, pulmonary function testing, and high resolution computed tomography are described; images provided. The authors discuss the need for an open lung biopsy or video-assisted thoracoscopic surgical biopsy to rule out the presence of lymphomatoid granulomatosis early in the course of illness. |