Fig. 1— a) Axial high-resolution computed tomography (HRCT) image showing nodular thickening extending along central bronchovascular bundles in the apical segment of the left lower lobe. Elsewhere, there were scattered nodular, ground-glass and airspace opacities consistent with pulmonary sarcoidosis. b) Bronchoscopic view of the right main and right upper lobe bronchus (arrow) showing diffuse mucosal erythema. c) HRCT thorax image taken 15 months after initial presentation showing thickened interlobular septa and patchy ground-glass attenuation. The subsegmental pulmonary arteries were enlarged relative to accompanying bronchi, reflecting raised pulmonary artery pressure. There was a small left pleural effusion. d) Contrast-enhanced computed tomography pulmonary angiogram during the patient's final illness, displaying a persistent left pleural effusion with superadded bilateral, patchy airspace consolidation. In addition, a filling defect, presumed thrombus, was seen in the right pulmonary venous confluence (circled in red).