A 48-year-old black woman presented to the ED with a 1-year history of progressive dyspnea with exertion and chest discomfort. Four years prior, she presented to the ED with dyspnea and eye pain. A chest radiograph done at that time demonstrated hilar adenopathy and pulmonary parenchymal infiltrates. Transbronchial biopsies were performed, and specimens showed epithelioid granulomas, leading to a diagnosis of sarcoidosis. Her dyspnea improved with prednisone, but she was subsequently lost to follow-up. On current presentation, she has no complaints of cough, ocular pain, visual changes, skin lesions, or other systemic symptoms. Her medical history includes schizophrenia, depression, and osteopenia. Medications were lamictal, fluoxamine, seroquel, and depakote. The patient is a nonsmoker and lifelong resident of New York state. She has no history of travel or sick contacts. Family history is notable for laryngeal cancer in her father.