A 50-year-old woman was referred to the interstitial lung disease clinic for asymptomatic abnormalities found on chest radiography that were refractory to therapy with antibiotics. The patient had a history of right trigeminal schwannoma that had gone undiagnosed for > 7 years. This delay in diagnosis had caused the patient to undergo a highly complicated resection that left the patient with a seizure disorder and severe trigeminal neuralgia. The patient had come to medical attention during a preoperative evaluation for cortical stimulation for her chronic pain when she was found to have an abnormal chest radiograph showing airspace consolidation in the middle lobe and both lower lobes (Fig 1A and B). The patient had a > 100-pack-year smoking history and a family history of lung cancers. A review of systems revealed Raynaud phenomenon and aspiration of food and liquids.