Lenalidomide has revolutionized treatment of hematologic malignancies since its introduction in 2004. With its US Food and Drug Administration approval for treatment of multiple myeloma, relapsed mantle cell lymphoma, and transfusion-dependent myelodysplastic syndrome (MDS), lenalidomide holds a key place in the therapeutic armamentarium.2,3 Its pleotropic effect is due to an antitumor effect, antiangiogenic activity, and immunomodulatory role. In particular, anticytokine action (ie, against tumor necrosis factor-α, IL-6, IL-12) of immunomodulatory drugs has therapeutic implications in some nonmalignant conditions like cutaneous sarcoidosis and erythema nodosum leprosum.3 Hence, with the available literature and dramatic response in lung function of the index patient, lenalidomide has proven its pivotal role beyond doubt in sarcoidosis. Myelosuppression, diarrhea, increased risk of thrombosis, and opportunistic infections are therapy-related side effects that pulmonologists should be well aware of while prescribing lenalidomide.3,4 Accordingly, we suggest regular monitoring of CBCs and renal function tests apart from the serial lung function tests and imaging studies during therapy. Thromboprophylaxis with oral anticoagulants or aspirin should also be coprescribed with lenalidomide.