CASE PRESENTATION: A 27 year man presented to emergency room with fever and dry cough. He has known pre-B cell acute lymphoblastic leukemia and underwent chemotherapy for a relapse about 2 months ago. Patient had severe and prolonged neutropenia. Prior to hospitalization, he was treated for a pneumonia with broad spectrum antibiotics. Radiograph of chest showed a left lower lobe infiltrate, while CT scan showed bilateral lower lobe nodules in centrilobular distribution with tree-in-bud appearance, additionally, a dense, mass-like acinar infiltrate was noted in the left lower lobe. Flexible bronchoscopy showed an endobronchial mass occluding the posterior sub segment of left lower lobe bronchus. Broncho-alveolar lavage cytology showed numerous fungi morphologically consistent with Zygomycetes species. Treatment with liposomal amphotericin B was initiated. In view of his immunocompromised state, risks of post obstructive pneumonia and hemoptysis, removal of the mass was planned. Severe, refractory thrombocytopenia precluded surgical resection. Repeat flexible bronchoscopy was performed under general anesthesia after platelet transfusion. Using a cryotherapy probe the endoluminal mass was removed in piecemeal. Histopathology was consistent with Zygomycetes.