Multiple bilaterale Lungenrundherde nach Mammakarzinom

History and admission findings: Multiple new pulmonary nodules were demonstrated at chest radiography in a 69-year-old woman who had been treated for breast cancer ten years previously. Investigations: Laboratory tests suggested mild inflammation. Pulmonary function tests demonstrated small airways disease. But because of an atypical morphology at computed tomography (CT), metastases were considered unlikely. CT-guided percutaneous biopsy revealed cryptogenic organizing pneumonia (COP). Treatment and course: Oral medication with decreasing doses of steroids resulted in clinical and radiological improvement. Conclusions: Even in a patient with known malignancy the differential diagnosis of multiple bilateral pulmonary nodules includes a variety of conditions and is meticulous, if necessary invasive diagnostic procedures are required.