A 70-year-old woman with a history of bronchiectasis diagnosed with bilateral pulmonary nodules was examined. She was a non-obese (body mass index: 18.3 kg/m²), non-diabetic never-smoker. The pulmonary nodules had been present for 4 years. Chest CT revealed multiple, well-defined and homogenous subcentimetre nodules of variable sizes scattered in the left and right lungs. The average nodule was –150 Hounsfield units (HU) with a density slightly less than muscle and similar to fat (HU: –50 to –200). The follow-up chest CTs with an interval of 4 years demonstrated slight growth of those pulmonary nodules (figure 1). Video-assisted thoracoscopic lung biopsies were performed on the left side. Two small pieces of lung tissue containing pulmonary nodules …