case_images: PMC6125993_01
case_images: A, B: High-resolution computed tomography (perihilar slice) showing normal lung parenchyma and without any lymphadenopathy; C, D: Positron emission tomography scan with flourodeoxyglucose (FDG) showing right upper lung lobe lymphadenopathy (white two-pronged arrows) and increased FDG uptake of lung parenchyma (white one-pronged arrows).
case_images: CNCS-6-021-01.jpg
case_images: PMC6125993_01_CNCS-6-021-01.jpg
case_images: Figure1
case_images: A high resolution CT scan did not show any lymphadenopathy or pulmonary pathology (Figure 1), and angiotensin-converting enzyme levels were elevated at 100 U/L and 102 U/L for 2 draws. See Figure 1 for PET scan image and findings. 
case_images: A: Parathyroid hormone (pg/mL) vs. number of days after presentation (June 15, 2017); B: Vitamin D2 (pg/mL) vs. number of days after presentation; C: Vitamin D3 (pg/mL) vs. number of days after presentation; D: Serum calcium (mg/dL) vs. number of days after presentation; E: Angiotensin-converting enzyme (U/mL) vs. number of days after presentation; F: Serum creatinine (mg/dL) vs. number of days after presentation. P = pamidronate injection (29 days after presentation); D = denosumab injection (41 days after presentation); S = start of prednisone (48 days after presentation).
case_images: CNCS-6-021-02.jpg
case_images: PMC6125993_01_CNCS-6-021-02.jpg
case_images: Figure2
case_images: See Figure 2 for graphs of serum calcium, PTH, 25-hydroxy vitamin D, 1,25-dihydroxy vitamin D, angiotensin-converting enzyme level, and serum creatinine levels.
case_images: A, B, C: Lung biopsy findings showing non-caseating granulomas; D, E, F: Bone marrow biopsy findings showing non-caseating granulomas. Stains: Hematoxylin and eosin stains; Magnification: high power 400x (A, B, C) and low power 100x (D, E, F).
case_images: CNCS-6-021-03.jpg
case_images: PMC6125993_01_CNCS-6-021-03.jpg
case_images: Figure3
case_images: Please see Figure 3 for details of biopsy findings and bone marrow biopsy results.