A woman in her early 60s presented with progressive dysphagia to solid foods for 2 years and new-onset dyspnea associated with cough and fever for 1 week. She had mild weight loss but denied symptoms of anorexia, vomiting, heartburn, chest pain, dyspepsia, hematemesis, or hemoptysis. She had poorly controlled hypertension for 10 years. There was no history of tobacco, alcohol, or drug consumption. Chest radiography results before admission revealed multiple exudative foci in both lungs. Physical examination results on admission showed wheezes and rales in both lung fields and were otherwise normal. There were no abnormalities on routine blood tests. A barium esophagram was performed to evaluate the dysphagia (Figure 1).