Background: A 51-year-old female patient was referred for a high-resolution CT scan of the lungs, to screen for bronchiectasis and infection. She had a long medical history starting with right sided breast cancer (pT2N0M0) in 1993 for which she was treated with curative intention (mastectomy with peri-operative chemotherapy and post-operative radiotherapy: 50 Gray in 25 fractions). In 2001, a suspicious lesion was seen on routine chest radiograph during follow-up. On a subsequent CT scan, the lesion could not be characterized with certainty. Therefore, a diagnostic thoracotomy was performed. On pathologic examination, the lesion consisted of reactive organizing cells without signs of malignancy. After thoracotomy, she started having chest pain with severe dyspnea and suffered from recurrent lung infections, unexplained airway obstruction and atypical asthma (there was little reversibility of the airway obstruction with medical bronchodilatation). She was hospitalized many times because of dyspnea and chest pain. Coronary insufficiency, lung emboli or cardiac failure could not be diagnosed. The final working diagnosis was atypical asthma with recurrent exacerbations and infections. The chest pain was diagnosed as neuropathic pain after mastectomy, radiotherapy and thoracotomy. She was severely disabled, depending on oxygen supply at home.