Fig. 1.

Computed tomography (CT) of the chest imaging of the upper and lower chest at baseline (A–B) shows subtle emphysematous changes (circle). Five days after cycle 1 of nivolumab (C–D), bilateral, predominantly subpleural ground glass opacities are seen, and no pulmonary embolism was detected. Symptoms and degree of hypoxia appeared disproportionate to the relatively subtle CT findings at day 5 post-nivolumab therapy. At cycle 2, day 11 post-nivolumab, the ground glass opacities are more prominent (E–F). A portable chest radiograph following intubation shows diffuse bilateral airspace disease (G).