A 45-year-old male patient presented with a-one week history of pleuritic chest pain, cough, and breathlessness. He had a diagnosis of chronic obstructive pulmonary disease for eight years. His initial chest radiograph revealed left. lower zone infiltration. A cavitary lesion developed despite treatment with two antibiotics. Thorax computerized tomography scan revealed bilateral cavitary lesions and aneurysms in the main pulmonary arteries. Later, the patient reported recurrent oral ulcers, but rhinoscopy demonstrated nasal septal perforation. A definitive diagnosis could not be established despite biopsies from the nasal septum and buccal mucosa.