What u are seeing is the inside of a bronchus of a 49 year old male who presented with Fever dysentry and cough for 3-4 weeks.... He had had recent travel history to bangladesh and developed dysentry there and gives history of drug abuse and active sexual life... on returning to malaysia he still had continious fever and Loss of weight....... on CXR a hypodense mass seen over the left apical region .....he was covered with antibiotics ...blood c&s was normal.... he was Anaemic Hb 8+... biopsy of this cobble shapped mass was taken. Proctoscopy reveled he has hemmoroids thus banding was done... a full CT thorax abdomen pelvis was done in view that the temperature refused to settle. CT showed a single ring like lesion on the brain . He discharged himself and wanted to wait for biopsy results at home. 3 weeks later once traced it showed necrotic tissue. fever still present. Ct guided biopsy of the mass was done. He was transfused again as HB still LOW. 1 week later biopsy results came back as Small Cell CArcinoma of the lung ,and the single round mass on brain was actually a metastatic lesion. Family wanted to discuss options before starting CHEMO Though strongly adviced to go for Chemo ASAP...in less than 2 weeks after confirmation of the results came, he started to develop Left sided seizures and was readmitted in emergency within 2 days he passed away..... Malignancy pulled wool over the eyes of us medical practisioners by hiding behing an atypical presentation .. It lead us to belive it was a travel related disease .... Immunocompramised disease..... and many more before settling to be the most fatal of em alll.....