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We report a case of neurogenic pulmonary edema (NPE) caused by middle cerebral artery infarction involving the right insular cortex. Hyperactivity of the insular cortex, which regulates sympathetic function, can cause NPE. The NPE should be considered in the differential diagnosis of dyspneic patients with insular cortex infarction.

Sarcoidosis may occur after treatment with pulmonary tuberculosis and requires differential diagnosis from tuberculosis reactivation. Miliary sarcoidosis should be promptly differentiated from miliary tuberculosis associated with high mortality.

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Key Clinical MessagePancreaticopleural fistula should be considered in alcohol abusers with pleural effusion, which can exhibit a black color.