A 28-year-old man with a 6-pack-year history of smoking and no medical history presented with fever after a business trip. A chest CT scan was performed to rule out coronavirus disease 2019 (COVID-19); multiple 1-to-8-mm pulmonary nodules were detected in the peripheral pulmonary parenchyma of the right lower lobe, but the nodules were not aggregated. Small lung cysts were also observed in the peripheral pulmonary parenchyma of the right lower lobe, suggesting obstructive changes (Fig. 1A-C). The fever disappeared within several days, but the pulmonary nodules were still observed after two months. At first, some type of pulmonary infection was suspected, but laboratory tests were normal including those for cryptococcus antigen, beta-D-glucan, and an enzyme-linked immunospot assay for the diagnosis of tuberculosis. An 18-fluorodeoxyglucose positron-emission tomography (18F-FDG PET)/CT study to rule out metastatic pulmonary nodules showed a slight uptake at the nodular site with a maximum standardized uptake value (SUVmax) of 1.8 without any evidence of primary tumors. The patient underwent a video-assisted thoracoscopic wedge resection as a surgical biopsy. Pathological examination of the resected specimen revealed multiple nodules composed of spindle cells, and immunohistochemistry revealed staining for chromogranin A, synaptophysin, and CD56, suggesting neuroendocrine tumors (Fig. 2). The MIB-1 index was less than 1%, and he was diagnosed as having multiple typical carcinoid tumors and tumorlets. NECH was also observed on some bronchioles (Fig. 3). Underlying disorders such as fibrosis, emphysema or inflammation were not observed. DIPNECH was suspected based on the pathological and CT imaging findings. After the biopsy, a high-resolution CT (HR-CT) scan was performed in the inspiratory and expiratory positions. The maximum intensity projection (MIP) reformation and the minimum intensity projection (MinIP) reformation were also confirmed to screen for undetected nodules and airway obstructions in other lobes. The residual peripheral nodules and airway trapping with small lung cysts in the right lower lobe were observed, but no signs of mosaic perfusion were seen (Fig. 1 D, E). All the nodules could have been resected by performing a right lower lobectomy, but the preservation of lung function was thought to be appropriate. A follow-up CT scan after 6 months showed no changes in the sizes of the nodules and no new lesions.