A Tunisian migrant with no past medical history, recently arrived in France, was referred for weight loss and multiple lung nodules on chest X-ray, suggesting lung metastases (Fig. 1a). The patient had worked in Sardigna as a shepherd during the previous 6years. He had never smoked. Physical examination was normal. Routine blood examination showed eosinophilia of 1.7G/L. A CT scan of thorax and abdomen is shown in Fig. 1b and c.