A 76-year-old woman was admitted to Nagoya City University Hospital because she had a nodule in the right middle lobe and hilar and mediastinal lymphadenopathy in chest computed tomography. The nodule was diagnosed as pulmonary nontuberculous mycobacteriosis by CT-guided needle biopsy and the culture of bronchial secretions obtained by bronchoscopy. Mediastinal lymphadenopathy was diagnosed as sarcoidosis by endobronchial ultrasound-guided transbronchial needle aspiration, and by some clinical findings. Later, a shadow in the left lower lobe of lung had grown and was diagnosed as pulmonary pleomorphic carcinoma by video-assisted thoracoscopic lung surgery. In consideration of the possibility for multiple respiratory diseases, we added some investigations and made accurate diagnoses. To our knowledge, this is the first case of pleomorphic carcinoma complicated with sarcoidosis and pulmonary nontuberculous mycobacteriosis.