A 62-year-old woman was referred to our hospital owing to a cough. Chest computed tomography (CT) showed multiple areas of consolidation below the pleura in the right lower lobe of the lung. After 1 month, chest CT demonstrated alveolar opacities in addition to consolidation. A diagnostic biopsy of the consolidation was obtained with video-assisted thoracoscopy. Because the pathological findings showed non-caseating epithelioid cell granulomas and multinucleated giant cells, sarcoidosis was diagnosed. The consolidation, which had developed from a loss of alveolar structure due to multiple non-caseating epithelioid cell granulomas, improved without corticosteroid treatment. The prognosis of atypical sarcoidosis with consolidation below the pleura in the lower lobe of the lung is difficult to predict based on images; therefore, strict follow-up with CT is necessary.