A 35-year-old man who lived in Tucson, Arizona, from November 2008 through October 2011 was found to have an abnormal nodular shadow in the right lower lung field on a medical examination after he returned to Japan. Computed tomography of the chest showed a nodular lesion including small cavities in the right S9 region surrounded by scattered shadows. We performed bronchoscopy, transbronchial lung biopsy, and bronchoalveolar lavage (BAL) of the right B9a region. A necrotizing granuloma with purulent inflammation and spherules containing endospores were seen upon histopathological examination. These findings were typical of pulmonary coccidioidomycosis. After bronchoscopy, BAL fluid cultures were positive for fungal colonies. Gene analysis of the fungi led to a diagnosis of chronic pulmonary coccidioidomycosis caused by Coccidioides posadasii. To our knowledge, few cases of pulmonary coccidioidomycosis diagnosed on bronchoscopy have been reported in Japan.