• Eline Cesilie Jager, Wytze Sake de Boer, Michael Leslie van Schaik, and Ben Tomlow.
• Department of Pulmonary Medicine, Isala Klinieken, Zwolle, the Netherlands.
• Chest. 2022 Jun 1; 161 (6): e355-e358.

Case PresentationA 79-year-old woman was admitted to the hospital for progressive dyspnea and severe hypoxemia, requiring oxygen supplementation. The dyspnea started approximately 3 to 4 weeks before presentation and was slowly progressive throughout the following weeks. Her medical history mentioned an adenocarcinoma with an epidermal growth factor receptor (EGFR) exon 19 deletion of the lung with metastases to the bones and brain for which treatment with osimertinib was started 14 months earlier. Furthermore, she was treated with rivaroxaban for a first episode of a pulmonary embolism. In the months leading up to her current presentation there were no changes in medication and no use of antibiotics. She had no known exposure to toxic fumes or substances, she was a nonsmoker, and her family history was unremarkable for autoimmune disorders or interstitial lung disease (ILD).Copyright © 2022 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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