CASE PRESENTATION: A 64 -year-old man presested with a nonproductive cough without fever and dyspnea. Chest scan showed the bilateral consolidation with air bronchogram in the lower lobes, predominantly in the right lung (Figure 1). He was initial diagnosed with “pneumonia” on admission, and received antibiotic therapy with improvement. The recurrence of cough occured in the next year. Chest radiography showed unabsorbed consolidation (Figure2) compared with before. He was admitted to our hospital and complainted of a lot of frothy sputum, dyspnea, and fever after 2 year. A chest scan demonstrated diffuse pulmonary parenchymal involvement with bilateral ground-glass opacity and consolidation (Figure 3). A bronchoscopic exam revealed a lot of white frothy secretions with congestive, edema mucosa in each bronchus (Figure 4), and was taken the TBLB. ROSE merely discovered the cellcular degeneration and necrosis (Figure 5). A bronchial pathology showed the adenocarcinoma in the left superior lobe (Figure 6).