CASE PRESENTATION: A 34 years old male patient was admitted to our hospitial with chief complaint of “cough for 2 years, recurrent purulent sputum for 1 year, hemoptysis for 4 months, recurred for 1week”. He denied lower back pain. 16 years ago he was diagnosed as lung tuberculosis and received anti-tuberculosis drugs for 8 months. his right hip ached intermittently, the symptom alleviated gradually without any treatment several months later. The patient experienced 3 episodes of acute pneumothorax. Physical examination showed extremly emaciation. multiple surgical scars on chest wall. Double lung percussion showed hyperresonance, auscultation showed roughbreath sounds without wheezes or crackles. Spinal forward bend, extend, rotation seemed slightly stiff, lateral normal. The thoracic mobility test: (2 cm); Other examiniations almost normal. Auxiliary examination:T - SPOT. TB negative; (bronchial secretions) tests: tuberculosis bacili, common bacteria cultivation, fungi, mycobacterium tuberculosis PCR negative, no fungus spore and mycelium; G test 31.18 pg/ml (negative); GM test 1.85 (positive) rheumatoid factor (RF): 20.7 IU/ml write, c-reactive protein (CRP): 102.00 mg/L write; The HLA-B27: +. Chest CT:double lung multiple pulmonary emphysema, bronchiectasis, multiple infection, left upper lobe cystic shadow Pericardial a small amount of effusion, bilateral partial pleura hypertrophy. Sacroiliac joint CT: bilateral sacroiliac arthritis and osteoarthritis stiffness. Lumbar positive side: lumbar bone not seen obvious abnormity. Diagnosis:Ankylosing spondylitis associated pulmonary damage mixed with infection (aspergillus and bacteria).