A 53-year old woman was admitted to hospital with a six-month history of cough and dyspnea, weight loss and left abdominal and lumbar pain. Inspiratory crackles were diffusely heard during physical examination. The chest radiography revealed bilateral symmetric opacities. Chest CT-scan showed bilateral crazy paving patterns with diffuse ground-glass opacities, inter and intralobular septal thickening and alveolar infiltrates with peripheral sparing. Bronchoscopy with bronchoalveolar (BAL) returned abundant opaque and milky lavage fluid (Fig.
