Case 1 was a 63-year-old man who presented with a 4-month history of productive cough and started to deteriorate after having a fever for a week. The patient had an 8-year history of cigarette smoking, and his father had been diagnosed with lung cancer. Repeated antibiotic treatment had been used since he started coughing, which produced a small amount of yellow sputum, and on January 6, 2018, he was diagnosed with community-acquired pneumonia. Unfortunately, his condition did not improve, and he gradually developed persistent right chest pain and shortness of breath after activity. He was admitted to our hospital on March 19th, and chest computed tomography (CT) showed an irregular solid nodule in the anterior segment of the upper lobe of the right lung and lamellar density shadows in the lower lobe of the right lung (Figure 1A and B). A bronchoscopic examination showed that the bronchi were unobstructed, slightly congested and had a mild amount of purulent exudate. A transbronchial lung biopsy (TBLB) was performed in the posterior basal segment and dorsal segment. Galactomannan (GM) of bronchoalveolar lavage fluid (BALF) was 1.068. No fungus, interstitial fibroblastic proliferation, incrassation or fibrosis was seen in the lung tissue biopsy, but acid-fast staining and PAS negativity suggested organizing pneumonia; the patient was then diagnosed with organizing pneumonia. The patient was started on prednisone 30 mg orally once a day on March 27, and he was discharged after his symptoms of cough, chest pain and shortness of breath had gradually improved. He took prednisone as prescribed after discharge. However, his condition worsened with a fever that developed on May 8, and he was admitted to the hospital on May 15. On examination, his body temperature was 39.6 C, and his superficial lymph nodes were not swollen. A small moist rale was detected in the lower right lung. Routine blood tests revealed a leukocyte count of 15.85x109/L, a red blood cell count of 4.18x1012/L, a hemoglobin level of 110.70 g/L, and a neutrophil percentage of 83.0%. His hypersensitive C-reactive protein was 171.23 mg/L, the erythrocyte sedimentation rate was 70 mm/h, and serum procalcitonin was 0.707 ng/mL. The serum was positive for AIGAs. His plasma HIV antibody, blood culture, beta-D-glucan, GM and Cryptococcus latex agglutination tests were all negative. The lesion in the right upper lobe was still present, and the high-density lesions in the posterior and outer basal segments of the lower lobe of the right lung were slightly smaller on May 16. A percutaneous lung biopsy was performed on May 21, 2018. The right lower lung biopsy showed a chronic inflammatory lesion but no granuloma or neoplastic lesion. Immunohistochemistry with PAS and acid-fast staining showed that the chronic inflammatory lesions were negative. After the admission of the patient and after considering an infection in the lung, the dosage of prednisone was gradually reduced and ultimately discontinued on May 24. The patient was successively treated with imipenem-cilastatin, voriconazole, compounded sulfamethoxazole and linezolid but still had a fever, with the highest temperature being 39.1 C. On May 30, his symptoms, including difficulty breathing, gradually worsened, and he developed type I respiratory failure. Therefore, he was transferred to the intensive care unit (ICU) for endotracheal intubation for salvage treatment. After admission to the ICU, the patient had scattered herpes in his right anterior chest wall and posterior chest wall. Herpes zoster was clinically diagnosed, and acyclovir sustained release tablets were given as oral antiviral treatment. T. marneffei was cultured from lung biopsy tissue performed on June 4, and chest CT showed growth of the two lung lesions (Figure 1C and D). Liposomal amphotericin B was started on June 6 as an antifungal agent; the patient's temperature returned to normal, and the patient's cough and shortness of breath improved after 3 days. He was transferred back to the general ward. Unfortunately, liposomal amphotericin B was discontinued due to progressive renal impairment and was replaced by voriconazole 0.2 g twice daily starting on June 19. He was discharged after a chest CT showed that the lung lesions were significantly smaller (Figure 1E and F) on June 25. He was started on a course of itraconazole after discharge. He developed another episode of cough and fever with a maximum temperature of 40 C on December 25, 2020. A chest CT showed that the nodules in the right upper lobe of the lung were significantly larger and that the lesions in the lower lobes of both lungs were stable on January 15, 2019 (Figure 1G and H). Bronchoscopy revealed that the mucosa in the anterior segment of the right upper lobe had lost its normal structure, and the lumen was narrow. The pathology from the TBLB performed in the anterior segment of the right upper lobe showed primary adenocarcinoma (Figure 2A-D). The patient was confirmed to have right lung adenocarcinoma and TSM. However, he was discharged after refusing treatment and died in February 2019.