A 22-year-old male presented to the cardiothoracic surgery department with 1-week of hemoptysis, with worsening for 1-day, accompanied by cough, chest tightness, and dizziness. He reported a history of occasional palpitations after fatigue. Physical examination revealed cyanosis and clubbing fingers (Fig. 1A). The oxygen saturation was 75.2 % and the hematocrit was 0.724L/L. Non-contrast chest CT showed mixed ground-glass opacity in the right upper lobe, suggesting inflammation (Fig. 1B). The e…