Patients with mixed connective tissue disease with lung involvement are more common. The main manifestations are shortness of breath, chest pain and dry cough. Interstitial pulmonary fibrosis, pleural effusion, pleural hypertrophy or pulmonary hypertension occur in a small number of patients. Spinal cord vasculopathy and primary small vessel vasculitis can cause lung involvement, as detailed below. Spinal vasculopathy Lung involvement is associated with pulmonary hemorrhage in 12% to 29% of patients with spinal vasculopathy and is an important factor in morbidity and mortality. Hemoptysis is a common manifestation of pulmonary involvement, ranging from blood in the sputum in mild cases to massive hemoptysis in severe cases. Most cases present within 1 month of admission, but it can also be chronic, with dyspnea and anemia, and pulmonary hemorrhage can lead to severe hypoxemia. Common imaging features are alveolar shadows without pulmonary edema or infection. An elevated carbon monoxide conversion factor (≥30%) is also indicative of pulmonary hemorrhage, and the diagnosis can be confirmed by bronchoalveolar lavage. Some patients with small-vessel pulmonary vasculitis have clinical imaging features consistent with an interstitial disease process resembling idiopathic pulmonary fibrosis. Primary small-vessel vasculitis pulmonary involvement in the white room is characterized by cough, hemoptysis/hemoptysis, and in severe cases, life-threatening respiratory failure due to extensive alveolar hemorrhage. x-ray is characterized by interstitial inflammation, fibrosis, pulmonary function tests, and abnormal ventilation.