The clinical data of a patient with PEHE complicated with COPD were collected； the relevant literatures were reviewed， and its diagnosis and treatment methods were summarized.

The male patient was 74 years old， who was hospitalized because of repeated chest tightness and asthma for half a year and half a month of deterioration. Physical examination showed barrel chest， and hyperresonant sounds were heard when percussing lungs； the respiratory sounds of lungs were reduced； there were no other obvious positive signs. The examination results of pulmonary function showed that forced expiratory volume in 1 second （FEV1） accounted for 58% of predicted value and FEV1/ forced vital capacity （FVC） was 56.9%. The chest CT results showed multiple nodules with different sizes， chronic bronchitis and bullous emphysema in both lungs. The bronchoscope results showed abnormal cell-nest， the clinical and immunologic markers were considered， and the results met the diagnosis of PEHE. The patient got better after treated with endostar and bronchodilator and was discharged from hospital. After that， chest tightness and asthma occurred again， so the patient was admitted to the hospital for symptomatic treatment because of COPD， but the symptoms were not relieved significantly and fatigue and systemic pain were found after endostar was given. The evaluation of imaging revealed intrahepatic metastases，and bone metastases in several areas， so the patient received anti-tumor and symptomatic treatment by taking anlotinib. Then， respiratory failure， hypoalbuminemia and secondary infection occurred. So symptomatic treatment was given after assessing the lesions of both lungs by imaging. But the patient was dead.

The clinical symptoms of PEHE are atypical， and it is easy to be ignored when a patient is accompanied by COPD. The presence of COPD can also affect what kind of treatment plan can be used.