The clinical data， imaging findings， bronchoscope and pathological findings of one patient with AITL were collected， the above data were analyzed， and the relevant literatures were reviewed.

A 66-year-old female patient was admitted with fever accompanying with cough and expectoration for 15 d. The physical examination results showed that there was a red rash scattered on all four limbs， no abnormality of the thorax， and the trachea was in the center. Dullness of the left lower lung was found by percussion， and the breath sounds of the left lower lung were weakened， without other obvious positive signs.The chest CT results showed the multiple patchy high-density shadows in the lower lobe of both lungs， especially in the left lower lung， and the mediastinum and bilateral axillary lymph nodes were enlarged. The possibility of double pneumonia was considered initially， and the space-occupying lesions were excluded. The results of bronchoscopic lung biopsy （TBLB），mediastinal lymph node transbronchial needle aspiration biopsy （TBNA）， and exfoliated pleural cells all excluded pulmonary malignancy. After anti-infection treatment and experimental anti-tuberculosis treatment， the patient still had repeated fever. The chest CT results showed that the high-density shadow range of the left lower lung was increased and consolidated. The comprehensive laboratory examination and imaging examination results showed no abnormalities， and the specific cause of the patient’s fever was unclear. The physical examination of the patient showed the multiple light red rashes on the trunk and limbs and the bilateral supraclavicular lymph node enlargement. Biopsy of right supraclavicular lymph node was performed， and AITL was finally reported pathologically.

AITL should be considered in the patients with unexplained fever with pulmonary imaging changes， rash and lymph node enlargement， if systemic anti-infective therapy does not respond well.