The echocardiogram of a 62-year-old woman with a medical history of anti-synthetase syndrome associated with interstitial lung disease (ILD) suggested pulmonary hypertension. An etiological evaluation of pulmonary hypertension was performed. The ventilation/perfusion scan had the aspect of perfusion defects with dissociation. The CT scan showed features of active ILD (basal and subpleural pulmonary infiltration with regular septal line thickening and ground glass-like opacities). After multidisciplinary discussion, the pulmonary hypertension was considered to be secondary to either chronic thromboembolic pulmonary hypertension (CTEPH) and/or ILD. It was decided (i) to initiate an oral anticoagulant (rivaroxaban) and (ii) to initiate intravenous cyclophosphamide plus oral corticosteroids. One year later, while the patient was still taking rivaroxaban, right heart catheterisation showed the persistence of pre-capillary pulmonary hypertension with …

中文翻译：

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走路像鸭子，叫起来像鸭子，不代表它不能是鹅！

一位 62 岁女性的超声心动图显示，其有与间质性肺病 (ILD) 相关的抗合成酶综合征病史，提示肺动脉高压。进行了肺动脉高压的病因学评估。通气/灌注扫描具有灌注缺陷和解离性。CT 扫描显示活动性 ILD 的特征（基底和胸膜下肺浸润伴规则的间隔线增厚和磨玻璃样混浊）。经过多学科讨论，肺动脉高压被认为继发于慢性血栓栓塞性肺动脉高压（CTEPH）和/或 ILD。决定 (i) 开始口服抗凝剂 (利伐沙班) 和 (ii) 开始静脉注射环磷酰胺加口服皮质类固醇。一年之后，