SBA 10

You are asked to see a 50yo female smoker with a 3-month history of increasing shortness of breath and weight loss. She attended hospital after developing haemoptysis. She has a new oxygen requirement and desaturates significantly on mobilising. Initial investigations reveal a Hb of 40g/L, D-dimer 0.8g/L, Cr 240 and Urea 14 (AKI Stage 3). A CXR shows bilateral diffuse patchy opacification of the middle zones. Respiratory viral screen is negative. What is the likely diagnosis?