Radiograph and CT study of a 16-year old boy with diffuse pulmonary involvement in Goodpasture syndrome. On admission, the boy complained of several weeks of dyspnoea with cough and haemorrhage. Histology confirmed the diagnosis of renal Goodpasture syndrome. The radiograph demonstrates diffuse extended opacities. The CT study reveals diffuse patchy-confluent alveolar opacities sparing the subpleural space.