Lung diseases with increased numbers of cases are reported worldwide with multiple factors including, smoking, lifestyle, and particularly people associated with petrochemical industries. Employees of petrochemical products industries, always at high risk. A single case control 56 years old long-term study from 2014 to final disposal of the case was undertaken, employed in industrial division, exposed to organic fumes, with low albumin, creatinine, elevated serum proteins (91.6 g/L), globulin, CO₂ (39 to 41 mmol/L). His radioallergosorbent test (RAST) positive for dog dander, English plantain, Parientaria officinalis and Dermatophagoides pteronyssinus, cat epithelium and Bermuda grass, Timothy grass, Penicillium notatum and Alternaria tenuis, birch and Japanese cedar with high IgE was positive at 547 without eosinophilia. Bilateral gynecomastia, enlarged right paratracheal lymph node (1.2 cm), subcarinal lymph node (1.1 cm), scattered peripheral fine reticular opacities, bilateral traction bronchiectasis with mild patchy ground glass opacity and micronodules. Nonspecific Interstitial lung diseases (NSILD) diagnosed with fall in lung volume (54.6%). 19.3% for upper, 23.9% mid, and 11.4% lower lung zone. Elevated INR (1.2), PT (5.5) and low PTT (30.9) and 7.92 neutrophil, made it classical case of lung transplantation in 2022. Bilateral gynecomastia was over looked that might occurred due exposure of organic fumes of benzene and other chemicals engine oil, smoke of the burning fuel, and hobbies of hunting birds in desert could have cause this disturbance. Hence it might be concluded that in such cases gynecomastia must be the defining factor in diagnosis and treatment before initiating respiratory therapy.