Presentation
Productive cough for six months. Smoker. Normal CXR one year ago.
Patient Data
Left upper zone opacity. Otherwise lungs clear. Normal heart size and mediastinal contours.
2.5 cm left upper lobe mass, with central cavitation.
No other pulmonary finding or mediastinal nodal enlargement.
Unremarkable upper abdomen and skeleton.
FDG avid left upper lobe mass with central photopenia concerning for central necrosis/cavitation.
No nodal or metastatic disease.
Case Discussion
This was a subtle chest x-ray finding, but much clearer on other modalities.
The patient underwent lobectomy and nodal resection which demonstrated poorly differentiated squamous cell carcinoma, with involvement of mediastinal nodes, staging the cancer as T2aN2M0.