Diagnosis of large-cell bronchogenic carcinoma (non-small cell carcinoma, not otherwise specified (NOS)).

Pathology: High-grade large-cell undifferentiated carcinoma located in the apical segment and measuring 2.5 cm in maximum dimension showing radiation/chemotherapy effect. Tumor extends into the overlying chest wall. The tumor is almost entirely necrotic with only small islands of viable tumor cells remaining, (approximately 10% of the tumor appears viable).

Surrounding lung parenchyma shows changes consistent with chemotherapy and radiation, namely interstitial fibrosis, intimal fibrosis and inflammation of the interstitium.

Prominent centrilobular emphysema is present with subpleural blebs and bullae.