A histopathologically proven squamous cell carcinoma (SCC) of the right upper lobe on pneumonectomy. The right endobronchial lesion was likely the endobronchial spread of the upper lobe tumor rather than the primary source of the right upper lobe mass. On retrospective chest X-ray review, the endobronchial lesion is identified on the lateral view overlying the pulmonary artery.

The histology is surprising in view of the absence of significant and/or necrotic lymph adenopathy with such a large tumor on CT imaging. This is confirmed on histology by the reported absence of metastases within the 10 lymph nodes excised at the time of pneumonectomy.

The bulging fissure is also unusual for an SCC of the lung however explained by the unusually large right upper lobe mass and consequent displacement of the minor fissure.

The patient was clinically well for a pulmonary parenchymal abscess or complicated lobar pneumonia and a non benign mass lesion lesion was suspected on chest X-ray, especially in view of her age.