Abstract
A 67-year-old man, a heavy smoker, visited our hospital after level D was diagnosed by sputum cytology in a lung cancer screening. Chest CT scan showed severe pulmonary emphysema and a small nodular lesion contiguous to emphysematous bullae in the left lower lobe. Six months later, level C was diagnosed by sputum cytology in our hospital. Serial examination of the sputum showed tumor cells resembling small cell carcinoma. A well defined nodular lesion 1.5 cm in diameter in left S10 was recognized on CT scan, and this was diagnosed as small cell lung cancer by bronchofiberscopic examination and CT-guided lung biopsy. The clinical stage was I A (T1NOMO). Left lower lobectomy and lymph node dissection was performed. The pathological specimen showed small cell carcinoma of the intermediate type. The pathological stage was I A (T1NOM0). We reported a rare case of peripheral early small cell lung cancer contiguous to emphysematous bullae in which tumor cells were detected in sputum.
