Abstract
We report a case of lung cancer arisen from an emphysematous bulla in the right upper lobe of the lung in a 63-year-old man. The patient had medical histories of diabetes mellitus and pulmonary tuberculosis. The smoking index was 1,200. He had been pointed out a bulla occupying the upper lobe of the right lung. Although a chest computed tomography did not reveal any growths in the bulla in August 2013, a 34 × 32 mm mass, highly positive for fluoro-D-glucose accumulation, was found in the bulla on positron emission tomography in December of the year. Other examinations did not show any evidence of lung cancer or aspergilloma, and a biopsy via bronchoscopy resulted in Class I. The tumor tended to enlarge. Subsequently, thoracoscopic surgery was performed. Needle biopsy after dissection of firm adhesions revealed only necrotizing tissue, and no diagnosis was obtained. Right upper lobectomy was performed and the tumor was identified as lung cancer by intraoperative frozen section diagnosis. The pathological diagnosis was squamous cell carcinoma, pT2aN0M0, pStage IB. Lung cancer arising rapidly from an emphysematous bulla within only 4 months is rare.
