2022 Volume 44 Issue 5 Pages 371-376
Background. Although cavity formation in lung cancer is not rare, there are few reports of direct bronchoscopic observation of the lumen of the cavity during the clinical course. Case. The patient was a 71-year-old man in whom a tumor shadow in the right upper lobe on chest computed tomography (CT) was pointed out in another hospital. He was then referred to our department for further examination. Bronchoscopy revealed tumor infiltration at the entrance of the right upper lobe, and biopsy under direct vision revealed squamous cell carcinoma. After a total of 6 courses of chemotherapy, the tumor decreased in size and formed an internal cavity. Subsequently, during follow-up without treatment, the cavity wall thickened, and a small amount of liquid was found inside. Chest CT showed a large connection between the right upper lobe bronchus and the cavity. Since it was necessary to distinguish re-growth of lung cancer from bacterial/fungal infection in the cavity, bronchoscopy was performed to observe inside the cavity. White elevated lesions and grayish white to greenish mucosal lesions were observed inside the cavity, and only squamous cell carcinoma was detected by bronchial washing and direct biopsy from the lesions. Conclusion. In this case, accurate evaluation of the pathological condition was possible by direct observation inside the cavity and performing culture and tissue collection by a bronchoscope.
