CTICasesMetachronous Endobronchial Squamous Cell Carcinoma
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Imaging findings
A patient with a prior adenocarcinoma of the left upper lobe undergoing routine surveillance imaging shows a persistent filling defect within the superior segmental bronchus of the right lower lobe. This lesion is observed to be expanding the bronchus.
Key takeaways
Endobronchial lesions are a common cause of missed findings on chest CT, particularly if attention is focused primarily on lung parenchyma rather than airways. A persistent, bronchus-expanding filling defect, even in a patient with a history of other lung cancer, warrants suspicion for a separate metachronous endobronchial malignancy, such as squamous cell carcinoma, which can lead to distal obstruction and mucus plugging.
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