Daily Radiology Case

Explanation

Squamous cell carcinoma of the lung classically presents as a centrally located mass arising from the bronchial epithelium. On imaging, this often appears near the hilum rather than in the lung periphery. Because it grows within or adjacent to bronchi, it frequently causes airway obstruction, leading to post-obstructive atelectasis or pneumonia. Cavitation is common due to tumor necrosis. The histologic findings of keratin pearls and intercellular bridges are hallmark features confirming the diagnosis.

Source: Saadallah A, Squamous cell lung cancer. Case study, Radiopaedia.org (Accessed on 19 Feb 2026) https://doi.org/10.53347/rID-229141

Hints

• A 60 yearold male presents with a chronic cough that has progressively worsened over several months. He reports intermittent streaks of blood in his sputum.
• He has a 40 pack year smoking history and recently developed mild unintentional weight loss and fatigue.
• On exam, he has decreased breath sounds over the right upper lung field. No fever. No acute infectious symptoms.
• Chest X-ray demonstrates a dense opacity near the right hilum with evidence of partial lobar collapse.
• Contrast-enhanced CT of the chest reveals a centrally located mass arising from a segmental bronchus with associated post-obstructive atelectasis and possible cavitation.
• Bronchoscopy shows an endobronchial lesion causing near-complete obstruction of the airway. Biopsy demonstrates keratin pearls and intercellular bridges.