A 72-year-old man presented with 10 years of hoarseness that worsened over the past year. Imaging found a nodule in his right upper lobe lung and enlarged lymph nodes near his hilar region. A biopsy of the lung nodule revealed small cell carcinoma of the lung that had spread to the lymph nodes.

1. A 72-year-old man with hoarseness and lung nodules CC: hoarseness onset : 10 years ago PI: 10 년전부터 hoarsness 간간히 있었으나 특별한 치료 없이 지내옴 . 1 년 전 겨울 voice change 심해져서 local ENT 방문후 , 큰병원 권유받아 지역대학병원 방문 w/u 상 r/o glottic ca c lung meta 로 SMC ENT 에서 LMS 시행함 . 이후 lung lesion 에 대해 tissue confirm( 수술 ) 위해 입원함 . PS; 1 tracheostomy state 개인력 및 사회력 흡연력 : Current smoker 하루 (1) 갑 기간 (50) 년

2. Chest PA Prominent right hilum and a small nodule in right upper lobe

3. Chest CT and PET CT and PET: a small nodule in right upper lobe and large hilar lymph node

4. Close view Blue tumor with extensive necrosis Small cell carcinoma

5. Microscopic view I Blue tumor with extensive necrosis Small cell carcinoma

6. Microscopic view II Blue tumor with extensive necrosis and lymphatic tumor emboli (arrow) Small cell carcinoma

7. Microscopic view III Lymphatic tumor emboli (arrows)

8. Microscopic view IV Small cell carcinoma is composed of small tumor cells with a round to fusiform shape, scanty cytoplasm, and absent or inconspicuous nucleoli Small cell carcinoma