Surgical Case of the Composite Tumor of Primary Lung Cancer and Follicular Bronchiolitis

A case was a 72-year-old female who was pointed out abnormal findings on her chest X-ray taken at the medical checkup. Chest computed tomography revealed a tumor with 3.1 cm in diameter at the right lower lobe and multiple small nodules in both lung lobes. We initially suspected lung cancer with intrapulmonary metastases. However, only tumor at the right lower lobe increased in size and the size of other small nodules was not changed. Therefore, we performed the right lower lobectomy with mediastinal nodal dissection and the partial resection of right middle lobe to establish the diagnosis. Pathological assessment revealed that the tumor at right lower lobe was adenocarcinoma with follicular bronchiolitis, and small nodules in the lower lobe were intrapulmonary lymph nodes, and the nodules in the middle lobe were lymph node infiltration with follicular bronchiolitis. The composite tumor of primary lung cancer and follicular bronchitis is very rare, and the cancer stage could be overdiagnosed.