An 80-year-old man was admitted with the complaints of intermittent cough with blood-tinged sputum for 3 months. His cough usually aggravated at night, and no prominent chest pain, anorexia or body weight loss was noted. The medicine he took from other clinic did not markedly improve the symptoms. He smoked cigarettes 1 pack a day for over 50 years and quitted 3 years ago. He had a gingival inflammation several months ago and underwent local treatment irregularly.
A physical examination showed that this patient was moderately nourished and had clear consciousness. Respiratory examinations found no cervical lymphadenopathy, musculoskeletal disorder or other abnormalities. His blood pressure was 150/80 mmHg. Chest X-ray revealed a solitary nodular shadow over the left upper lung field (Image 1). The computed tomogram (CT) showed a speculated mass, 2 cm in diameter, over the left B1-2…
