Lung: Case #3

Primary Site	Left upper lobe, lung
Physical Exam	08/16/XX	Patient admitted because of mass in LUL. On hyperventilating and forced exhaling, wheezing can be initiated toward lower aspects.

X-Rays & Scans	06/10/XX	CT chest: Nodular density in left upper lobe; 1.2 cm paratracheal LN to the R of midline. 1.5 - 2 cm lesion situated in the anterior segment of left upper lobe pointing towards left hilum.
	08/17/XX	Bone scan: Negative.
	08/16/XX	CT liver: Negative. Chest: 3 x 3 cm mass in left upper lobe consistent with carcinoma.

Scopes	08/18/XX	Mediastinoscopy: Inflammatory hyperplasia of mediastinal lymph nodes.

Operative Findings	09/13/XX	Thoracotomy and lobectomy: 3 x 3 cm mass in subapical region leaning towards anterior segment; does not invade the pleura; several surrounding LNs are enlarged.

Pathological Reports	09/13/XX	Gross: LUL mass, L ant hilar LN, L subcarinal LN, and LUL. Micro: Mod to poorly diff adenoca, lung tissue and 2 peribronchial LNs; LUL mass = 2.5 cm mod to poorly diff adenoca with invasion of the pulmonary vein within the tumor mass, but not extending out from the mass. Bronchial margins are free.

Treatment	09/13/XX	Surgery: Left thoracotomy and left upper lobectomy.
Treatment	11/01/XX	Chemotherapy: began paclitaxel, carboplatin.