Images in a 79-year-old man with extensive small cell lung cancer (SCLC)
and underling fibrotic interstitial lung disease. The patient was a
former smoker and presented with worsening cough and dyspnea on
exertion. (A–C) Chest CT scans demonstrate a left
upper lobe lesion (* in A) and peritoneal and
retroperitoneal deposits (arrows in C) that were biopsied
and showed metastatic SCLC. Notably, the clinical record indicated that
the annual low-dose CT screening 6 months earlier was negative for
cancer. Underlying lungs show fibrotic interstitial lung disease in
peripheral and somewhat basilar distribution (arrows in A
and B), accompanied by interlobular septal thickening,
ground-glass and reticular opacities, traction bronchiectasis, and a few
areas suggestive of early honeycombing. The patient was treated with
several lines of systemic therapy, including carboplatin plus etoposide
and nivolumab; however, he died 6 months after the diagnosis.