Pneumonectomy for lung cancer diagnosed 21 years after irradiation of 6000 rads for hilar lymphadenopathy

A 42-year-old man have received irradiation of 60 Gy for reactive hyperplastic lymphadenitis at the age of 21. Ten years later, he began to have bloody sputum. Bronchial dilatation was noted 17 years later. Twenty-one years after radiation therapy, he was noted to have atelectasis of the left total lung with a history of severe hemoptysis. Histology revealed well-differentiated squamous cell carcinoma invading the bronchial wall, lymphatic vessels and fibrotic tissues. Radiation-induced lung cancer is discussed in relation to delayed effects of radiation. (Namekawa, K)