78 year old man who was a heavy smoker complained of malaise, weight loss and cough productive of whitish sputum that is sometimes tinged with blood.
The left upper lobe bronchus shows an ulcerated infiltrative lesion arising in the wall and partially obliterating the lumen. There is a pale tumour mass in the adjacent lung parenchyma (blackened due to heavy carbon deposition). The peri-bronchial and tracheal lymph nodes are enlarged, pale and matted. The carina is widened.