This 47 year old gentleman came for routine medical check as part of his new job apllication. He is a smoker 1 packs a day. He denied any symptoms.
CXR showed a 2cm nodular mass in the right mid zone (arrows). The mass has homogenous density but ill-defined and irregular margin. A possibility of malignancy has to be considered. He has since been refered to a chest physician for further evaluation.
Alveolar cell carcinoma is notorious in presenting only when they are large. Most often they are located peripherally and as there is no large airway in the vicinity, will continue to grow without causing any symptoms such as coughing and hemoptysis.