[A case of lung cancer with axillary nodal involvement].

A 57-year-old man with lung cancer was reported. Primary tumor was located at left S1+2, and directly invaded to chest wall (from 1st. rib to 4th rib). Hypercalcemia and delirium were observed. Whole body examination showed that no distant metastasis except for nodal swelling of left axillary region. Left upper lobectomy combined with chest wall resection was performed. Hilar, mediastinal and axillary nodes were also dissected. Histological examination revealed that nodal involvement was not present at neither hilar or mediastinal region, but was present in axillary node. It was thought that lymphatic extension had occurred from trough chest wall to axillary nodes but not through mediastinal rout. So systematic dissection of locally invaded region as well as hilar and mediastinal region was recommended in each cases.