A 55-year-old patient presents with chronic cough. A chest x-ray film demonstrates a circular lesion near the apex of the lung. CT-guided biopsy of the lesion demonstrates a malignant tumor arising in an area of scarred lung. Which of the following type of cancer is MOST likely to be present?

Tumors that arise peripherally and can cause coin lesions, includes adenocarcinoma, bronchioloalveolar carcinoma, and large cell carcinoma. Of these, adenocarcinoma is the form specifically associated with lung scarring related to old granulomatous disease, old chronic obstructive lung disease, or other old damage to the lungs.Remember bronchioloalveolar carcinoma as the one that is not associated with smoking. Large cell carcinoma is an aggressive, undifferentiated form of lung cancer. Remember oat cell (small cell) carcinoma as the one that can commonly cause paraneoplastic syndromes such as SIADH and Cushing's syndrome. Also know:Cigarette smoking is most strongly associated with squamous carcinoma and small cell undifferentiated carcinoma and to a lesser degree with adenocarcinoma. Ref: Chandrasoma P., Taylor C.R. (1998). Chapter 36. The Lung: III. Neoplasms. In P. Chandrasoma, C.R. Taylor (Eds), Concise Pathology, 3e.