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Peer-reviewedCC BY 4.0Frontiers in Oncology

Two case reports of small cell lung cancer: typical CT manifestations, with one case illustrating adjunctive CT-based diagnosis without pathological confirmation

  • Yibing Zhu1
  • Qingyu Wang2
  • Meiqi Yu3
  • Yinggang Qin2
  • Li Sun4
  • Ming Ye5
  • Junyi Li6
  • Huibin Huang1
6 affiliations
  1. 1Department of Emergency, Guang’anmen Hospital, China Academy of Chinese Medical Sciences
  2. 2Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences
  3. 3Department of Orthopedics, Guang’anmen Hospital, China Academy of Chinese Medical Sciences
  4. 4Department of Radiology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences
  5. 5Department of Nephrology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences
  6. 6Department of Surgery, Guang’anmen Hospital, China Academy of Chinese Medical Sciences
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Abstract

Background: Small cell lung cancer (SCLC) is a highly malignant neuroendocrine tumor with rapid progression and poor prognosis. Pathological examination is the gold standard for its diagnosis, yet pathological sampling is unfeasible in some clinical scenarios due to various constraints, making imaging and tumor markers critical for clinical decision-making. This two-case report describes the typical computed tomography (CT) findings of SCLC and explores the clinical value of combining CT imaging with tumor markers in guiding the diagnosis and treatment of SCLC patients for whom pathological confirmation is not feasible.

Case report: We report two SCLC cases: Case 1 was a 56-year-old male with pathologically confirmed SCLC who presented typical imaging findings of hilar and mediastinal fused lymph nodes and achieved a partial response after combined chemoradiotherapy. Case 2 was a 67-year-old male with chest tightness and hemoptysis for 2 months, whose chest CT showed fused lymph nodes (a typical SCLC feature) and markedly elevated neuron-specific enolase (NSE: 221 ng/mL; reference range 1-16.2 ng/mL). Biopsy was unfeasible due to recent coronary stenting and ongoing antiplatelet therapy, and a clinical diagnosis of limited-stage SCLC was made via a combination of typical CT imaging features, significantly elevated NSE and clinical symptoms. The patient received timely EC regimen chemotherapy and subsequent standard chemoradiotherapy, which resulted in a clinical complete response (CR).

Conclusions: This case report details the typical CT manifestations of SCLC and demonstrates that the combined application of typical CT findings, tumor markers and clinical symptoms may provide a pragmatic basis for timely clinical diagnosis and treatment of SCLC patients when pathological sampling is not achievable. This approach may help avoid treatment delay and improve clinical outcomes for such patients, while emphasizing that pathological examination remains the gold standard for SCLC diagnosis.

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Cite

BibTeXRIS
BibTeX
@article{zhu2026case,
  title = {{Two case reports of small cell lung cancer: typical CT manifestations, with one case illustrating adjunctive CT-based diagnosis without pathological confirmation}},
  author = {Yibing Zhu and Qingyu Wang and Meiqi Yu and Yinggang Qin and Li Sun and Ming Ye and Junyi Li and Huibin Huang},
  journal = {Frontiers in Oncology},
  year = {2026},
  month = oct,
  doi = {10.3389/fonc.2026.1865534},
  url = {https://www.frontiersin.org/articles/10.3389/fonc.2026.1865534/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Two case reports of small cell lung cancer: typical CT manifestations, with one case illustrating adjunctive CT-based diagnosis without pathological confirmation
AU  - Yibing Zhu
AU  - Qingyu Wang
AU  - Meiqi Yu
AU  - Yinggang Qin
AU  - Li Sun
AU  - Ming Ye
AU  - Junyi Li
AU  - Huibin Huang
PY  - 2026
DA  - 2026/10/21
JO  - Frontiers in Oncology
DO  - 10.3389/fonc.2026.1865534
UR  - https://www.frontiersin.org/articles/10.3389/fonc.2026.1865534/full
AB  - Background: Small cell lung cancer (SCLC) is a highly malignant neuroendocrine tumor with rapid progression and poor prognosis. Pathological examination is the gold standard for its diagnosis, yet pathological sampling is unfeasible in some clinical scenarios due to various constraints, making imaging and tumor markers critical for clinical decision-making. This two-case report describes the typical computed tomography (CT) findings of SCLC and explores the clinical value of combining CT imaging with tumor markers in guiding the diagnosis and treatment of SCLC patients for whom pathological confirmation is not feasible.  Case report: We report two SCLC cases: Case 1 was a 56-year-old male with pathologically confirmed SCLC who presented typical imaging findings of hilar and mediastinal fused lymph nodes and achieved a partial response after combined chemoradiotherapy. Case 2 was a 67-year-old male with chest tightness and hemoptysis for 2 months, whose chest CT showed fused lymph nodes (a typical SCLC feature) and markedly elevated neuron-specific enolase (NSE: 221 ng/mL; reference range 1-16.2 ng/mL). Biopsy was unfeasible due to recent coronary stenting and ongoing antiplatelet therapy, and a clinical diagnosis of limited-stage SCLC was made via a combination of typical CT imaging features, significantly elevated NSE and clinical symptoms. The patient received timely EC regimen chemotherapy and subsequent standard chemoradiotherapy, which resulted in a clinical complete response (CR).  Conclusions: This case report details the typical CT manifestations of SCLC and demonstrates that the combined application of typical CT findings, tumor markers and clinical symptoms may provide a pragmatic basis for timely clinical diagnosis and treatment of SCLC patients when pathological sampling is not achievable. This approach may help avoid treatment delay and improve clinical outcomes for such patients, while emphasizing that pathological examination remains the gold standard for SCLC diagnosis.
SN  - 2234-943X
ER  -