Intrabullous carcinoma: a diagnostic dilemma

Two cases of bronchogenic carcinoma arising within the walls of bullae are described. They manifested as air-fluid levels within the bullae. Such air-fluid levels are generally considered to be due to infection and conservative management is recommended. This approach delays the recognition of potentially resectable neoplasms, as was the case in our patients. We discuss the clinical and radiographic clues which raise the specter of neoplasm in such cases.