A rare case of radiologically occult lung cancer in the peripheral reg
ion beyond bronchoscopic visibility is reported. A 69-year-old female
was referred because of positive sputum cytology. Despite detailed bro
nchoscopic and otorhinoralyngologic examinations, the source of malign
ant cells was not localized. During the follow-up period, squamous cel
l carcinoma of the lung periphery was detected radiologically three ye
ars after its presence was detected in sputum. Awareness of the existe
nce of this type of cancer and careful follow-up are important in the
management of patients with positive sputum cytology and no evidence o
f cancer.