Bronchial biopsy samples were initially diagnosed as squamous cell carcinoma despite the fact that the patient was young and a nonsmoker. Briefly, a 30-year-old white male nonsmoker was admitted to the hospital for sudden thoracic pain owing to a 6.5-cm tumor involving the left lower lobe ( Fig. 1 A) with minimal homolateral pleural effusion and mediastinal lymph node involvement ( Fig. 1 B). Malignant tumors made of spindle cells in the lung usually comprise pleomorphic or spindle cell carcinoma, some intermediate- to high-grade neuroendocrine tumors, and (less frequently) sarcomas (either primary or metastatic), amelanotic melanoma, mesothelioma, or thymus-like tumors, whereas the existence of spindle cell–looking NUTC in the lung was unprecedented.
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