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A computed tomography (CT) scan revealed 2 nodules in the right upper and middle lobes of the lung and swelling of an upper mediastinal lymph node (#2r) in a 77-year-old male. Positron emission tomography (PET)/CT showed abnormal uptake only in the right middle lobe nodule, so we suspected a double primary lung cancer (cT1bN0M0, stage ⅠA), and performed a right upper and middle lobectomy with ND2a-2 dissection. Pathological investigation revealed that the lung nodules were adenocarcinomas and the lymph node swelling #2r was a metastasi
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