<![CDATA[Introduction: The delay in lung cancer diagnosis remains a significant issue in peripheral hospitals due to limited facilities such as CT scans, bronchoscopy, and cytological and histopathological examinations. This condition often leads to misdiagnosis, particularly with pulmonary tuberculosis and lung tumors. Thoracic ultrasound is an accessible, non-invasive modality that is sensitive in detecting subpleural abnormalities, making it a potential effective screening tool for guiding diagnosis and intervention. Case: A 49-year-old male presented with complaints of shortness of breath, right chest pain, and weight loss. The patient had previously undergone anti-tuberculosis therapy for two months with a negative sputum culture. Chest radiography revealed pathology in the right lower lung. Thoracic ultrasound identified a hyperechoic mass with irregular borders and pleural effusion, with a guiding distance of 3.8 cm for intervention. A transthoracic needle aspiration (TTNA) was performed using a 25G Spinocan needle, resulting in 12 cytological samples. Cytology indicated C4: suspicious for malignancy. At the referral hospital, a chest CT scan confirmed a spiculated mass at the right hilum with dissemination to the pleura, pericardium, bilateral lymph nodes, and adrenal glands (T4N3M1c2). Bronchoscopy revealed infiltrative stenosis, and biopsy confirmed the diagnosis of squamous cell lung cancer. Conclusion: Thoracic ultrasound has proven beneficial in early screening and detection of subpleural masses in healthcare facilities with limited resources. This modality enhances the accuracy of early assessments and enables safe and targeted TTNA, thereby expediting the diagnosis of lung cancer and preventing delays in referral. The integration of thoracic ultrasound into the diagnostic pathway in peripheral hospitals can improve service quality and enhance patient outcomes.]]>
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