Squamous cell carcinoma projecting as a polypoid mass into the bronchial lumen. Respiratory epithelium is seen in the middle and bronchial cartilage to its right. This case of squamous cell carcinoma serves as a reminder that these tumors typically arise from the large bronchi near the hilum. The bronchi commonly undergo squamous metaplasia years before transforming into dysplasia and carcinoma-in-situ and then invasive carcinoma. Tumors such as this that fungate into the bronchus can present clinically with cough, weight loss and dyspnea. If the tumor causes lobar atelectasis, the stage is increased and the prognosis is poorer.