Bronchial necrosis with wall destruction and direct visualization into the cavity is seldom described in the context of lung cancer, except after radiation therapy. We describe 5 cases of cavitating lung cancer with direct communication with the airways, large enough to allow the passage of a flexible bronchoscope. We encountered all of these cases between May 2009 and January 2010. None of the patients had received radiation previously. During bronchoscopy, necrosis of the bronchus was evident with replacement of the involved lung by a large cavity lined by tumor tissue.