A 69-year-old male was admitted to our hospital because of dry cough. Chest X-P and CT scans showed a mass shadow in the right lung, thickening of pulmonary vessels and pleural effusion. Cytological examination of transbronchial brushing specimen revealed lung adenocarcinoma. Cancer cells were also detected in pleural effusion. High levels of CA 19.9 were noticed: 48,400 U/ml in serum and 395,000 U/ml in pleural effusion, respectively. Two courses of combined chemotherapy (CDDP + VDS) were done. Concurrent chest radiation therapy (40 Gy) to primary tumor was also performed. After treatment the primary tumor decreased in size on CT scan analysis, but the patient suffered from respiratory failure due to the increase of sputa and pleural effusion and died 104 days after admission.