Diseases of the chest and the principles of physical diagnosis . ^ malignant. It is frequently asserted that in primarycarcinoma of the lungs and bronchi that the right side is more frequentlyinvolved than the left. Adler^ states that the difference in the involve-ment of the two sides is too small to serve as a basis for a theory. Weller^ 1 Primarj- Malignant Growths of the Lungs and Bronchi, 1911. 2 Loc. cit. DISEASES OF THE LUNGS 545 found that in 69 cases the two sides were involved with approximatelyequal frequency. Primary sarcoma is also quite as apt to occur on oneside as the other. Pr
Diseases of the chest and the principles of physical diagnosis . ^ malignant. It is frequently asserted that in primarycarcinoma of the lungs and bronchi that the right side is more frequentlyinvolved than the left. Adler^ states that the difference in the involve-ment of the two sides is too small to serve as a basis for a theory. Weller^ 1 Primarj- Malignant Growths of the Lungs and Bronchi, 1911. 2 Loc. cit. DISEASES OF THE LUNGS 545 found that in 69 cases the two sides were involved with approximatelyequal frequency. Primary sarcoma is also quite as apt to occur on oneside as the other. Primary malignayit growths may occur as a single large tumor havingits origin in the root of the lung and extending into the pulmonary tissueor there may be a number of small nodules varying in size from a hazel-nut to a small orange. Less commonly the lung may be studded with. Fig. 321.—-Sarcomatosis. small nodules resembling miliary tubercles. This widespread distribu-tion, sometimes referred to as carcinomatosis or sarcomatosis, as the casemay be, is seen more frequently as a result of metastasis (Figs. 320 and321). Occasionally the growths are almost entirely subpleural. Rarelythe tumor may be single and found projecting into the lumen of one ofthe larger bronchi. Instead of appearing as an isolated tumor formation the growth mayoccur in an infiltrating form. Wilson Fox describes two types of infiltra-tion. First, it may occur as a general infiltration in w^hich large areasof the lung are involved. This may be uniform or here and there tracesof pulmonarj^ tissue may remain intact. The process closely resembles 546 DISEASES OF THE BRONCHI, LUNGS, PLEURA, AND DIAPHRAGM a dense tuberculous infiltration (see Fig. 325). Secondly, the infiltra-tion may radiate from the root of the lung by wsty of the lymphatic chan-nels attending the bronchi. Small or large
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