Peroral endoscopy and laryngeal surgery . enpushed upon with the tube mnuth. In determining deformit\- of the outline of the esophageal lumen,it is necessary to be careful that the head of the patient is not rotated:because rotation may cause distortion of the esophagus as demonstratedgraphically in the radiogra]>h. Fig. 392. In the later stages, when thesubmucosal growth begins to break through, the mucous membrane be-comes nodular, and then is usually darker in color with apparent greatincrease of vascularity. In the fungating forms of cancer, the funga- MALIGNANT DISKASIC OK THE KSOPHAGU
Peroral endoscopy and laryngeal surgery . enpushed upon with the tube mnuth. In determining deformit\- of the outline of the esophageal lumen,it is necessary to be careful that the head of the patient is not rotated:because rotation may cause distortion of the esophagus as demonstratedgraphically in the radiogra]>h. Fig. 392. In the later stages, when thesubmucosal growth begins to break through, the mucous membrane be-comes nodular, and then is usually darker in color with apparent greatincrease of vascularity. In the fungating forms of cancer, the funga- MALIGNANT DISKASIC OK THE KSOPHAGUS. 447 tions may lake a polyimid sliaiL-, tin- individual jjolypi being covered witiiepithelium and the general color being quite similar to normal esophagealmucosa or to nasal edematous (lolypi, or they may be (|uite red. Thislatter form is rather rare. Much more common are the fungations whichlook like exuberant granulations in an unhealthy woiuul. We also oc-casionally see white grass-like [irojections such as are seen at times in the. Fig. 3QJ.—Radiograiih of a coin in the esophagus, showing the diagonal res-piratory esophageal movement with rotated head, and illustrating the necessityof the exact median non-rotated position nf tlie head if any diagnostic importanceis to be attached to asymmetrical respiratory esophageal movement in escphagos-copy for suspected periesophageal or submucosal esophageal lesions. Incidentallythis illustrates, also, one of the disadvantages of the lateral position for esoph-agoscopy for disease. Radiograph by Dr. George J. Boyd. larynx. The ulcerated fcirms of esophageal malignancy seldom resembleulceration seen in the nuicosa hit;her up. Iart of this seeming dissimi-larity is due to the |iosilion in which the ulcer lies with reference to thejioint of view. Ilceratinn in the csojihagus is seen more or less on edgethrotigh the esoiihagoscopc, and because of the basal infiltration, it isseldom feasible to turn the ulcer sidewise, as could be dot
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectrespira, bookyear1915
