. The American journal of roentgenology, radium therapy and nuclear medicine . of tumor may alsoarise from subdivisions of the bronchi or Diagnosis of Primary Tumors of the Lung 99 from bronchioles far out in the hmg struc-ture. They show the same inchstinct edgesand projections as those arising at the hila. In the miHary type of the disease there isdiffuse nodulation throughout the huigs, buteach nodule or mass of nodules has thissame hazy appearance at its periphery, andthere is present the surrounding zone due tocongestion. If the appearance described above is pres-ent, it may then be state
. The American journal of roentgenology, radium therapy and nuclear medicine . of tumor may alsoarise from subdivisions of the bronchi or Diagnosis of Primary Tumors of the Lung 99 from bronchioles far out in the hmg struc-ture. They show the same inchstinct edgesand projections as those arising at the hila. In the miHary type of the disease there isdiffuse nodulation throughout the huigs, buteach nodule or mass of nodules has thissame hazy appearance at its periphery, andthere is present the surrounding zone due tocongestion. If the appearance described above is pres-ent, it may then be stated with a good de- correct diagnosis by the presence of enlargedlymph-nodes in the neck. The microscopicexamination of such a node removed fromthe neck or axilla may show the character ofthe process in the lung. The nature of thedisease has occasionally been determined bythe presence of portions of tumor in apleural effusion. A hemorrhagic effusion isstrongly suggestive of malignant disease. It is stated that the diagnosis is some-times established by bronchoscopic examina-. FiG. 3. Benign Timor, Probably Dermoid Cyst. gree of certainty that the lesion is carci-noma. There are, however, numerous casesof lung carcinoma in which the roentgen ap-pearance is not entirely typical, and thereare also conditions which are not carcinomain which the roentgen appearance closelysimulates the latter. It is in such cases thatwe must rely upon the future course of thedisease and corroborative clinical findings inorder to establish a diagnosis. The sputummay furnish conclusive or corroborative evi-dence. In rare cases tumor elements may befound or the fairly characteristic raspberry-jelly or prune-juice sputum may be sputum is often bloody as in other lungdiseases. The gradual increase in dyspneadue to growth of the tumor into the bronchior trachea is a valuable sign. Barker men-tions two cases in which he was led to a Fig. 4. EcHiNococcus Cyst of Lung. tion. Fever is of variable oc
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