. Radiography and radio-therapeutics . malig-nant. In the malignantcases the progress of thedisease gradually increasesthe difficulty of swallow-ing. There are, however,cases where a retrogres-sion of the growth, eitheras the result of treatmentor a temporary diminution of size from natural causes, may lead to animprovement in deglutition. Among the less malignant cases lymphadenomamay be quoted, where, after treatment by X-rays and radium, a markeddiminution in the size of the gland may lead to this temporary , in an aneurismal condition with marked dilatation, there may
. Radiography and radio-therapeutics . malig-nant. In the malignantcases the progress of thedisease gradually increasesthe difficulty of swallow-ing. There are, however,cases where a retrogres-sion of the growth, eitheras the result of treatmentor a temporary diminution of size from natural causes, may lead to animprovement in deglutition. Among the less malignant cases lymphadenomamay be quoted, where, after treatment by X-rays and radium, a markeddiminution in the size of the gland may lead to this temporary , in an aneurismal condition with marked dilatation, there may bea shrinkage leading to an amehoration in the symptoms. The distinctionbetween an oesophageal obstruction due to active growth and an aneurismalcondition is often very difficult, if not impossible, to establish. Othermethods of investigation must be employed, and time be allowed to elapsebefore a final decision is arrived at. In aneurism a marked improvementmay follow upon treatment, whilst in malignant cases the progress is usually. Fig. 268.—Malignant stricture of tlie seen in narrow channel ; cesophagus dilated above thepoint of stricture, and a faint irregular streak of food below it. 316 EADIOGRAPHY steadily downwards with increasing difficulty in swallowing, and finallycomplete obstruction. A malignant stricture may, in the early stages, as a result of local treat-ment, greatly improve, but this improvement is of a temporary nature only,the disease sooner or later reasserting itself. Ulcers may occur with or without cicatricial changes. Very markedobstruction may result from the presence of these. Or the obstruction mayarise from reflex causes, such as ulceration or new growth in the of the larynx may cause a marked degree of oesophagealembarrassment. The thoracic portion of the oesophagus may be compressed by aneurismof the aortic arch, by a mediastinal tumour originating either in the thymusor in the lymphatic glands, or by abscess
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