Clinical tuberculosis . that the process becomes the other hand, I have seen cachexia and emaciation the sameas in pulmonary tuberculosis. The physical signs present depend partly on Avhere the growthis situated. In the centrally located growths there is increasedresistance on palpation and percussion, as well as a dullness overthe areas surrounding the hilus of the lung; while in pure pul-monary metastases there are either isolated or conglomeratetumor masses in the pulmonary tissue itself which if largeenough produce the same changes. The side of involvement usually shows diminished
Clinical tuberculosis . that the process becomes the other hand, I have seen cachexia and emaciation the sameas in pulmonary tuberculosis. The physical signs present depend partly on Avhere the growthis situated. In the centrally located growths there is increasedresistance on palpation and percussion, as well as a dullness overthe areas surrounding the hilus of the lung; while in pure pul-monary metastases there are either isolated or conglomeratetumor masses in the pulmonary tissue itself which if largeenough produce the same changes. The side of involvement usually shows diminished located in the mediastinum pressure on the vessels attimes becomes great and causes a dilatation of these on thesurface. Auscultation may or may not show rides. Diminishedbreathing may be present when pressure is made by the tumorupon a bronchus and when air is excluded from the pulmonarytissue by the tumor structure. The supraclavicular, cervical andaxillary glands may be the seat of metastatic MAUGXANT TTMORS AND TUBERCULOSIS C23 The sputum may be blood-tinged at times. Sometimes frag-ments of the tumor are found, and sometimes clusters of cellswhich are considered as having diagnostic importance. The x-ray is of value where its findings are correlated withthat of physical examination and clinical history. Fig. 105shows the x-ray plate of one of my cases. Diagnosis of primary cancer in the lung is not easy. In mycase, the widespread lesion, with little or no sputum, comfortduring quiet, with dyspnea on movement, absence of tempera-ture, and a peculiar feeling to the palpating fingers which wasentirely different ivom tuberculosis caused me to make a diag-nosis of probable new growth in spite of the absence of a historyof cancer in some other portion of the body. Later, tumor cellswere found in the sputum and the case was proved postmortem. In the secondary metastatic tumors of the lung, the historyof a previous tumor in some part of the body is suggest
Size: 1358px × 1840px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1920, bookpublisherstlou, bookyear1922
