. Radio-diagnosis of pleuro-pulmonary affection . nce. Sometimes the shadow of the glands projectsgreatly on one side or the other. But this image may belacking. To see more distinctly the shadow of these glands, themedian shadow must be separated by having the patientassume different anterior, posterior and oblique positionsso that the mediastinum can be investigated. The glandsare then seen as a diffuse shadow without definite outline,obscuring the middle portion of the corresponding medianclear space and almost level with the bronchial this connection Schwarz has observed tha
. Radio-diagnosis of pleuro-pulmonary affection . nce. Sometimes the shadow of the glands projectsgreatly on one side or the other. But this image may belacking. To see more distinctly the shadow of these glands, themedian shadow must be separated by having the patientassume different anterior, posterior and oblique positionsso that the mediastinum can be investigated. The glandsare then seen as a diffuse shadow without definite outline,obscuring the middle portion of the corresponding medianclear space and almost level with the bronchial this connection Schwarz has observed that before radio-scopic examination this bifurcation had been placed asmuch too high. In reality it corresponds to the sixth rib 92 RADIO-DIAGNOSIS: PLEURAE posteriorly; consequently, mediastinal adenopathy oughtto be looked for at this level or above, while pulmonaryadenopath^s situated lower down, corresponds to the seventhor eighth rib. IMediastinal adenopathy, especially if large and if itsimage projects beyond the median shadow, may, strictly. Fig. 19. DIAGRAM OF THE DISTRIBUTION OF THE GLANDS, AFTER AUTOPSYPredominance of mediastinal glands on the right side occupying the entirelength, superimposed one upon another from the diaphragm up to the caseous glands in the right hilus (see Radiograph 17). speaking, be confused in children with hypertrophy of thethymus and in adults with tumor of the mediastinum. Differential diagnosis from thymic hypertrophy is com-paratively easy, the latter giving a radioscopic image moreelevated, located under the clavicles and usually with acontour almost rectilinear and symmetrical on both image superimposed on that of the heart has roughlythe appearance of an hour-glass. Besides, thymic hyper-trophy is found only in the new born while tracheo-bronchialadenopathic syndroma is rather the usual accompanimentof childhood. Age will therefore be an important factor toconsider and, on the other hand, as the thymus and other T
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