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April, 1940 CARCINOMA OF THE BRONCHUS—HARRILL 181 the lower respiratory tractf2). A family history of cancer was obtained in one case. Histologically the bronchial mucosa consists of a layer of ciliated columnar cells resting on a basal cell layer of ovoid cells. Deep beneath the basal cell layer lies the sub-mucosal tissue, consisting of areolar, fibrous and elastic tissue, and containing numerous mucous glands. (Fig. 1.) In the presence of chronic inflammatory processes in the bronchi, the ciliated columnar epithelium is often found to change to squamous-celled epithelium. Ormerod(3) has demonstrated the change from one type to the other in a single field. Fried(4) considers the basal cell layer responsible for the regenerative processes. The pathology of these tumors has been of interest to pathologists for many years, but they have not agreed upon which of the first two layers is responsible for the formation of squamous-celled carcinoma. The adenocarcinomas probably arise in the mucous glands of the submucosal layer. Halpert(5) states that all bronchogenic carcinomas arise from the “reserve cells” of the basal cell layer by atypical proliferation. The macroscopic appearance of the tumors in 19 cases could be classified as fungating, submucous and polypoid. Twelve presented themselves as fungating, friable masses; five as submucous growths; two as polypoid; and the twentieth in the series was undetermined. As to location, the distribution was fairly even. Eleven were located on the right side and nine on the left. Seventeen were located in the main bronchi and were visualized by bronchoscopy. The remaining three originated in a peripheral bronchus. (Fig. 2.) The local pulmonary and general symptoms, by themselves, are not diagnostic. When cough, with or without sputum, hemoptysis and dyspnea, occurs for the first time in an individual of the cancer age, especially when associated with pain, carcinoma of the lung should be highly considered. Cough of duration from one month to ten years was present in 18 (90 per cent) of the cases, and was found to be the most constant symptom. It was productive in 13 cases (70 per cent). 2. Miller. J. A., in Musser, J. H: Internal Medicine. Phila tlelphia. Lea and Febiger. 1932, p. 616. 3. Ornierod, F. C.: The Pathology and Treatment of Carcinoma of the Bronchus, J. Laryng. and Otol. 52:733 (Nov.) 1937. 4. Fried. B. M.: Primary Carcinoma of the Lung, Baltimore, Williams and Wilkins*, 1932, p. 46. 5. Halpert, B., cited by Ochsner and DeBakey (9). Fig. 2. Distribution according to the side involved and the area from which biopsy was taken. The second most prominent symptom was chest pain. This occurred in 14 (70 per cent) of the cases. Pain due to carcinoma of the lung is found to be more continuous than that due to any other intrathoracic condition, with the possible exception of aortic aneurysm. It has been said that its persistency and intensity almost puts it in a class by itself. The pain in 9 cases was referred to the side of the lesion. In 2 cases it was referred to both sides of the chest. In the remaining 3 cases, the historian only mentioned that pain in the chest was present. In 2 cases chest pain was the only pulmonary symptom. Hemoptysis was present in 10 cases (50 per cent), ranging in duration from one month to six years. It is interesting to speculate as to the possibility of a benign adenoma undergoing malignant changes in the bronchus of the patient who had hemoptysis for six years. Dyspnea was present in 4 cases (20 per cent), and occurred late in the course of the disease. Of the general symptoms, loss of weight, weakness, and night sweats, ii\ the order mentioned, were the most prominent. Only in few of the cases did the general symptoms cause the patient to seek hospitalization. Other than thoracic pain, symptoms suggestive of metastasis to the ribs were present in 2 cases, to the cervical vertebrae in 1, to the thoracic vertebrae in 1, to the head of
Object Description
Rating | |
Fixed Title * | NCHH-17: North Carolina Medical Journal [1940-2001] |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1940 |
Identifier | NCHH-17-001 |
Form General | Periodicals |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 1 |
Health Discipline | Medicine |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-001.pdf |
Document Sort | all; nchh-17 |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-001 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Revision History | done |
Description
Fixed Title * | Page 181 (image) |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1940 |
Identifier | NCHH-17-001-0199 |
Form General | Periodicals |
Page Type | all; all images; diagram; article |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Filename | northcarolinamed11940medi_0199.jp2 |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 1 |
Issue Number | 4 |
Page Number | 181 |
Health Discipline | Medicine |
Full Text | April, 1940 CARCINOMA OF THE BRONCHUS—HARRILL 181 the lower respiratory tractf2). A family history of cancer was obtained in one case. Histologically the bronchial mucosa consists of a layer of ciliated columnar cells resting on a basal cell layer of ovoid cells. Deep beneath the basal cell layer lies the sub-mucosal tissue, consisting of areolar, fibrous and elastic tissue, and containing numerous mucous glands. (Fig. 1.) In the presence of chronic inflammatory processes in the bronchi, the ciliated columnar epithelium is often found to change to squamous-celled epithelium. Ormerod(3) has demonstrated the change from one type to the other in a single field. Fried(4) considers the basal cell layer responsible for the regenerative processes. The pathology of these tumors has been of interest to pathologists for many years, but they have not agreed upon which of the first two layers is responsible for the formation of squamous-celled carcinoma. The adenocarcinomas probably arise in the mucous glands of the submucosal layer. Halpert(5) states that all bronchogenic carcinomas arise from the “reserve cells” of the basal cell layer by atypical proliferation. The macroscopic appearance of the tumors in 19 cases could be classified as fungating, submucous and polypoid. Twelve presented themselves as fungating, friable masses; five as submucous growths; two as polypoid; and the twentieth in the series was undetermined. As to location, the distribution was fairly even. Eleven were located on the right side and nine on the left. Seventeen were located in the main bronchi and were visualized by bronchoscopy. The remaining three originated in a peripheral bronchus. (Fig. 2.) The local pulmonary and general symptoms, by themselves, are not diagnostic. When cough, with or without sputum, hemoptysis and dyspnea, occurs for the first time in an individual of the cancer age, especially when associated with pain, carcinoma of the lung should be highly considered. Cough of duration from one month to ten years was present in 18 (90 per cent) of the cases, and was found to be the most constant symptom. It was productive in 13 cases (70 per cent). 2. Miller. J. A., in Musser, J. H: Internal Medicine. Phila tlelphia. Lea and Febiger. 1932, p. 616. 3. Ornierod, F. C.: The Pathology and Treatment of Carcinoma of the Bronchus, J. Laryng. and Otol. 52:733 (Nov.) 1937. 4. Fried. B. M.: Primary Carcinoma of the Lung, Baltimore, Williams and Wilkins*, 1932, p. 46. 5. Halpert, B., cited by Ochsner and DeBakey (9). Fig. 2. Distribution according to the side involved and the area from which biopsy was taken. The second most prominent symptom was chest pain. This occurred in 14 (70 per cent) of the cases. Pain due to carcinoma of the lung is found to be more continuous than that due to any other intrathoracic condition, with the possible exception of aortic aneurysm. It has been said that its persistency and intensity almost puts it in a class by itself. The pain in 9 cases was referred to the side of the lesion. In 2 cases it was referred to both sides of the chest. In the remaining 3 cases, the historian only mentioned that pain in the chest was present. In 2 cases chest pain was the only pulmonary symptom. Hemoptysis was present in 10 cases (50 per cent), ranging in duration from one month to six years. It is interesting to speculate as to the possibility of a benign adenoma undergoing malignant changes in the bronchus of the patient who had hemoptysis for six years. Dyspnea was present in 4 cases (20 per cent), and occurred late in the course of the disease. Of the general symptoms, loss of weight, weakness, and night sweats, ii\ the order mentioned, were the most prominent. Only in few of the cases did the general symptoms cause the patient to seek hospitalization. Other than thoracic pain, symptoms suggestive of metastasis to the ribs were present in 2 cases, to the cervical vertebrae in 1, to the thoracic vertebrae in 1, to the head of |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-001.pdf |
Document Sort | all; nchh-17 |
Article Title | Carcinoma Of The Bronchus |
Article Author | James A Harrill |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-001 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Revision History | done |
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