File:Radiography, x-ray therapeutics and radium therapy (1915) (14735219436).jpg

Identifier: radiographyxray00knox (find matches)
Title: Radiography, x-ray therapeutics and radium therapy
Year: 1915 (1910s)
Authors: Knox, Robert, 1868?-1928
Subjects: Radiography Radiotherapy
Publisher: New York, Macmillan
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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th in the pulmonary systemrequire to be dealt with in the differential diagnosis. Cases with enlargedbronchial glands will cause some difficulty. The peribronchial forms ofphthisis give rise to marked increase of the hilus shadows, which are extremelydifficult and often impossible to differentiate from new growth. The chiefpoint of distinction between the two lies in the fact that in the peribronchialform of phthisis the increase of shading is more evenly distributed at bothroots, and may extend up to the apex or down to the base of the lung,forming tree root shadows, with nodular enlargements of small size, thelatter indicating the presence of calcified or fibrosed bronchial glands. Whena recurrence of cancer occurs at the roots of the lungs it tends to be moredefinitely localised to one spot, and spreads outwards into the lung substance,while the remaining portion of the bronchial tree on that side may show nomarked increase. The bronchial ramification on the other side is generally
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PLATE XXXVII.—Chests showing Changes in Heart and Lungs. a, Lobar j)nenmonia, localised to right upper lobe. h, Secondary carcinoma of mediastinum spreading out into lung substance. c, Greatly enlarged heart. Hypertrophy and hydropericardium. TUBERCULOSIS OF THE LUNGS 201 free. A bilateral increase of shadows is more in favour of a tuberculouscondition than a malignant growth. The tuberculous condition may, how-ever, be present in a patient who subsequently develops a cancer or a sarcomaof the lung. When disease has been shown to be present, it is often difficult todetermine whether it is active or not. The distinction between active andhealed tuberculosis has often to be made. In the former the mottling of thelung shadows is more marked, in the latter the appearances conveyed aremore those of streaking, indicating a fibrotic condition. In some cases theshadows appear to be denser, and occasionally it is possible to make outareas of calcification. These ruay be seen at the apices, b

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