C. Allen Good

Alveolar-cell carcinoma (terminal bronchiolar carcinoma). A study of surgically excised tumors with special emphasis on localized lesions.

The lesion variously described as alveolar-cell carcinoma, bronchiolo-alveolar carcinoma, and terminal bronchiolar carcinoma is a primary pulmonary neoplasm of relatively infrequent occurrence. In an operable case the tumor is typically peripheral. It may involve a small area of pulmonary parenchyma or it may be extensive, involving an entire lobe or all of a lung. In contrast to most bronchogenic carcinomas, this tumor, on gross examination, appears to arise from the pulmonary parenchyma rather than from a major bronchus. The microscopic finding of papillary neoplastic transformation of the lining mucosa of terminal bronchioles, in many cases, suggests an origin from terminal bronchiolar epithelium. The exact definition of alveolar-cell carcinoma and its relationship to ordinary adenocarcinoma of the lung have been a subject of some dispute. Some authors have used the term “terminal bronchiolar carcinoma” to cover a large number of peripheral adenocarcinomas of the lung, including those with much infiltr...

The Radiographic Features of Tracheopathia Osteoplastica

Tracheopathia osteoplastica is a rare, benign tumorous condition of the trachea and major bronchi. The multiple osteocartilaginous tumors are formed in the wall of the trachea and project into the internal surface of that structure, producing a variable amount of obstruction to the airway. Solitary chondromas and solitary osteomas of the trachea usually are excluded from this particular category. Apparently, the literature does not contain any detailed account of the radiographic features of this disease entity. It was felt advisable, therefore, to review roentgenograms of patients with this condition who had been seen at the Mayo Clinic. Also, we wish to present a case in which the diagnosis of tracheopathia osteoplastica was made on the basis of the clinical history and the characteristic radiographic picture as seen in tomograms. Report of Case Case I: A 71-year-old white man registered at the clinic on Oct. 18, 1955, complaining of progressive exertional dyspnea and productive cough of three years dur...

Chronic Idiopathic Pericardial Effusion without Tamponade

Persistent pericardial effusion in the absence of obvious preceding or concurrent disease presents a baffling problem. In such cases chylopericardium, cholesterol pericarditis, lupus erythematosus, malignant disease, myxedema, severe anemia, and scleroderma, must be considered. Six cases are reported with large effusions present for from 1 to 11 years. The diagnostic measures to be used, the results of histologic examination, and the effects of surgery on the clinical course are discussed.

Partial duplication of the gallbladder, diverticulum type; report of a case.

Duplications of the gallbladder may be classified as (a) double (two cystic ducts), (b) bilobed (one cystic duct draining a bifid viscus), and (3) diverticulum (c). These anomalies seldom occur in man, particularly the bilobed and diverticulum types. Boyden (2) in 1926 found 15 examples of duplication of the gallbladder in the worlds literature and added 5 of his own. He considered none of these to be diverticula. Gross (3) in 1936 reviewed 148 anomalies of the gallbladder, 9 of which he classified as congenital diverticula. Castro (4) reviewed 68 of 74 cases in the Mayo Clinic files up to 1944 that were suggestive of diverticulum of the gallbladder, and accepted only 3 as cases of congenital diverticulum. Report of Case A 50-year-old white woman, a farmers wife, was registered at the Mayo Clinic on May 13, 1948, complaining of intolerance to fatty foods and episodes of distress at the right costal margin, relieved by vomiting. Cholecystographic examination showed a normally functioning gallbladder. The...

A preliminary evaluation of Cave's roentgenographic method of fetal cephalometry

Abstract A brief review of the literature relating to roentgenographic cephalometry has been presented. Particular emphasis has been given to the recent work of Cave, and his so-called precision method has been evaluated. If grossly unsatisfactory roentgenograms are excluded—and we are of the opinion that such roentgenograms can usually be excluded—accurate measurements of diameters of the fetal skull in the uterus to within ±6.6 per cent can be obtained by this method in approximately 85 per cent of the cases. In the case of measurements of fetal skulls adjudged to be of grade A in the roentgenogram, accuracy to within ±5.5 per cent was consistently obtained (92 per cent). We believe that a simple, inexpensive, and relatively precise technique of roentgenographic cephalometry might well represent a helpful adjunct in the management of suspected cephalopelvic disproportion in the primigravid woman for whom a trial of labor has been planned and a fetal development above the average is suspected. Although this method, in our limited experience, does not seem to be a method of precision, it is certainly deserving of further investigation.

Disseminated indeterminate pulmonary disease; value of lung biopsy.

Forty or fifty years ago the roentgenologic picture of disseminated pulmonary disease usually was thought to mean tuberculosis. Since that time many other causes have been recognized, and an awareness of the wide variety of conditions which produce this picture has grown rapidly in the past quarter of a century. In 1938, for example, King (1) catalogued 10 possible causes, in 1942 Austrian and Brown (2) enumerated 22, in 1948 Felson and Heublein (3) counted 75, and by 1952 Scadding (4) had raised the figure to 80. For purposes of classification the numerous conditions may be subdivided into seven groups: infections, inhalations, aspirations, vascular diseases, systemic diseases and pulmonary diseases of uncertain etiology, neoplasms, and allergies. With the growing recognition of the many entities producing a roentgenologic appearance of disseminated pulmonary disease has come the realization that the information gained from the clinical history, the physical examination, and the routinely available labor...