The Bradshaw lecture on the results of bronchial obstruction : delivered before the Royal College of Physicians of London on November 1st, 1910 / by G. Newton Pitt.

  • Pitt, G. Newton (George Newton), 1853-1929.
Date:
1910
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Credit: The Bradshaw lecture on the results of bronchial obstruction : delivered before the Royal College of Physicians of London on November 1st, 1910 / by G. Newton Pitt. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    CASES OF SARCOMA OF BRONCHIAL GLANDS COMPRESSING THE BRONCHI. Case lix,—Sarcoma compressing especially Left Bronchus and Pulmonary Artery : Gangrene. 1889. Man, aged 60. Post Mortem.—A mediastinal sarcoma surrounded the bronchi and invaded the left one, almost occluding it. The right was slightly compressed. The left pulmonary artery was extremely reduced in size by the growth around it; there was acute gangrene of the upper part of the left upper lobe, the base was airless, the right lung was normal; there was no dilatation of the tubes. Case lx. — Sarcoma• compressing the Left Bronchus: Necrosis of Lung : Left Pneumothorax. 1905. Man, aged 63. Cavity at the apex. There was dysphagia, hoarseness, and the left vocal cord was para- lysed. There was dullness at the left apex with deficient breath sounds. Post Mortem.—There was sarcoma of the glands in the mediastinum extending into the root of the left lung, and obstructing the left bronchus. There were traces of old tubercle at the left apex, with a recent cavity due to extension of the growth and necrosis, leading to pneumo- thorax. Case lxi.—Sarcoma compressing Bight Bronchus: Pleuritic Effusion : Oedema of Lung. 1895. Man, aged 36. Admitted with pain, dullness at the right base, with deficient entry of air; oedema of the back, A rub could be heard, and there was dyspnoea; 8 pints of fluid were drawn off. Post Mortem.—Sarcoma of the glands, surrounding and pressing on the right bronchus, not occluding it, with invasion of the right upper lobe at the root. The rest of the lung was solid with bronchopneumonia. The left lung was oedematous. Case lxii.—Sarcoma invading Left Bronchus: Gangrene of Lung : Cavitation. 1899. Woman, aged 22 She was ill for three months with pain in the left chest, which was dull; there was no tactile vocal fremitus, voice or breath sounds. On the 18th the dyspnoea was intense, and 21 oz. of turbid fluid were taken from the left chest. On the 19tb, 4 oz. were drawn from the pericardium. The chest was very tender. On the 23rd, 3 oz. of pus were removed. The patient died while an attempt was being made to drain the pleura. Post Mortem. — A sarcomatous growth was found, invading the left bronchus at the bifurcation. There was a necrotic bronchopneumonia, especially at the lower lobe, which contained a quantity of pus in numerous large cavities. Lymph was found over the pleura. Case lxiii —Growth in Glands compressing Left Bronchus : Gangrenous Cavity. 1901. Man, aged 46. Pain in the chest with paraplegia, defective movement of the left chest with crepitations in the axilla. Post Mortem —The left bronchus was invaded by a growth commencing in the mediastinum. The upper lobe was collapsed at the apex and contained a gangrenous, ragged cavity, 3 in. across. Some growth in the upper lobe. The lower lobe was pneumonic. Case lxiv.—Growth at Boot of Bight Lung compressing Bronchus: Bronchiectasis. 1904. Woman, aged 43. There was a history of chest symptoms for two years. The right chest was dull, with deficient breath and voice sounds; 23 oz. of serum were drawn off. There was dyspnoea, which was fatal the day after admission. Post Mortem.—A growth in the mediastinum, 3 in. across, surrounded the right bronchus and reduced its lumen to one fourth; it had also invaded the lung. The pleura was firmly adherent to the chest wall. The right lung was fibroid and compressed, and there was some dilatation of tubes in the lower lobe. Bronchopneumonia. Case lxv.—Growth compressing Bight Bronchus : Bronchiectasis: Gangrene. 1898. Man, aged 57. He had had dyspnoea for four months, with stridor and haemoptysis for one month. The right chest was dull. There was cavernous breathing behind down to the spine of the scapula, and deficient breathing below. Post Mortem.-—The right lung was invaded by growth, breaking down in places and also compressing the bronchus. The few tubes which remained in the right upper lobe were dilated; the left lung was oedematous. Case lxvi.—Sarcoma compressing Left Bronchus and invading Lung. 1902. Woman, aged 20. She had a cough and there were large glands in the neck. The left chest was dull; there was no bronchial breathing and no dysphagia. Post Mortem.—-There was a sarcomatous mass in the posterior mediastinum invading the left lung, which it almost entirely occupied. Case lxvii.-—Sarcoma compressing Upper Branch of Left Bronchus : Infarct in Upper Lohe. 1905. Woman, aged 59. There were dyspnoea, cyanosis, orthopnoea The left chest was dull except at the base, where the resonance was only deficient. There were no breath sounds over this side; 90 oz. of fluid were drawn from the left side. Post Mortem.—There was a mass of glands behind the trachea and compressing the upper branch of the left bronchus. The left lower lobe was solid with septic bronchopneumonia, and there was an infarct in the upper lobe. Case lxviii.—Sarcoma compressing Bight Bronchus : Bronclnectasis. 1905. Woman, aged 57. There was a cough, with stridor and increasing dyspnoea. Post Mortem —There was a mass of growth in the right lung at the root surrounding the bronchus. The rest of the lung was solid. The bronchial tubes in the lower part were dilated. The tubes were full of muco-pus. A mass of round-cell sarcomatous growth invaded the anterior surface of the trachea. Case lxix —Sarcoma compressing Bight Bronchus. 1905. Woman, aged 54 There was cough and wasting. There were dilated veins on the right side of the chest. The gland behind the right sterno mastoid was invaded by growth. Dullness at the right apex. Post Mortem.—A large mass of sarcomatous growth in the anterior part of the mediastinum had invaded the lung at the right apex and compressed the bronchus. It had also invaded the walls of the innominate veins. Case lxx.—Sarcoma compressing Bight Bronchus : Pleuritic Effusion. 1905. Woman, aged 19 There was a sarcoma of the humerus, rapidly invading the glands and the thorax. Post Mortem.—There were 30 oz. of fluid in each chest. The growth penetrated the trachea just above the bifurca- tion, and compressed the right bronchus and superior vena cava. There were masses of growth in the anterior and posterior mediastinum, and nodules of growth in the right lung. There was recent lymph on the surfaces. There was an entire absence of any dilatation of the bronchi owing to the fluid in the chest. Case lxxi.—Sarcoma invading Bight Bronchus : Bronchiectasis: Gangrene. 1902 Man, aged 50. He had had a cough for two months, and there was dyspnoea. Post Mortem.—There was sarcoma of the glands at the root of the right lung ; the right bronchus was invaded and eroded on its anterior surface. The tubes of the right lower lobe were dilated, and there were gangrenous cavities.