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To the Editor:
—In the article by Drs. Holt and Ratterman on this subject (The Journal, Jan. 15, 1916, p. 171), statement is made that "sarcoma of the lungs, whether primary or secondary, is very rarely found." These authors report a case of multiple metastatic sarcoma of the lungs very fully and carefully. I wish to take exception to the statement regarding the frequency of secondary sarcomas of the lung, and in reply assert that not only are they relatively common but also they are to be looked for in every case of primary sarcoma, especially of the bone. The lungs are a characteristic location for secondary metastases in sarcoma for the reason that this type of neoplasm early invades blood vessels and especially the thin walls of veins. The wall is invaded by the advancing malignant growth, and the round or spindle cells are caught in the blood stream
Jackson H. Multiple Metastatic Sarcomas of the Lungs. JAMA. 1916;LXVI(11):833. doi:10.1001/jama.1916.02580370053031