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Periodic study with tuberculin test and x-ray examination of more than 3,000 young men and women at the University of Lund in southern Sweden permitted the authors to observe the development of pulmonary lesions in 133 students. Their observations dealing with the genesis of tuberculosis are of great importance. The studies were carried out with thoroughness and the results are reported in detail. Only rarely was the "subclavicular infiltrate" found to be the earliest lesion. As a rule the initial manifestation of pulmonary tuberculosis was above the clavicle, indicated by discrete soft spots in the x-ray film. Spread below the clavicle was usually followed by confluence of the spots, simulating a primary exudative infiltrate. Apical infiltrations of this sort were frequently noted, without evidence of a primary complex, in students who had only recently become tuberculin positive. Apical lesions progressed to clinical disease and occasionally to death, with equal frequency
Studien über die Entstehung und Entwicklung der Lungentuberkulose mit besonderer Berücksichtigung des Verlaufs der tuberkulösen Erstinfektion des Jugendlichen und Erwachsenen. JAMA. 1938;111(25):2331. doi:10.1001/jama.1938.02790510079036
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