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May 2, 1966

Simulation of Lung Cancer By Metastatic Tumors

JAMA. 1966;196(5):459. doi:10.1001/jama.1966.03100180131053

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To the Editor:—  The criteria for the diagnosis of bronchogenic carcinoma highlighted in "Current Concepts in Cancer—No. 9" (195:653, 1966) are illusory and help to perpetuate the erroneous diagnosis of bronchogenic carcinoma on the basis of biopsy and radiographic confirmation. Bronchial and scalene node biopsies positive for cancer are not pathognomonic of bronchogenic carcinoma. These findings are indicative only of a malignant tumor in the lung and do not specify whether the tumor is of primary or secondary origin.Metastatic involvement of the bronchi may simulate both the gross and histological appearance of bronchogenic tumors. Secondary tumors involving the subepithelial lymphatics may ulcerate through the bronchial mucosa and present an accessible mass visible on bronchoscopy (Cancer16:1521, 1963). On occasion, histological examination of malignant biopsied material may reveal findings characteristic of certain extrathoracic carcinomas (thyroid, kidney, etc), but most often the tissue is reported as undifferentiated carcinoma apparently

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