The question concerning the nature and location of the incipient changes in reinfection forms of pulmonary tuberculosis has enjoyed renewed interest in recent years. There has been considerable discussion on the subject of subapical versus apical location of the early manifestations. The importance of the infraclavicular infiltrations and their significance as precursors of manifest and progressive phthisis has been especially stressed by the German school. It is not intended here to dilate further on this point, which has been so thoroughly discussed by numerous writers. Suffice it to state that the results of these investigations definitely indicate that in a large proportion of the clinically manifest forms the earliest changes are situated outside the apex of the lung.
The interest in the subject presented in this paper was originally aroused by a group of cases in which the location of the changes is frequently considered as atypical for adult forms
REISNER D. PULMONARY TUBERCULOSIS OF THE LOWER LOBE. Arch Intern Med (Chic). 1935;56(2):258–280. doi:10.1001/archinte.1935.03920020050004
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