The history of the progress in the more accurate understanding of disease of the chest runs pari passu with the more widespread use of bronchoscopy. The bronchoscope has proved to be of the utmost help not only in definitely establishing the existence of carcinoma in cases in which it is unsuspected or in confirming the clinical diagnosis of its presence but also, on occasion, in making it possible to negate a positive clinical diagnosis.
As experience was gained in the bronchoscopic examination of carcinoma of the lung it was realized that in a certain proportion of cases a definite diagnosis cannot be made by endoscopy. In fact, occasionally no abnormality of the bronchial tree can be detected, although the case ultimately proves to be one of carcinoma. In this group of cases the neoplasm cannot be visualized because of its peripheral location, and hence no pathologic tissue presents itself
KRAMER R, SOM ML. BRONCHOSCOPIC STUDY OF CARCINOMA OF THE LUNG: AN ANALYSIS OF THREE HUNDRED CASES OF BRONCHIAL CARCINOMA WITH ONE HUNDRED POSTMORTEM EXAMINATIONS. Arch Otolaryngol. 1936;23(5):526–543. doi:10.1001/archotol.1936.00640040536002
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