Recently the old debate regarding the possibility of a primary tuberculous infection of the larynx and the associated theories concerning the method of laryngeal invasion seems to have been reawakened.
Brieger and Pagel1 report their findings in 4 cases in which the lesions at first looked very much like primary lesions of the larynx, perhaps of hernatogenous origin. However, in 3 of the cases a careful clinical study showed demonstrable pulmonary lesions. In the other case it was only by careful postmortem examination that the pulmonary lesion was found. Histologic study of part of the pulmonary tissue finally revealed evidence of rupture of a small pulmonary nodule into a bronchus. As far as the pathogenesis of the laryngeal lesion is concerned, Brieger and Pagel say in conclusion: "We do not contest the possibility of an independent hematogenous development of a laryngeal lesion, but this should not be overrated."
WOOD GB. TUBERCULOSIS OF THE UPPER PART OF THE RESPIRATORY TRACT: LITERATURE OF THE PAST TWO YEARS. Arch Otolaryngol. 1938;27(4):476–487. doi:10.1001/archotol.1938.00650030487012
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