Document 10LL2EbM8eM9rrvQRR3abOaQ5

, !, .. ti-. number -! r - - - c.'ip I ir-n.nl. I* 10'! Id:".. u. i 'M'rnC'i , t lie .1. 1- v Iv'l'v niv .tl II . .. : :...| A wniirui. For ii:n;; nici'i . large 'I It''' rw i sc c.n.T .1 lu'i'.'itdnwu of Vh-.l inr mn I vs -mil : ve must. in. mind that i.n ron:pu r i sun to I lit U.S. , :i cmpl eyed in asbestos plants far exceeds c lie number of bvh in Germany and in l.nglnnd*. ,i:= i.e I'.avc already muni tuned, one jm|<ori.ant cons i di.-rat ion is the i i i i-iii -i-li.'ti, - of growth loen I. i.s.ar i on witli the most severe dinners cm w.l by asbcst.or.is in the lower part of Lin- lung. Moreover, tlie It Uilulogical nature of pulmonary growtli is evident. R;iv c ten 1 ly , tlie incidence of mostly cornified carcinoma of tlie paverr.1:t epithelium is hy far the highest. Out of 8 diagnosed cases of btenciiial cancer, we found 6 such cases. The general lung cancer statis tics for various typos of growths thus become one-sided to the advantage of cancer of the pavement epithelium. If we perform a histological break down of limp, rancor into three large groups, namely non-diffcreut iatod cells, carcinoma of the pavement epithelium and carcinoma of the* columnar epithe lium, the first will have tlie highest statistics with a total allotment of about 2/3 of all casco.' Since cancer of the pavement epithelium lias the i-.c-t tendency towards metastasizing, it would be understandable that, of the above observations, four were found to be without metastases. The histological nature of lung cancer itself, as well as the abovc-mentioned highest incidence of cancer of Che pavement epithelium, explains its classification under Lung cancer. Cancer was only observed following a relatively long period of latency fo l.l owing exposure to the dust. Could this be due to the fact that rim period of employment under asbestos dust conditions was very Jong, or that a short period of employment with considerable exposure resulted in a longer interval during which the effect of the dust continued to progress? A scries of thorough observations, which were partly performed by the author himself, showed chat, particularly in the case of asbestosis patients, dusc intoxication often appeared during this first interval, and often led to progressive fibrosis- Among all the lung cancer cases observed in asbestosis patients, there is not one single case in which a long period of action of asbestos particles was hot reported. This agrees very well wvch other observations made of other types of occupational cancer. Ocher histological findings in the lungs of nsbestosis carriers allow iv i" better understand tlie ahove-mentitmed correlations. In tlie small bruuchi of .lungs affected by asbestos particles, we mostly find pcnorali;-vd epithelial metaplasia, considered as a per-cancerous stage. It is very probahle that the carcinomatous regeneration originates here. In one 'as..', Nordmann oven made the observation that, in a severe case of carcinoma in ihc left lover lnho, a smaller cancer was beginning to develop on tlie ui her side, which was not to be considered as metastasis, but rather as a ct-1 1-deva.l opi ng cancer originating from the metaplastic bronchial epithelium. For that reason, lie considers the mul tilocular development, of cancer in ashsiosis patients Co he particularly significant. Here we find parallels to i In Scltne.-hergor lung cancer. -16-