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Bronchogenic vs Metastatic Carcinoma of the Lung

John D. Steele
JAMA. 1966;197(4):300. doi:10.1001/jama.1966.03110040110035.
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To the Editor:—  In his letter (196: 459, 1966), Dr. Milton B. Rosenblatt implies that solitary metastatic tumors of the lung are commonly mistaken for bronchogenic carcinomas even after resected tissue has been examined microscopically.Our evidence does not support this supposition. In a series of 306 malignant tumors of the lung appearing as solitary pulmonary nodules 6 cm and less in diameter, only 26 were metastatic. In 23 of the 26 there was a history of previous malignancy outside the lung (J Thorac Cardiov Surg46:21, 1963).Our patients have been followed for from 2 1/2 to 6 years, less than 2% having possibly been lost to follow-up. The relative five-year survival rate of the patients having bronchogenic carcinoma is 38.6% (Ann Thorac Surg2:368, 1966). In many cases, autopsies were performed.In no instance has any tumor originally classified as a primary bronchogenic carcinoma later proved to


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