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Nomenclature Explosion
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FARREHI ET AL
5 ZIatkis A, Zak B, Boyle AJ: A new method for the direct determination of serum cholesterol. J Lab Clin Med 41:486-492, 1953 6 Young G, Eastman R: A micromethod for the determination of serum triglycerides. S Mr J Lab Clin Med 9:28-31, 1963 7 New weight standard for men and women. Stat Bull Metropol Life Ins Co 40:1-4,1959
8 Judkins MP: Percutaneous transfemoral selective coronary arteriography. Radiol Clin North Am 6:467-492, 1968 9 LeBovit C, Cofer E, Murray J, et al: Dietary evaluation of food used in households in United States. US Dept Agricul Household Food Con Sur Rep No. 16, 1955 10 Hollister LE, Wright A: Diurnal variation of serum lipids. J Atheroscler Res 5:445-450, 1965
Nomenclature Explosion The clinical entity currently known as alveolar cell carcinoma of the lung has been recorded under thirtythree different names. From this plethora the following is a partial listing only: multinodular carcinoma, diffuse lung cancer, carcinosis, adenoma-like tumor of the lung, pulmonary mucous epithelial hyperplasia, pulmonary alveolar adenomatosis, papillary gelatinous adenocarcinoma, mucocellular papillary adenocarcinoma, diffuse, solitary or multiple bronchiolar carcinoma, pulmonary adenomatosis. Reason for the numerous terms may be attributable to variability of and physiologic changes in ultrastructural units of the lung; to advances in diagnostic technology, such as electron microscopy; to inadvertant false premise in documentation, such as negation of the existence of alveolar epithelium; to differences in interpretation of identical findings; to observations recorded at various stages of the disease; to morphologic changes brought about by various methods of histologic fixation. Relative to the alveolar epithelium, it is well to refer to the thoroughgoing observations of von Hayek (The Human Lung [English language edl New York, Hafner, 1960). Alveolar epithelial celIs cover one-tenth of the surface of the 300 to 400 million human alveoli and lie sunken into depressions or project between capillaries and extend through the entire thickness of the alveolar septum. Their membranous processes constitute a continuous cover of the alveoli. The shape of alveolar epithelial cells varies under the influence of fulness of adjacent capillaries. Their appearance has been described as Hat, cuboidal, rounded and irregular.
More than one-half of their surface IS In contact with capillaries, a more intimate relationship than anywhere else in the human body. In addition to pleomorphic great alveolar cells, there are attenuated squamous alveolar cells. According to several reports, alveolar cell carcinoma constitutes 0.4 to nearly 10 percent of primary carcinomas of the lower respiratory tract. Belgrad et al reported that 71 percent of patients with alveolar cell carcinoma were women (Radiology 79:789, 1962). In the x-ray film it may be seen as a solitary nodule, disseminated miliary form, diffuse involvement similar to pneumonic infiltration (localized or widespread) or transitional forms. Bilateral involvement is a late occurrence encountered in about 20 percent of instances. Cavity has been observed in about one-half of solitary nodules. Metastatic spread is slow. The patient may remain symptomless for 8-10 years. In the majority, progressive dyspnea is the most prominent symptom. Also, the patient may complain of cough, hemoptysis, pain in the chest, malaise, anorexia and loss of weight. In some cases, large amounts of watery, frothy, mucoid sputum are expectorated. Cytologic examination of specimens of sputum or those obtained by bronchial brushing is of utmost importance in diagnosis. Olsen et al (Chest 57:558, 1970) offered an excellent review of the subject together with precepts derived from their own extensive experience. It confirms the motto that unison in terminology is the key to proficient medical communication. Andrew L. Banyai, M.D.
CHEST, VOL. 63, NO.3, MARCH, 1973
FARREHI ET AL
5 ZIatkis A, Zak B, Boyle AJ: A new method for the direct determination of serum cholesterol. J Lab Clin Med 41:486-492, 1953 6 Young G, Eastman R: A micromethod for the determination of serum triglycerides. S Mr J Lab Clin Med 9:28-31, 1963 7 New weight standard for men and women. Stat Bull Metropol Life Ins Co 40:1-4,1959
8 Judkins MP: Percutaneous transfemoral selective coronary arteriography. Radiol Clin North Am 6:467-492, 1968 9 LeBovit C, Cofer E, Murray J, et al: Dietary evaluation of food used in households in United States. US Dept Agricul Household Food Con Sur Rep No. 16, 1955 10 Hollister LE, Wright A: Diurnal variation of serum lipids. J Atheroscler Res 5:445-450, 1965
Nomenclature Explosion The clinical entity currently known as alveolar cell carcinoma of the lung has been recorded under thirtythree different names. From this plethora the following is a partial listing only: multinodular carcinoma, diffuse lung cancer, carcinosis, adenoma-like tumor of the lung, pulmonary mucous epithelial hyperplasia, pulmonary alveolar adenomatosis, papillary gelatinous adenocarcinoma, mucocellular papillary adenocarcinoma, diffuse, solitary or multiple bronchiolar carcinoma, pulmonary adenomatosis. Reason for the numerous terms may be attributable to variability of and physiologic changes in ultrastructural units of the lung; to advances in diagnostic technology, such as electron microscopy; to inadvertant false premise in documentation, such as negation of the existence of alveolar epithelium; to differences in interpretation of identical findings; to observations recorded at various stages of the disease; to morphologic changes brought about by various methods of histologic fixation. Relative to the alveolar epithelium, it is well to refer to the thoroughgoing observations of von Hayek (The Human Lung [English language edl New York, Hafner, 1960). Alveolar epithelial celIs cover one-tenth of the surface of the 300 to 400 million human alveoli and lie sunken into depressions or project between capillaries and extend through the entire thickness of the alveolar septum. Their membranous processes constitute a continuous cover of the alveoli. The shape of alveolar epithelial cells varies under the influence of fulness of adjacent capillaries. Their appearance has been described as Hat, cuboidal, rounded and irregular.
More than one-half of their surface IS In contact with capillaries, a more intimate relationship than anywhere else in the human body. In addition to pleomorphic great alveolar cells, there are attenuated squamous alveolar cells. According to several reports, alveolar cell carcinoma constitutes 0.4 to nearly 10 percent of primary carcinomas of the lower respiratory tract. Belgrad et al reported that 71 percent of patients with alveolar cell carcinoma were women (Radiology 79:789, 1962). In the x-ray film it may be seen as a solitary nodule, disseminated miliary form, diffuse involvement similar to pneumonic infiltration (localized or widespread) or transitional forms. Bilateral involvement is a late occurrence encountered in about 20 percent of instances. Cavity has been observed in about one-half of solitary nodules. Metastatic spread is slow. The patient may remain symptomless for 8-10 years. In the majority, progressive dyspnea is the most prominent symptom. Also, the patient may complain of cough, hemoptysis, pain in the chest, malaise, anorexia and loss of weight. In some cases, large amounts of watery, frothy, mucoid sputum are expectorated. Cytologic examination of specimens of sputum or those obtained by bronchial brushing is of utmost importance in diagnosis. Olsen et al (Chest 57:558, 1970) offered an excellent review of the subject together with precepts derived from their own extensive experience. It confirms the motto that unison in terminology is the key to proficient medical communication. Andrew L. Banyai, M.D.
CHEST, VOL. 63, NO.3, MARCH, 1973