Primary Carcinomatous Cavities of the Lung; Possible Role of Neoplastic Cell Autophagism

¹ Director, Phthisiology Clinic, University of Rome and the Carlo Forlanini Centre of Studies of the I.N.P.S.

On the basis of 19 clinical observations made by the author and his co-workers, the syndrome of clinically primary or pseudocystic peripheral pulmonary carcinomatous cavities is described. This syndrome is to be distinguished from the better-known syndrome of "pulmonary cancer abscess." The differential diagnoses of cavitary tuberculosis of the lung and pulmonary abscess are discussed, since one of these clinical forms may easily be confused with the others.

Moreover, the pathogenesis of these cavities of peripheral epitheliomas of the lung is examined and a new pathogenic hypothesis is proposed, regarding the possibility of the role of a "neoplastic cell autophagism," due to a particular enzymic system, secreted by epithelial cells, like that which sometimes occurs in cases of pulmonary metastasis of pancreatic carcinomas.

Finally, the attention of pneumophthisiologists is drawn to the necessity of bearing this particular syndrome in mind, especially in cases of doubtful diagnosis of tuberculosis, or of pulmonary abscesses of anomalous course, in subjects of rather advanced age admitted to the santatorium. It is mandatory to subject them to necessary bronchologic and laboratory examinations and tests prompty, in order to solve the diagnostic difficulty and resort to pulmonary resection when necessary.