Carcinoma of the lung and dysphagia.

In order to determine the frequency of dysphagia in primary carcinoma of the lung we reviewed the records of 615 consecutive hospital admissions which took place over a 9%-year period; the incidence was 2.2 per cent in 405 proved cases. The mechanism is esophageal involvement and compression by subcarinal and periesophageal lymph nodes. Dysphagia is not an early symptom; it indicates advanced disease and usually forecasts inoperability. Even in some cases when dysphagia is not present, the esophagogram can be of help in assessing the involvement of periesophageal nodes and hence inoperability. The roentgenologic appearance varies from compression of the esophagus to one of involvement of the esophageal wall and occasionally to that of a circumferential lesion. Lung carcinoma should be considered in the differential diagnosis of all patients with midesophageal dysphagia.