Malignant change in bronchiectasis.

It has been known for some time (Deelman, 1924; MacKenzie and Rous, 1941; Pullinger, 1943 and 1945; Burrows and Clarkson, 1943; Burrows, Mayneord, and Roberts, 1937; Lacassagne, 1933; and others) that various types of injury can influence the development of experimentally produced tumours, hastening their development and localizing their site. In man, many instances have been recorded where a cancer has been found closely related to an area involved by former injury. Thus, for example, cancers have apparently developed in old burn scars (Treves and Pack, 1930), in association with varicose ulcers (Black, 1952), and sometimes in relation to chronic inflammatory lesions (lupus vulgaris, syphilitic lesions, etc.). It is possible that cancer may have some aetiological relation with such injury or chronic disease. In the lung, instances have been recorded where cancer has been found, apparently originating in the walls of tuberculous cavities, in the " fibrous apical cap" (James and Pagel, 1944) and, according to several authors including Schwartz (1950), in bronchial scars resulting from tuberculous ulceration. In recent years there have been recorded by several observers (Stewart and Allison, 1943; Petersen, Hunter, and Sneeden, 1949; Prior and Jones, 1952; Raeburn and Spencer, 1953; and others) a number of small early peripheral lung cancers, and evidence has been found that the majority of these tumours arose in areas of scarred lung. Among these tumours there have been several which showed histological similarity to each other and resembled, in many respects, the " carcinoid " type of bronchial adenoma and also the basal-cell tumours of skin. The literature regarding these neoplasms has been well reviewed in the articles by Prior and Jones and by Raeburn and Spencer. The case to be described falls into this group of tumours, although in this instance the neoplastic tissue was found widely disseminated in the lung. CASE HISTORY