Pulmo

lung abscess an infection of the lung, characterized by a localized accumulation of pus and destruction of tissue. It may be a complication of pneumonia or tuberculosis. A lung abscess may also follow a period of excessive drinking by an alcoholic. Infected matter that has been aspirated (usually in a drunken stupor) may lodge in a bronchiole and produce inflammation. Lung cancer may also be responsible for formation of an abscess.

The first symptoms include a dry cough and chest pain. Later these may be followed by fever, chills, productive cough, headache, perspiration, foul-smelling sputum, and sometimes dyspnea. If the abscess is a complication of pneumonia, the symptoms tend to be moderated to an exaggeration of the pneumonia symptoms.

When a lung abscess forms, it is in the acute stage and treatment with antibiotics usually is effective. postural drainage may be prescribed to assist in drainage of exudate from lungs and bronchioles. In most cases, this treatment produces a cure. If the abscess becomes chronic, surgery may be necessary and usually involves removal of the portion of the lung containing the abscess.

accessory lung pulmonary sequestration.

bird breeder's lung pigeon breeder's lung.

black lung coal workers' pneumoconiosis.

brown lung byssinosis.

lung cancer malignant growths of the lung. Although the exact cause of lung cancer is not known, inhaled carcinogens are known to be important predisposing causes. Cancer in the lungs may also be a metastasis of malignancy elsewhere in the body. Many years ago it was realized that miners of certain ores who inhaled the mine dust developed lung cancer much more often than workers in other occupations. Later, other carcinogens of lung tissue, such as air polluted by fumes from burning fuels or motor exhausts, were singled out as probable causes of the increasing number of cases of the disease in urban and industrial areas. The most obvious carcinogen, however, and the one most widely encountered, is tobacco smoke, especially cigarette smoke, which is much more frequently and deeply inhaled than the smoke of pipes or cigars.

A study based on autopsies of the lungs of individuals who had died from many varied causes, but whose smoking history was known, showed that unrecognized cancer and precancerous changes in tissue were numerous among smokers and rare among nonsmokers. These findings led the Surgeon General of the United States to appoint an investigative committee, which ultimately issued a report stating that “cigarette smoking is a health hazard of sufficient importance in the United States to warrant appropriate action.”

Since the factors causing lung cancer act slowly and may produce a tumor near the periphery of the lung, early symptoms are vague or may not appear at all, and nearly a third of the cases are in an advanced stage when they are discovered. The earliest and most common symptom is a cough. Dry at first, this cough later produces sputum, which eventually becomes blood-streaked. An isolated persistent wheeze in the chest is frequently a symptom and indicates a partial obstruction in a bronchus. Chest pains, weakness, and loss of weight are later symptoms, as is dyspnea.

Diagnosis depends on a careful physical examination, including a chest x-ray. If a suspicious density is seen on the x-ray, samples of sputum will be examined microscopically for the presence of malignant cells. bronchoscopy is also done, and at the same time a specimen for biopsy can be obtained or the bronchial secretions can be washed out and the cells stained and examined.

When examination indicates lung cancer, prompt treatment is essential. This may involve the surgical removal of the lobe of the lung containing the cancer or of an entire lung if the malignant cells have spread. A significant number of persons affected by lung cancer can be cured by such operations if the surgery is performed in time. In some cases of widespread involvement surgery is not possible; these patients are treated with radiation therapy and antineoplastic drugs.

Carcinogens that can trigger lung cancer must be avoided and, when possible, eliminated. Mine workers should take adequate precautions to avoid inhaling harmful dusts. Public health authorities and industry must act more effectively to control air pollution. The most important step toward protection against lung cancer is elimination of cigarette smoking. State and local units of the American Lung Association are excellent sources of information about lung disease and its prevention.

Lung cancer clinical guidelines have been published in both the United States and Canada. In Canada they are available at the web site of Cancer Care Ontario, http://www.cancercare.on.ca. and in the United States they are available at the web site of the National Guideline Clearinghouse, http://www.guideline.gov.

coal miner's lung coal workers' pneumoconiosis.

farmer's lung hypersensitivity pneumonitis caused by inhalation of moldy hay dust.

iron lung popular name for Drinker respirator.

pigeon breeder's lung hypersensitivity pneumonitis caused by inhalation of particles of bird feces, seen in those who work closely with pigeons or other birds; it may eventually result in pulmonary fibrosis.

shock lung acute respiratory distress syndrome.

wet lung