In order to predict the prognosis of a patient with bronchogenic carcinoma after a radical operation, the presence or absence of lymphnode metastasis in the intrathoracic space would seen very important.
Daniels's operation is employed to find subclavicular lymph nodemetastasesand mediastinoscopy may help demonstrating metastases lymph nodes.
Subcarinal lymph node metastasis used to be investigated by mediastinoscopy. However, we have been employing an aspiration biopsy smear technique using a long needle to the time of bronchoscopy under general anesthesia simultaneously with a brushing cytology for the diagnosis of bronchogenic carcinoma.
A bronchoscope was inserted into the trachea immediately after an intravenous of muscle relaxant and an aspiration biopsy was obtained with subsequent of the lesion. A small needle, I. I mm in outer diameter and 50mm in length, was inserted 5 to 10 mm in depth into the bifurcation tracher under direct vision with a rigid fiberscope and the aspirates with a syringe was submitted to the cytological diagnosis.
A total of 59 cases of bronchogenic carcinoma have been examined. Of 52 examined satisfactorily, 12 (23.1%) were positive for malignancy. With regard to the subcarinal angle the bifurcation tracher, a higher incidence of positive cytology was noted in cases with highly graded subcarinal angle. However, it would seem important to have noted some positive cases in those with normal or slightly dilated bifurcation. As for location, a positive rate tended to be higher in the lower lobes than anywhere else and to be somewhat higher in undifferentiated carcinomas. Eighteen of the 52 cases were resectable, in which only one was positive and the remaining seventeen were negative. Fifteen of the 17 cases with a negative result did not disclose the metastasis to the subcarinal lymphnodes and the remaining two cases were positive. The one with a positive cytological result demonstrated metastases in the histopathological surveys of the resected specimen.
No complications such as gross bleeding, mediastinitis and cardiac puncture were noted. It is concluded that a cytological method by means of aspirating from a subcarinal lymph node under bronchoscopy is of clinical worth in detecting metastases.

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By using ridgid telescope and flexible fiber bronchoscope, the intensity of visual field became peripheler in the lung than that obtained by the previous ones.
In the present work, we are going to report briefly on the relationship between bronchoscopic findings and how it has been consisted by the bronchial spread of lung cancer, pathologically.
The direct vision and indirect vision (stenotic types) of tumor invasion were divided into following
4 types respectively according to bronchial invasion of the carcinoma.
Direct vision.
I.localized polypoid type
II.polypoid process extending proximally
III. direct invasion of parabronchial, wall and lymphatics
IV. invasion of epithelium from the metastatic lymphnode Indirect vision
I.narrowing of the bronchus due to expansive growth of the tumor
II.narrowing of the bronchus due to the subepithelial lymphnode metastasis
III., IV. transposition of the bronchus due to expansive growth of the tumor
These findings were examined histologically and comparatively.
Recognition for spread of carcinoma of the bronchus should be performed always in combination with above information and X-Ray or cytological diagnosis.
In this way, is more adequate surgical suggestion and other suitable therapoetic treatment obtained.

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In this series, it has been examined pathologically that the site of origin and bronchial spread of the carcinoma of the lung in relation tothe bronchoscopic findings which have no demonstrable bronchial connection.
The patterns of regional bronchus in resected lung cancer were divided into 5 types.
Most of those cases were peripheral originated tumors and their histological pattern were adenocarcinomas which have a slight bronchial invasion.The preoperative bronchoscope and bronchial scrubbing smear test were negative.
It was discussed the bronchial invasion in those cases might have been correlated with the biological and histological malignancy of the carcinoma.
It was emphasized that the recognition of these correlation is usefull for diagnosis or treatment to lung cancer.

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1) Wistar strain rats were injected with N-methyl-N-nitrosourethane (NMU), intraperi-toneally.After 7 months, a high incidence of pulmonary carcinoma were observed in the rats.
2) Fourty rats of group A were injected with NMU for 5 months (2mg/kg of body weight, 30 times). At the 171 days after the treatment, one died with pulmonary carcinoma. Seven of the 17 rats which survived over 7 months had the development of pulmonary carcinomas. Histologically, 5 of 8 rats showed adenocarcinomas and 3 of adenoacanthomas were seen.
3) Fourty four rats of group B were injected with NMU for 3 months (2mg/kg of body weight, 18 times) followed by without NMU for 4 months.No pulmonary carcinomas in rats were found.
4) The developments of pulmonary adenomas were multiply observed in 24 of the 27 rats in group A and 23 of the 29 rats in group B which survived over 100 days.Adenomas were classified as follows;mucinous adenoma and papillary adenoma as preneoplastic change in the lungs of rats.
5) Many rats treated with NMU were occasionally observed the complication of pulmonary fibrosis, and in a few rats, the bronchiectatic cysts were noticed.
6) Marked pulmonary hemorrhage, congestion and vascular changes were observed in the rats of acute death by large amount of NMU.

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X-ray films of 25 cases of periferal lung cancer less than 2cm in diameter were observed to investigate roentgen features of small lung cancers.
When the diameter of abnormal shadows were less than 1cm, small nodular or mottling shadows were prominent, being unable to suggest lung cancer.
When the shadows enlarged to arround 1cm in diameter, the shadows became tumorous or infiltrative. At that time, laminograms of the shadows revealed sun-burst appearance, spicular radiation and bundle-like shadows connected with pleura, which are strongly suggestive of lung cancer.

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