90 RESPIRATORY SYSTEM. 
‘What are the changes in the sub-acute and chronic forms of miliary 
tuberculosis ? 
In the former the changes are similar to those in acute miliary 
tuberculosis, but are confined to the apices of the lungs. The patient 
may recover, or the lesion may pass into the chronic form of miliary 
tuberculosis and extend slowly until a large part of the lungs is in- 
volved. In the Jatter, beside the growth of miliary tubercles, the 
walls of the bronchi may be inflamed and may become necrotic and 
destroyed in places. Bronchiectasise may form and there may be an 
interstitial pneumonia with a thickening of the pleura. 
Describe the lesions found with acute phthisis. 
This is an acute tubercular process, but beside the formation of 
products due to this form of inflammation there are other changes 
similar to those occurring in a broncho-pneumonia, with a general 
consolidation of lung tissue and a filling of the air spaces with epithe- 
lium, fibrin and pus. Bronchiectasize may be formed. 
What are the changes in chronic phthisis? 
The changes are the same as in acute phthisis, but the trouble runs 
along course. The air spaces may be filled with fibrin, pus and epi- 
thelium in varying proportions and in various stages of degeneration, 
or may be filled with new connective tissue. Various nodules are 
found and these nodular portions may be composed of miliary tuber- 
cles, in the air spaces or about the bronchi, or they may be made up 
of cheesy material exclusively. The bronchi are the seat of a catarrhal 
inflammation and may be dilated, the dilatations being either fusiform 
or sacculated. Tubercle and granulation tissue may be present in the 
walls of the bronchi. There may be areas of coagulation necrosis which 
may undergo cheesy degeneration. Sometimes all active processes stop 
and the tubercular tissue be changed and converted into new connec- 
tive tissue. 2 
What is the form of inflammation in syphilitic pneumonia ? 
There is an interstitial inflammation which renders the walls of the 
air spaces thicker; these spaces may be compressed or obliterated by 
this new tissue. The inflammation may be confined to the walls of 
the air spaces or it may be diffuse. Obliterating endarteritis often 
accompanies this form of pneumonia. 
What forms of tumors have been found in the lung? 
Dermoid cysts, fibromata, enchondromata, osteomata, sarcomata and 
carcinomata. 
