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The diagnosis of lung cancer in men who have worked in coal-mines is complicated by the clinical and radiographic similarities of malignant and pneumoconiotic lesions. Cases are reported which illustrate some of the problems, namely the similarity between peripheral lung cancer and coal-workers' massive fibrosis, between lung cancer and Caplan's syndrome, and between bronchial obstruction caused by a tumour and by an anthracotic lymph gland.
Criteria for distinction between the two types of lesion are discussed, and bronchography as an aid to differential diagnosis is referred to.
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