Disseminated indeterminate pulmonary disease; value of lung biopsy.

Forty or fifty years ago the roentgenologic picture of disseminated pulmonary disease usually was thought to mean tuberculosis. Since that time many other causes have been recognized, and an awareness of the wide variety of conditions which produce this picture has grown rapidly in the past quarter of a century. In 1938, for example, King (1) catalogued 10 possible causes, in 1942 Austrian and Brown (2) enumerated 22, in 1948 Felson and Heublein (3) counted 75, and by 1952 Scadding (4) had raised the figure to 80. For purposes of classification the numerous conditions may be subdivided into seven groups: infections, inhalations, aspirations, vascular diseases, systemic diseases and pulmonary diseases of uncertain etiology, neoplasms, and allergies. With the growing recognition of the many entities producing a roentgenologic appearance of disseminated pulmonary disease has come the realization that the information gained from the clinical history, the physical examination, and the routinely available labor...