ABSTRACT
The neoplastic process, reckoned from the first initiating event, ranges over a great many years. Roughly speaking it includes two phases: the premalignant phase lasting over many years from initiation to eventual malignant transformation, and the overtly malignant phase comprising local invasive growth and metastasis. Evidence has accumulated that during both phases of the carcinomatous process the connective tissue bordering on the gradually deteriorating epithelium is somehow actively involved. As early as the turn of the century the view has been advanced that in cancer it is the interaction between the epithelial and stromal components that ultimately result in the malignant behavior of one component, the epithelium. Interstitial pulmonary fibrosis, often a corollary of a diffuse connective tissue disease such as scleroderma, may be a factor in lung cancer. Supposedly it may be the participation of the connective tissue that presents the additional stimulus.
