• Asbestosis

    by  • 26/05/2013 • Respiratory

    Asbestosis

    1. Asbestos = mixture of silicates of iron, magnesium, nickel, cadmium and aluminium.
    2. Uncommon RLD
    3. Asbestos bodies on CXR is a ‘warning sign’ and shows exposure – not diagnostic of disease.
    4. Mesothelioma = cancer of mesothelium (protective lining that covers lung) – commonly occurs at pleura as a result of asbestos exposure.

     

    Exposure Chest X-ray Lung Symptoms Outcome
    function
    Asbestos bodies Light Normal Normal None Evidence of asbestos exposure only
    Pleural plaques

    (‘pleural thickening’)

    Light Pleural thickening (parietal pleura) and calcification (also in diaphragmatic pleura) Mild restrictive ventilatory defect Rare, occasional mild effort dyspnoea No other sequelae
    Effusion First two decades following exposure Effusion Restrictive Pleuritic pain, dyspnoea Often recurrent
    Bilateral diffuse pleural thickening Light/moderate Bilateral diffuse thickening (of both parietal and visceral pleura) more than 5mm thick, extending over ¼ of chest wall Restrictive ventilatory defect Effort dyspnoea May progress in absence of further exposure
    Mesothelioma Light (interval of 20-40 years from exposure to disease) Pleural effusion, usually unilateral Restrictive ventilatory defect Pleuritic pain, dyspnoea Median survival 2 years
    Asbestosis Heavy (interval of 5-10 years from exposure to disease) Diffuse bilateral streaky shadows, honeycomb lung (interstitial disease) Severe restrictive ventilatory defect and reduced gas transfer Progressive dyspnoea Poor, progression in some cases after exposure cases
    Asbestos-related carcinoma of the bronchus The features of asbestosis, bilateral diffuse pleural thickening or bilateral pleural plaques plus those of bronchial carcinoma Fatal

     

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