Asbestos Related Lung Disease
Pathophysiology: Asbestos exposure may lead to several clinically different thoracic conditions:
- Asbestos related lung disease
- Asbestosis
- Malignant mesothelioma
- Lung and other cancers
The most benign of these is asbestos related lung disease. This condition is usually seen in men who have worked or have been exposed to asbestos fibers for many years (25+) but may be seen with shorter exposures and may even be seen in spouses of workers due to "passive exposure", and rarely, in patients with no apparent asbestos exposure at all.
CXR Findings: pleural thickening ± calcification along the domes of the hemidiaphragms, pleural thickening along the inner lower half of the chest walls, pleural thickening with plaque formation in the lower 2/3 of the hemithoraces (seen as irregular densities best on the frontal view)
Clinical Clues: Although a restrictive lung deficit on rare occasion may occur, asbestos related disease is rarely associated with clinical disease and is not compensable. There is of course a definite increased incidence of lung cancer in these patients with a markedly increased risk if they smoke.
"Aunt Sophies":
- Post infectious pleural thickening and dystrophic calcifications: eg. TB, fungal lung disease, post empyema, post infectious pleural effusions
- Pleural tumors: metastases with dystrophic calcifications, post treatment or radiation calcification
- Hemothorax with dystrophic calcifications and pleural fibrosis
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