Asbestosis (lung disease)

Asbestosis – fibrous plaques on the diaphragm caused by asbestos

Asbestosis is interstitial pulmonary fibrosis caused by long-term exposure to dust-containing asbestos.

Asbestosis – enlarged interstitium containing asbestos bodies

Etiopathogenesis[edit | edit source]

The fibers reach the alveolus, activate macrophages, and develop an inflammatory and fibrotic process. The mechanism is not precisely clarified, the shape of the fibers and their „indestructibility“ play a role. The fibers are long and therefore cannot be eaten by a single macrophage. One fiber thus activates many cells, which creates an inflammatory reaction – ROS, cytokines, etc. Fibers longer than 5 µm are especially dangerous. Long latency, progressing 20 or more years.

Pathology[edit | edit source]

Histology corresponds to other types of interstitial fibrosis. In the advanced stage, a honeycomb lung structure develops. A typical finding is an asbestos body – axial asbestos fiber coated with mucopolysaccharides, containing hemosiderin (as beads on a thread). They can also be found in healthy individuals (they are considered evidence of exposure).

Clinical picture[edit | edit source]

Initially, there is small exertional dyspnea, which gradually progresses to rest. A cough with a small expectoration is present. It progresses slowly (even after being eliminated from risk). The main complication – Chronic obstructive pulmonary disease (COPD). Physical examination – crepitus on the lung bases (may not be present). Hypoxemia, respiratory insufficiency, cor pulmonale occur in the advanced stage. With long latency, there is a high risk of developing mesothelioma.

Investigation methods[edit | edit source]

Lung-X ray – symmetrical shading of irregular opacities basally (finding in the upper fields is small). Usually, there is emphysema in the upper fields.

ILO classification[edit | edit source]

Asbestosis – basal X-ray shading

Fine striping, mesh (s), medium-coarse (t), coarse, irregular shadows (u) CT, HRCT. Pulmonary function examination – restrictive disorder, reduced compliance, diffusion capacity for CO.

Links[edit | edit source]

Source[edit | edit source]

BENEŠ, Jiří. Studijní materiály [online]. [cit. 24.02.2010]. <https://jirben.wz.cz>.

References[edit | edit source]

PELCLOVÁ, Daniela. Nemoci z povolání a intoxikace. 2. edition. Karolinum, 2006. 207 pp. ISBN 80-246-1183-X.

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