Asbestos related lung disease

Question 1

Pleural plaques

Answer 1

Benign and do not undergo malignant change

Don’t require follow-up

Common form of asbestos related lung disease

Generally occur after latent period of 20-40 years

Question 2

Pleural thickening

Answer 2

Diffuse pleural thickening similar pattern to that seen following empyema or haemothorax

Question 3

Asbestosis

Answer 3

Severity related to length of exposure

Latent period typically 15-30 years

Typically causes lower lobe fibrosis

Treated conservatively

Question 4

Features of asbestosis

Answer 4

Dyspnoea and reduced exercise tolerance

Clubbing

Bilateral end-inspiratory crackles

Lung function tests show restrictive pattern with reduced gas transfer

Question 5

Mesothelioma

Answer 5

Malignant disease of the pleura

Crocidolite (blue) asbestos is the most dangerous form

Question 6

Features of mesothelioma

Answer 6

Progressive shortness of breath

Chest pain

Pleural effusion

Question 7

Management of mesothelioma

Answer 7

Palliative chemotherapy

Very poor prognosis

Median survival 8-14 months following diagnosis

Question 8

Lung cancer

Answer 8

Most common cause of cancer associated with asbestos exposure