Asbestos related lung disease

Question 1

Asbestos can cause a variety of lung disease from?

Answer 1

benign pleural plaques to mesothelioma.

Question 2

What are pleural plaques? are they malignant?

Answer 2

Pleural plaques are benign and do not undergo malignant change. They, therefore don’t require any follow-up. They are the most common form of asbestos-related lung disease and generally occur after a latent period of 20-40 years

Question 3

Pleural thickening?

Answer 3

Asbestos exposure may cause diffuse pleural thickening in a similar pattern to that seen following an empyema or haemothorax. The underlying pathophysiology is not fully understood.

Question 4

The severity of asbestosis is related to

Answer 4

the length of exposure

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💡 This is in contrast to mesothelioma where even very limited exposure can cause disease. The latent period is typically 15-30 years. Asbestosis typically causes lower lobe fibrosis.

It is treated conservatively - no interventions offer a significant benefit.
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Question 5

Features of asbestosis?

Answer 5

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- dyspnoea and reduced exercise tolerance
- clubbing
- bilateral end-inspiratory crackles
- lung function tests show a restrictive pattern with reduced gas transfer

Question 6

Mesothelioma?

Answer 6

Mesothelioma is a malignant disease of the pleura. Crocidolite (blue) asbestos is the most dangerous form.

Question 7

Possible features of mesothelioma?

Answer 7

• progressive shortness-of-breath
• chest pain
• pleural effusion

Question 8

Prognosis of mesolethioma?

Answer 8

Patients are usually offered palliative chemotherapy and there is also a limited role for surgery and radiotherapy. Unfortunately, the prognosis is very poor, with a median survival from diagnosis of 8-14 months.

Question 9

Whilst mesothelioma is in some ways synonymous with asbestos, lung cancer is actually the most

Answer 9

common form of cancer associated with asbestos exposure. It also has a synergistic effect with cigarette smoke in terms of the increased risk.