Asbestos Related Lung Disease

Question 1

What are the signs of asbestos related lung disease?

Answer 1

asbestosis:
• dyspnoea
• crackles
• chest pain
• clubbing

mesothelioma:
• chest pain 
• dry cough
• dyspnoea
• weight loss
• may get abdominal distension/pain
• fatigue 
• night sweats

Question 2

What are the signs of asbestos related lung disease?

Answer 2

asbestosis:
• crackles 
• clubbing
• cyanosis
• decreased chest expansion
• decreased breath sounds
• dullness to percussion

mesothelioma:
• clubbing
• recurrent pleural effusions
• signs of metastasis (bone pain, hepatomegaly, lymphadenopathy etc.)

Question 3

What are the investigations for asbestos related lung disease?

Answer 3

Asbestosis
• CXR - linear interstitial changes first in lower lobes, pleural thickening, plaques, pleural effusions, rounded atelectasis
• pulmonary function tests - normally restrictive
• high res CT
• bronchealveolar lavage
• lung biopsy

Mesothelioma
• CXR - unilateral pleural effusion. pleural thickening, reduced lung volumes, lower zone interstitial fibrosis, pleural calcification, 
• CT chest and upper abdomen
• thoracocentesis - exudative fluid
• VATS