Asbestos-related Lung disease

Question 1

Define asbestosis

Answer 1

Diffuse interstitial fibrosis of the lung as a consequence of exposure to asbestos

Question 2

Define mesothelioma

Answer 2

Aggressive epithelial neoplasm of mesothelioma cells that occur in the lung pleura

Question 3

Aetiology for asbestosis

Answer 3

Inhalation of asbestos fibres

Question 4

Aetiology of mesothelioma

Answer 4

Exposure to asbestos (80%)
Radiotherapy exposure
Genetic disposition e.g. BAP1 mutation
Simian virus 40

Question 5

Symptoms of asbestos-related lung disease

Answer 5

Chest pain (mesothelioma)
Dyspnoea (increasing - mesothelioma, on exertion - asbestosis)
Cough (dry, frequency increasing)
Weight loss

Question 6

Signs of asbestos-related lung disease on examination

Answer 6

Clubbing
Signs of metastases e.g. lymphadenopathy, hepatomegaly, bone pain, abdominal pain
Diminished breath sounds and crackles at the bases in asbestosis
Dullness to percussion

Question 7

Investigations for asbestosis

Answer 7

CXR: interstitial fibrosis, lower zone. Pleural thickening

Pulmonary functions tests: usually restrictive picture i.e. FVC reduced/ FVC/FEV1 ratio normal)

Question 8

Investigations for mesothelioma

Answer 8

CXR: Unilateral pleural effusion, irregular pleural thickening, reduced lung volume

CT: Pleural thickening and/or discrete pleural plaques, pleural and/or pericardial effusion, enlarged hilar lymph nodes