Asbestosis

Introduction:
Pneumoconiosis = restrictive interstitial lung disease.
Organs Involved are lung (bibasilar), respiratory bronchioles and alveolar ducts.
It is the third most common interstitial fibrotic lung disease.

Etiolopathogenesis :
Caused by light thin sharp asbestos fibers, which induce inflammation and fibrosis. History of asbestos exposure, even a very remote one, is considered and a potential risk factor.

Complications:
Higher incidence of bronchogenic carcinoma and mesothelioma are the main complications. Other complications include hyalinized fibrocalcific plaques, fibrinous pleuritis, peribronchial fibrosis, recurrent respiratory infections and pleural effusion.

Physical Findings:
Cardiac findings are late, after pulmonary hypertension sets in. It may end up in right heart failure.
Basilar inspiratory rales are the usual auscultatory findings.
Extremities may have clubbing.

Diagnosis:
Blood shows increased ESR, hypergammaglobulinemia.
Chest skiagram shows pleural thickening or calcification (lower lobe predominance)
Histopathology examination is done by bronchoscopy, open biopsy or video-assisted thorascopy. Asbestos bodies (ferruginous bodies):
These are complex of hemosiderin and glycoprotein within macrophage.
Diffuse interstitial cellular and fibrotic reaction is a constant finding.

Prognosis:
May progress without further exposure