Asbestosis - Thoracic Imaging

Title: Thoracic Imaging - Asbestosis
Diagnosis: Asbestosis
Author: Martins Martina
Comment: Howarth Nigel
Hospital: HUG
Department: Département de Radiologie
State: Terminée
Date: 21.03.2003
: 3353
KeyWords: Asbestosis; occupation; dyspnea
Anatomy: Thorax
Chapter: Occupational pneumonitis
ACR: 60.773

Clinical Presentation: Progressive dyspnea. Occupational exposure toasbestos.
Comment: Inhaled asbestos fibres reach the bronchioles andpulmonary alveoli.
Phagocytosis of the fibres by the alveolarmacrophages produces ferruginous or asbestos
bodies, due to thefibresí ferroprotein coating. These bodies alter the macrophage
andtrigger the release of lysosomal enzymes. This triggers in turn amobilisation of
lymphocytes and polynuclears, the production offibroblasts and the synthesis of collagen,
leading to fibrosis. Thefibrosis develops in the parenchyma and/or pleura. Asbestos
plaquesare typically found on the diaphragm and in the posterior andlateral mid-zones of
the chest. These plaques are dense, calcified,generally asymptomatic and discovered
fortuitously on a chestX-ray.
Description: Peribronchial thickening and disorganisedbronchovascular pattern,
suggestive of COPD. Bilateral pleural anddiaphragmatic calcifications.

Order: 0
Dislocation: 0
Polytrauma: 0
Open: 0
Pathologic: 0
Operation: 00.00.00
Graft: 0

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Valeyre D, Letourneux M. Asbestosis. Rev Mal Respir1999;16:1294-307. Challeux E,
Letourneux M. Medical impact ofscreening of benign pleural lesions associated with the
inhalationof asbestos. Rev Mal Respir 1999;16:1286-93. Mossman BT, Churg
A.Mechanisms in the pathogenesis of asbestosis and silicosis. Am JRespir Crit Care Med
1998;157:1666-1680. Genevois PA, de MaertelaerV, Madani A, Winant C, Sergent G, De
Vuyst P. Asbestosis, pleuralplaques and diffuse pleural thickening: three distinct
benignresponses to asbestos exposure. Eur Respir J 1998;11:1021-27.Staples CA.
Computed tomography in the evaluation of benignasbestos-related disorders. Radiol Clin
North Am 1992;30:1191-1207.Remy-Jardin M, Degreef JM, Beuscart R, Voisin C, Remy J.
Coalworker's pneumoconiosis: CT assessment in exposed workers andcorrelation with
radiographic findings. Radiology1990;177:363-371.

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