Home > D. Systemic pathology > Environmental and occupational diseases > asbestosis

asbestosis

Saturday 31 August 2013

Images

- Asbestosis - Extensive fibrosis of pleura and lung parenchyma.
- Asbestosis - Fibrous pleural plaque.
- Asbestosis - Pleural fibrosis & calcification.
- Asbestosis - Asbestos bodies.
- Asbestosis - Asbestos body.
- Asbestosis and non-small cell lung carcinoma, NOS.

Epidemiology

Despite bans on the importation and use of asbestos in many industrialised nations such as the European communities and Australia, the incidence of malignant mesothelioma (MM) continues to rise, for example in both the UK and in Australia, in both men and women.

During recent times, the proportions of asbestos exposure that underpin this increasing incidence have changed in Australia, from occupational exposures to an increasing proportion of non-occupational exposures related mainly to home maintenance or renovation exposures. In Western Australia (WA), during the period 2005–8 inclusive, Olsen et al found that home renovation exposures accounted for 8.4% of all men with MM and 35.7% of all women diagnosed with MM and, after adjustments for sex, and the year and age of diagnosis, the latency period for ‘home renovation’ MM appeared to be significantly shorter than for other exposure groups.

Pathology

- asbestos related diseases

  • asbestos related pulmonary diseases

- asbestos related cancers

  • asbestos related mesothelioma

Localization

- pleural asbestos
- pulmonary asbestos

Physiopathology

A great deal has been written concerning the role of asbestos in the diagnosis of mesothelial disorders. In a recent review, the U.S. Canadian Mesothelioma Panel cautioned that a history of asbestos exposure should not unduly influence the histopathologic diagnosis of mesothelioma.

The majority of pleural biopsies in asbestos-exposed patients demonstrate benign processes, and conversely patients without recognized exposures to asbestos can develop malignant mesothelioma.

A history of occupational exposure to asbestos broadens the differential diagnosis to include:
- localized benign hyaline plaques,
- diffuse pleural fibrosis,
- asbestos-related fibrinous pleural effusions.

All of these processes can at times mimic mesothelioma. In addition, asbestos exposure has also been implicated as a cause of epithelioid hemangioendothelioma, an unusual vascular lesion of the pleura.

References

- Wright JL, Churg A. Morphology of small-airway lesions in patients with asbestos exposure. Hum Pathol. 1984 Jan;15(1):68-74. PMID: 6693111