Diagnostics

• Chest x-ray

  • Diffuse bilateral infiltrates predominantly in the lower lobes

  • Interstitial fibrosis

  • Supradiaphragmatic and pleural reticulonodular opacities/plaques

    • Initially, mostly linear infiltrates are seen.

    • Eventually, calcified (ivory white) or noncalcified plaques appear.

  • Rounded atelectasis

  • In some cases, pleural effusion

  • Radiographs are classified by the extent of radiographic abnormalities according to the WHO International Labor Office classification. [4]

• HR-CT

  • Parenchymal fibrosis (especially basilar, peribronchiolar, and septal)

  • Pleural plaques and pleural reticulonodular opacities

  • Supradiaphragmatic opacities/plaques

  • Subpleural linear opacities

restrictive ventilatory defects (decreased pulmonary compliance)

• Early: decreased DLCO

• Later: reduced vital capacity and total lung capacity

• Normal to increased ratio of FEV1 to FVC

• Bronchoalveolar lavage : microscopic asbestos bodies

  • Occasionally found in alveolar sputum sample, stain positive with Prussian blue

  • Appear as ferruginous bodies: dumbbell-shaped and golden-brown fusiform rods, surrounded by an iron protein coat

• Biopsy

  • Microscopic asbestos bodies

  • Fibrosis

• Idiopathic pulmonary fibrosis

• Interstitial pneumonitis

• Chronic empyema

• Combined pulmonary fibrosis and emphysema

• Other pneumoconioses

• No curative treatment exists; management includes the following measures.

  • Cessation of exposure

  • Oxygen therapy

  • Immunization against influenza and pneumococcal pneumonia

  • Antimicrobial treatment of respiratory infections

• Palliative care in the case of advanced disease