Respiratory function changes after asbestos pleurisy.

Abstract

Six patients with radiographic evidence of diffuse pleural thickening after industrial asbestos exposure are described. Five had computed tomography of the thorax. All the scans showed marked circumferential pleural thickening often with calcification, and four showed no significant evidence of intrapulmonary fibrosis (asbestosis). Lung function testing showed reduction of the inspiratory capacity and the single-breath carbon monoxide transfer factor (TLco). The transfer coefficient, calculated as the TLCO divided by the alveolar volume determined by helium dilution during the measurement of TLco, was increased. Pseudo-static compliance curves showed markedly more negative intrapleural pressures at all lung volumes than found in normal people. These results suggest that the circumferential pleural thickening was preventing normal lung expansion despite abnormally great distending pressures.

Restrictive lung function and asbestos-induced pleural fibrosis. A quantitative approach.

“…However, the methodology used to assess pleural disease differed in these studies and may account for the apparent discrepancy. While the previous studies (7,13,19,21 ) used the standard chest x-ray and the ILO classification system to identify and classify pleural disease, the current investigation used the CT scan and computer modeling to determine the presence and extent of asbestos-induced pleural fibrosis. Importantly, autopsy studies (44,45) and studies using CT scans (48-5 1 ) indicate that the chest radiograph is neither a sensitive nor specific method for identifying asbestos-induced pleural disease.…”

“…Asbestos-induced pleural fibrosis (circumscribed plaques and diffuse pleural thickening) is the most common radiographic abnormality among asbestos-exposed persons (1)(2)(3)(4)(5) and has been shown to be consistently associated with the presence of restrictive lung function (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). Findings from our center (21 ) suggest that although parenchymal inflammation and fibrosis contribute to the loss oflung function in persons with asbestosinduced pleural fibrosis, the pleural lesions themselves appear to independently contribute to the impaired lung function.…”

Benign Asbestos Pleural Effusion Associated with Pulmonary Aspergilloma.

“…While diffuse pulmonary fibrosis was not seen in the biopsy specimen pathologically, discrete foci of fibrosis in the walls of respiratory brochioles associated with accumulations of asbestos bodies were demonstrated, confirming the diagnosis of asbestosis (15). Typical BAPEwithout apulmonary lesion is usually associated with normal pulmonary function, whereas diffuse pleural thickening progresses to a severe restrictive respiratory impairment (16). In this case, the pleural thickening was not so marked, and pulmonary function tests showed a moderate mixed respiratory impairment.…”

Fibrosing Pleuritis with Extrathoracic Extension

“…Asbestos-related diffuse pleural fibrosis may present with pleural pain or as a chance finding and may follow benign pleural effusions (Epler et al 1982). Heavy cigarette smoking may be a contributory factor (Wright et al 1980, Dernovik etal. 1982.…”