Asbestosis differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kim-Son H. Nguyen, M.D., M.P.A., Beth Israel Deaconess Medical Center, Harvard Medical School, Boston MA, Cafer Zorkun, M.D., Ph.D. [2]
Overview
Differential Diagnosis
- Pleural disease is common in patients with asbestos exposure, occurring in up to 50%, but does not necessarily indicate asbestosis. Pleural disease includes circumscribed pleural plaques, with or without calcification, or diffuse pleural thickening, including blunting of the costrophrenic angle, and rarely rounded atelectasis secondary to pleural adhesions.
- The plaques are most commonly on the parietal pleura, particularly adjacent to ribs, most commonly along the 6th-9th ribs and along the diagphragm. They are typically absent from the apices and costrophrenic angle. Calcification is found on CXR in 20%, on CT scanning in 50%, and at post in 80%.
- Parenchymal fibrosis from asbestos exposure can occur with or without pleural plaques
- Pleural disease is not common in other causes of interstitial lung diseases