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Imaging Diagnosis of Asbestosis

Article information

J Korean Med Assoc. 2009;52(5):465-471
Publication date (electronic) : 2009 May 30
doi : https://doi.org/10.5124/jkma.2009.52.5.465
Jeung Sook Kim, MD
Department of Radiology, Dongguk University College of Medicine, Korea. jeungkim@duih.org, kjs7143@kornet.net

Abstract

Asbestosis is diffuse interstitial pulmonary fibrosis associated with asbestos fiber inhalation. The typical chest radiographic findings in asbestosis are small irregular or reticular opacities, predominating at the lung bases. Honeycombing is evident in more advanced diseases. But chest radiograph is relatively insensitive in detecting the presence of asbestosis. HRCT is more sensitive than simple chest radiograph for diagnosis of asbestosis, especially the early change of asbestosis. The early findings of asbestosis on HRCT are subpleural dotlike opacities and curvilinear opacities. As progression of fibrosis, intralobular interstitial thickening and interlobular septal thickening are presented. In advanced diseases, parenchymal bands, traction bronchiectasis or bronchiolectasis, and honeycombing are noted. These findings are typically located in lower posterior subpleural portions with bilateral symmetric patterns. Imaging findings that are compatible with asbestosis, rale, and a reduced diffusing capacity can increase confidence of diagnosis of asbestosis.

Keywords: Asbestosis; Asbestos; Radiography, Thoracic; Tomography, X-ray Computed; High resolution computed tomography

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Copyright © 2009 Korean Medical Association

Figure 1

Figure 1

A 71-year-old woman with asbestosis. (A) Chest PA radiograph shows reticular and small nodular densities in both lungs, more prominent in lower lungs. And multiple calcified plaques are also seen in both mid thoraces and both diaphragmatic pleura. (B) Magnification view of left lung shows reticular densities and small nodular densities.

Figure 2

Figure 2

A 80-year-old man with asbestosis. (A) Chest PA radiograph shows reticular densities and honeycombing in both lungs, more prominent in lower lungs with bilateral symmetric distribution. And multiple dense calcified plaques are seen in both lower thoraces and both diaphragmatic pleura. (B) Magnification view of left lung shows reticular densities and honeycombings.

Figure 3

Figure 3

A 75-year-old man with asbestosis. (A) HRCT shows dotlike opacities associated with intralobular interstitial thickening in the subpleural lung (arrows). (B) HRCT shows reticular patterns in the lung periphery corresponding to thickened interlobular septa.

Figure 4

Figure 4

A 77-year-old woman with asbestosis. (A) Supine HRCT shows a curvilinear line in the posterior left lung. (B) Prone HRCT shows a subpleural line (white arrowheads) and a parenchymal band (black arrow).

Figure 5

Figure 5

A 80-year-old man with asbestos exposure with pleural thickening and calcification. HRCT shows extensive honeycombing at the left lung base. Interlobular septal thickening (arrows) and parenchymal band (arrowheads) are also noted in right lung.

Figure 6

Figure 6

Dependent atelectasis in a patient with asbestos exposure. (A) In the supine HRCT, focal ill-defined ground-glass opacity (GGO) and short line are visible posteriorly. (B) In the prone HRCT, the lungs are normal in appearance. There is no evidence of GGO and fibrosis.