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Clinical consequences of asbestos-related diffuse pleural thickening: A review.

Miles SE, Sandrini A, Johnson AR, Yates DH - J Occup Med Toxicol (2008)

Bottom Line: DPT may be associated with symptoms such as dyspnoea and chest pain.It causes a restrictive defect on lung function and may rarely result in respiratory failure and death.Treatment is primarily supportive.

View Article: PubMed Central - HTML - PubMed

Affiliation: Dust Diseases Board Research & Education Unit, Sydney, NSW, Australia. Deborahy88@hotmail.com.

ABSTRACT
Asbestos-related diffuse pleural thickening (DPT), or extensive fibrosis of the visceral pleura secondary to asbestos exposure, is increasingly common due to the large number of workers previously exposed to asbestos. It may coexist with asbestos related pleural plaques but has a distinctly different pathology. The pathogenesis of this condition as distinct from pleural plaques is gradually becoming understood. Generation of reactive oxygen and nitrogen species, profibrotic cytokines and growth factors in response to asbestos is likely to play a role in the formation of a fibrinous intrapleural matrix. Benign asbestos related pleural effusions commonly antedate the development of diffuse pleural thickening. Environmental as well as occupational exposure to asbestos may also result in pleural fibrosis, particularly in geographic areas with naturally occurring asbestiform soil minerals. Pleural disorders may also occur after household exposure. High resolution computed tomography (CT) is more sensitive and specific than chest radiography for the diagnosis of diffuse pleural thickening, and several classification systems for asbestos-related disorders have been devised. Magnetic resonance imaging and fluorodeoxyglucose positron emission tomography (PET) scanning may be useful in distinguishing between DPT and malignant mesothelioma. DPT may be associated with symptoms such as dyspnoea and chest pain. It causes a restrictive defect on lung function and may rarely result in respiratory failure and death. Treatment is primarily supportive.

No MeSH data available.


Related in: MedlinePlus

Computed tomography (CT) scan of the thorax demonstrating asbestos-related diffuse pleural thickening. Note the "crow's feet" or parenchymal bands which are clearly seen on the left, and the overall reduction in lung volume.
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Figure 2: Computed tomography (CT) scan of the thorax demonstrating asbestos-related diffuse pleural thickening. Note the "crow's feet" or parenchymal bands which are clearly seen on the left, and the overall reduction in lung volume.

Mentions: A link between pleural disease and asbestos exposure was first recognized in the 1930s [4] but it was not until the 1960s that a distinction between diffuse pleural thickening and pleural plaques was made[5]. Asbestos-related DPT refers to extensive fibrosis of the visceral rather than the parietal pleura, with adherence to the parietal pleura and obliteration of the pleural space (Figures 1 &2) [6,7]. In contrast, the parietal pleura is primarily involved in pleural plaques (Figure 3). DPT has unique radiographic features and significant symptomatic and functional consequences for affected patients[6]. It may cause exertional dyspnoea and has been associated with chest pain and in very rare cases with respiratory failure and death due to lung "constriction". Benign asbestos-related pleural effusions are believed to antedate the majority of cases of diffuse pleural thickening and to contribute towards disease progression. DPT may coexist with pleural plaques but has a distinctly different pathology, natural history and prognosis. Treatment is largely limited to supportive and symptomatic care, although rare case reports in the past have documented pleurectomy to be effective in a few progressive cases [8].


Clinical consequences of asbestos-related diffuse pleural thickening: A review.

Miles SE, Sandrini A, Johnson AR, Yates DH - J Occup Med Toxicol (2008)

Computed tomography (CT) scan of the thorax demonstrating asbestos-related diffuse pleural thickening. Note the "crow's feet" or parenchymal bands which are clearly seen on the left, and the overall reduction in lung volume.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2553409&req=5

Figure 2: Computed tomography (CT) scan of the thorax demonstrating asbestos-related diffuse pleural thickening. Note the "crow's feet" or parenchymal bands which are clearly seen on the left, and the overall reduction in lung volume.
Mentions: A link between pleural disease and asbestos exposure was first recognized in the 1930s [4] but it was not until the 1960s that a distinction between diffuse pleural thickening and pleural plaques was made[5]. Asbestos-related DPT refers to extensive fibrosis of the visceral rather than the parietal pleura, with adherence to the parietal pleura and obliteration of the pleural space (Figures 1 &2) [6,7]. In contrast, the parietal pleura is primarily involved in pleural plaques (Figure 3). DPT has unique radiographic features and significant symptomatic and functional consequences for affected patients[6]. It may cause exertional dyspnoea and has been associated with chest pain and in very rare cases with respiratory failure and death due to lung "constriction". Benign asbestos-related pleural effusions are believed to antedate the majority of cases of diffuse pleural thickening and to contribute towards disease progression. DPT may coexist with pleural plaques but has a distinctly different pathology, natural history and prognosis. Treatment is largely limited to supportive and symptomatic care, although rare case reports in the past have documented pleurectomy to be effective in a few progressive cases [8].

Bottom Line: DPT may be associated with symptoms such as dyspnoea and chest pain.It causes a restrictive defect on lung function and may rarely result in respiratory failure and death.Treatment is primarily supportive.

View Article: PubMed Central - HTML - PubMed

Affiliation: Dust Diseases Board Research & Education Unit, Sydney, NSW, Australia. Deborahy88@hotmail.com.

ABSTRACT
Asbestos-related diffuse pleural thickening (DPT), or extensive fibrosis of the visceral pleura secondary to asbestos exposure, is increasingly common due to the large number of workers previously exposed to asbestos. It may coexist with asbestos related pleural plaques but has a distinctly different pathology. The pathogenesis of this condition as distinct from pleural plaques is gradually becoming understood. Generation of reactive oxygen and nitrogen species, profibrotic cytokines and growth factors in response to asbestos is likely to play a role in the formation of a fibrinous intrapleural matrix. Benign asbestos related pleural effusions commonly antedate the development of diffuse pleural thickening. Environmental as well as occupational exposure to asbestos may also result in pleural fibrosis, particularly in geographic areas with naturally occurring asbestiform soil minerals. Pleural disorders may also occur after household exposure. High resolution computed tomography (CT) is more sensitive and specific than chest radiography for the diagnosis of diffuse pleural thickening, and several classification systems for asbestos-related disorders have been devised. Magnetic resonance imaging and fluorodeoxyglucose positron emission tomography (PET) scanning may be useful in distinguishing between DPT and malignant mesothelioma. DPT may be associated with symptoms such as dyspnoea and chest pain. It causes a restrictive defect on lung function and may rarely result in respiratory failure and death. Treatment is primarily supportive.

No MeSH data available.


Related in: MedlinePlus