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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

CT scan of the thorax demonstrating "folded lung" or Blesovsky's syndrome in association with diffuse pleural thickening.
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Figure 4: CT scan of the thorax demonstrating "folded lung" or Blesovsky's syndrome in association with diffuse pleural thickening.

Mentions: Rounded atelectasis may also occur in association with DPT. It is known as shrinking or contracted pleuritis, a pleuroma or "Blesovsky" s syndrome" (Figure 4)[62]. Rounded atelectasis is believed to be the result of infolding of the thickened fibrotic visceral pleura with collapse and chronic inflammation of the underlying lung parenchyma. The "comet sign", or a rounded mass connected by a fibrous band to an area of thickened pleura, is the pathognomonic HRCT feature. It can occur in response to any cause of acute pleuritis, but asbestos appears to be the commonest recognised cause[11]. Symptoms generally only occur if the area of atelectasis is large enough to compromise lung function[3]. The differential diagnosis of rounded atelectasis includes a peripheral lung cancer or a benign inflammatory pseudotumour. The latter, however, generally evolves more quickly[11].


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

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

CT scan of the thorax demonstrating "folded lung" or Blesovsky's syndrome in association with diffuse pleural thickening.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 4: CT scan of the thorax demonstrating "folded lung" or Blesovsky's syndrome in association with diffuse pleural thickening.
Mentions: Rounded atelectasis may also occur in association with DPT. It is known as shrinking or contracted pleuritis, a pleuroma or "Blesovsky" s syndrome" (Figure 4)[62]. Rounded atelectasis is believed to be the result of infolding of the thickened fibrotic visceral pleura with collapse and chronic inflammation of the underlying lung parenchyma. The "comet sign", or a rounded mass connected by a fibrous band to an area of thickened pleura, is the pathognomonic HRCT feature. It can occur in response to any cause of acute pleuritis, but asbestos appears to be the commonest recognised cause[11]. Symptoms generally only occur if the area of atelectasis is large enough to compromise lung function[3]. The differential diagnosis of rounded atelectasis includes a peripheral lung cancer or a benign inflammatory pseudotumour. The latter, however, generally evolves more quickly[11].

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