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Asbestosis is a diffuse interstitial pulmonary fibrosis caused by inhalation of asbestos fibers (serpentine chrysotile or amphiboles like crocidolite, amosite). It is a chronic occupational lung disease with long latency, associated with significant malignancy risk.

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https://www.youtube.com/watch?v=zehEhHAd5Tc

Etiopathogenesis

• Asbestos fibers (microscopic, durable) deposit in alveoli and interstitium.
• Fibers are engulfed by macrophages → persistent inflammation and release of fibrogenic mediators (IL-1, TNF-α, TGF-β).
• Progressive fibrosis begins in the respiratory bronchioles and alveolar ducts, spreading to interstitium.
• Asbestos bodies: asbestos fibers coated with iron-protein complexes (seen in histology).
• Latency: usually 15–30 years after exposure.

Clinical Features

• Latency: decades after exposure.
• Progressive dyspnea on exertion, chronic cough.
• Bibasilar inspiratory crackles.
• Clubbing of fingers.
• Symptoms worsen with progression to restrictive lung disease and hypoxemia.

Complications:

• Progressive massive fibrosis (PMF) → respiratory failure, cor pulmonale.
• Pleural disease: pleural plaques (hallmark), pleural effusion, diffuse pleural thickening.
• Malignancy risk:
  • Bronchogenic carcinoma (↑ synergistically with smoking).
  • Mesothelioma (strongly linked).
  • Laryngeal carcinoma, GI cancers (lesser).