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ASPESTOSIS

ASPESTOSIS. Radiographic findings Ritchie O. Rosso Jr. Smd ‘05. Clinic History. 88 year old male, presenting for pre-op CXR for anticipated unilateral hip replacement by Ortho No current pulmonary symptoms other than mild SOB on exertion History of CAD (3 vessel CABG in 2001)

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ASPESTOSIS

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  1. ASPESTOSIS Radiographic findings Ritchie O. Rosso Jr. Smd ‘05

  2. Clinic History • 88 year old male, presenting for pre-op CXR for anticipated unilateral hip replacement by Ortho • No current pulmonary symptoms other than mild SOB on exertion • History of CAD (3 vessel CABG in 2001) • 40 pack-year smoking history; quit “quite a few years ago.” Worked on factory line for Dupont x 40 years.

  3. Hopital course • Pt. did well through surgery, but developed moderate CP with small troponin leak and was transferred to Cardiology service. Stress test done revealed “low risk,” and pt. subsequently discharged on 7/9/04 with long list home meds (including many pulmonary meds + O2) • Had previous admission 5/01 for SOB and accumulation pulmonary fluid, after which he underwent CABG

  4. Radiographic features of Aspestosis • Benign pleural effusion (usually w/in 10 yrs. of exposure) • Pleural plaque formation +/- calcification • Pleural thickening • Rounded atelectasis • Pulmonary fibrosis (usually >20 yrs. after exposure) • Malignant mesothelioma • Bronchial carcinoma

  5. Findings/diff diagnosis • Nodular shadows associated with short line shadows are seen in fibrosing alveolitis whatever the cause (especially pneumoconioses such as coal workers’ lungs, tin handlers, aspestosis) • Allergic alveolitis • Late stage xanthomatous lesions (Histiocytosis X)

  6. Aspestosis • Amphibole fibers (straight fibers) more carcinogenic than chrysotile (curved fibers) • Smokers with aspestos exposure 60-70 times more likely than nonsmokers to develop bronchogenic carcinoma

  7. References/ACR code • Radiology Recall. Spencer B. Gay, Richard J. Woodcock. 2000. pp. 112 • Diagnosis of Diseases of the Chest. Fraser, Pare, genereux. 1989. pp.1333-1335. • ACR 66.77

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