Asbestosis is a type of pneumoconiosis caused by the inhalation of asbestos fibers and occurs primarily as a result of occupational exposure. After a long latency period, this condition manifests with nonspecific symptoms, e.g., coughing and dyspnea, which are caused by fibrotic changes in the lungs. The diagnosis is established based on a history of occupational exposure (such as working with textiles, cement, ship-building, insulation) and characteristic changes on chest x-ray (reticular opacities and pleural plaques). Currently, there is no curative treatment for asbestosis. Management consists of measures that provide symptomatic relief like oxygen therapy, prompt antimicrobial treatment of respiratory infections, cessation of exposure, and immunization against influenza and pneumococcal pneumonia. Long-term exposure to asbestos can lead to complications like fibrosis, respiratory failure, and malignancy (especially bronchogenic carcinoma, and mesothelioma). Pleural effusion may be the first sign of a malignant mesothelioma. A combination of chemotherapy, surgery, and/or radiation therapy is used to manage malignant mesothelioma. The prognosis of patients with malignant mesothelioma is poor, with the mean survival time being ∼ 1 year.
- Inhalation of airborne asbestos fibers into alveoli ; → inflammation and fibrosis of pleural parenchyma → risk of carcinogenic effects
- Diffuse bilateral infiltrates predominantly in the lower lobes
- Interstitial fibrosis
Supradiaphragmatic and pleural reticulonodular opacities/plaques
- Initially, mostly linear infiltrates are seen.
- Eventually, calcified (ivory white) or noncalcified plaques appear.
- In some cases,
- Radiographs are classified by the extent of radiographic abnormalities according to the WHO International Labor Office classification. 
- Chest x-ray
- Pulmonary function test: restrictive ventilatory defects (decreased pulmonary compliance)
- Bronchoalveolar lavage : microscopic asbestos bodies
- Definition: malignant tumor that develops from mesothelial cells
- Pleural mesothelioma (most common)
- Peritoneal mesothelioma (rarely)
- Pericardial mesothelioma (very rarely)
- Clinical findings
- Pleurocentesis; : bloody (exudative) pleural effusion
- Imaging (chest x-ray and CT)
Laparoscopy, thoracoscopy, and pleuroscopy with stained biopsy: ; reveal mesothelioma cells and psammoma bodies
- Risk of implantation metastasis. 
- It is important to differentiate mesothelioma from adenocarcinoma.
- Immunohistochemistry: Mesothelioma often stains positive for; mesothelin, serum mesothelin-related protein (SMRP), calretinin, cytokeratin 5/6 (negative in most adenocarcinomas), and vimentin. 
- Electron microscopy shows tumor cells with long and slender microvilli (in contrast to the short and stubby microvilli found in adenocarcinomas), tonofilaments, and desmosomes.
- Treatment 
- Prognosis: poor, with a mean survival time of ∼ 1 year
- Progressive respiratory failure
We list the most important complications. The selection is not exhaustive.