Asbestosis
Summary
Pneumoconiosis from asbestos fiber inhalation, classically in shipyard workers, plumbers, and insulation/construction trades. Produces lower-lobe interstitial fibrosis and pleural plaques, with markedly increased risk of bronchogenic carcinoma and mesothelioma.
Detail
Asbestos fibers reach distal airways and are taken up by macrophages, forming ferruginous bodies (golden-brown, beaded rods of asbestos coated in hemosiderin/iron) visible on Prussian blue stain. Imaging shows lower-lobe reticular opacities, honeycombing, and calcified pleural plaques on the parietal pleura and diaphragm (pathognomonic but themselves benign). Bronchogenic carcinoma is the most common asbestos-related malignancy and risk is synergistically multiplied by smoking; mesothelioma is most specific but not most common and is not smoking-related. Latency is typically 20-40 years.
Sources
- First Aid for USMLE Step 1 2024
- Robbins Basic Pathology 10th ed
- Pathoma
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