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The patient history reveals occupational, family, or neighborhood exposure to asbestos fibers. Physical examination reveals characteristic dry crackles at lung bases. Chest X-rays show fine, irregular, and linear diffuse infiltrates; extensive fibrosis results in a “honeycomb” or “ground-glass” appearance. X-rays may also show pleural thickening and calcification, with bilateral obliteration of costophrenic angles. In later stages, an enlarged heart with a classic “shaggy” heart border may be evident. Computed tomography scan of the lungs also aids in diagnosis.
Pulmonary function tests show:
❑ Vital capacity, forced vita capacity, and total lung capacity — decreased
❑ Forced expiratory volume in 1 second — decreased or normal
❑ Carbon monoxide diffusing capacity — reduced when fibrosis destroys alveolar walls and thickens alveolocapillary membranes.
Arterial blood gas analysis reveals:
❑ Partial pressure of arterial oxygen — decreased
❑ Partial pressure of arterial carbon dioxide — low due to hyperventilation.
Source: Professional Guide to Diseases (Eighth Edition), 2005
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