Asbestos disease

▪ Asbestos is little dust and a lot of fibrosis.

▪ Prolonged exposure for a number of years to
asbestos dust produces three types of severe
diseases: asbestosis of lungs, pleural disease
and tumors.
▪ At risk are workers engaged in mining,
fabrication and manufacture of number of
products from asbestos such as asbestos
pipes, tiles, roofs, textiles, insulating boards,
sewer and water conduits, brake lining, clutch
castings etc.
▪ There are two major geometric forms of
asbestos:
1.Serpentine consisting of curly and
flexible fibers.
2.Amphibole consists of straight, stiff and
rigid fibers. It includes the less common
chemical forms crocidolite (blue
asbestos),tremolite etc.
 ▪ 1. The inhaled asbestos fibers are
phagocytosed by alveolar macrophages from
where they reach the interstitium. Some of the
engulfed dust is transported via lymphatics to
the pleura and regional lymph nodes.

Pathogenesis ▪ 2.Th e asbestos-laden macrophages release

for neutrophils and for more macrophages,
thus inciting cellular reaction around them.
3. Asbestos fibers are coated with glycoprotein
and endogenous haemosiderin to produce
characteristic beaded or dumbbell-shaped
asbestos bodies.
▪ 4. All types of asbestos are fibrogenic
and result in interstitial fibrosis.
Fibroblastic proliferation may occur via
macrophage-derived growth factor such
as interleukin-1.
▪ 5. A few immunological abnormalities
such as antinuclear antibodies and
rheumatoid factor have been found in
cases of asbestosis but their role in the
genesis of disease is not clear
▪ 6. Asbestos fibers are carcinogenic, the
most carcinogenic being crocidolite
 ▪ A. ASBESTOSIS
Grossly, the affected lungs are
small and firm with cartilage-like
thickening of the pleura. The
sectioned surface shows variable
degree of pulmonary fibrosis,
especially in the subpleural areas
Pathology and in the bases of lungs . The
advanced cases may show cystic
changes.
▪ Histologically,:
1. There is non-specific interstitial fibrosis.
2. There is presence of characteristic asbestos
bodies in the
involved areas . These are asbestos fibers
coated with glycoprotein and haemosiderin
and appear beaded or dumbbell-shaped.
3. There may be changes of emphysema in the
pulmonary parenchyma between the areas of
interstitial fibrosis.
▪ 4. The involvement of hilar lymph nodes in
asbestosis is not as significant as in silicosis.
▪ PLEURAL DISEASE Pleural disease in
asbestos exposure may produce one of
the following 3 types of lesions:
1. Pleural effusion It develops in about 5%
of asbestos workers and is usually serious
type.
2. Visceral pleural fibrosis Quite often,
asbestosis is associated with dense fibrous
thickening of the visceral pleura encasing
the lung.
Pleural plaques
Grossly, the lesions appear as
circumscribed, flat, small (upto 1 cm in
diameter), firm or hard, bilateral nodules.
Microscopically, they consist of hyalinised
collagenous tissue which may be calcified
so that they are visible on chest X-ray
 ▪ 1. Bronchogenic carcinoma is the most
common malignancy in asbestos workers.
Its incidence is 5 times higher in non-
smoker asbestos workers than the non-
smoker general population
C. TUMOURS
▪ 2.Malignant mesothelioma is an
uncommon tumour but association with
asbestos exposure is present in 30 to 80%
of cases with mesothelioma.
 Berylliosis is caused by heavy exposure to
dust or fumes of metallic beryllium or its
salts. Beryllium was used in the past in
Berylliosis Fluorescent tubes and light bulbs but
currently it is principally used in nuclear
and aerospace industries and in the
manufacture of electrical and electronic
equipment.
▪ ACUTE BERYLLIOSIS Acute berylliosis
occurs in individuals who are unusually
sensitive to it and are heavily exposed to
it for 2 to 4 weeks.
▪ CHRONIC BERYLLIOSIS Chronic berylliosis develops in
individuals who are sensitised to it for a number of years,
often after a delay of 20 or more years. The disease is a
cell-mediated hypersensitivity reaction in which the metal
beryllium acts as a hapten.
▪ The condition is characterised by development of non
caseating epitheloid granulomas like those of sarcoidosis.
▪
▪ These granuloma are diffusely scattered throughout the
lung parenchyma. The granulomas have giant cells which
frequently contain 3 types of inclusions:
1. Birefringent crystals.
2. Concentrically-laminated haematoxyphilic Schumann or
conchoid bodies.
3. Acidophilic stellate-shaped asteroid bodies.
▪Thank you 😊