Asbestos-Related Diffuse Pleural Thickening

作者：Fujimoto Nobukazu^*; Kato Katsuya; Usami Ikuji; Sakai Fumikazu; Tokuyama Takeshi; Hayashi Seiji; Miyamoto Kenji; Kishimoto Takumi

来源：Respiration, 2014, 88(4): 277-284.

DOI：10.1159/000364948

• Asbestos
• Pleural thickening
• Medical Research Council dyspnea scale
• Respiratory function test
• Pleural plaques
• Blunted costophrenic angle
• Imaging

Background: The clinical features of asbestos-related diffuse pleural thickening (DPT) remain unclear. Objectives: To clarify the association between radiological findings of DPT and respiratory function. Methods: Medical data from patients with asbestos-related DPT were collected, including their history of occupational or neighborhood asbestos exposure, initial symptoms, modified Medical Research Council dyspnea grade, smoking history, radiological findings, and respiratory function test results. Results: There were 106 DPT patients between 2005 and 2010 [i.e. 103 men (97.2%) and 3 women (2.8%)]. The median age at diagnosis was 69 years (range 46-88). Patient occupations related to asbestos exposure included: asbestos product manufacturing (n = 17); the shipbuilding industry (n = 14); the construction industry (n = 13); heat insulation work (n = 12); plumbing, asbestos spraying, and electrical work (n = 7 each), and transportation and demolition work (n = 4 each). The median duration of asbestos exposure was 25 years (range 2-54), and the median latency period before the onset of DPT was 46 years (range 25-66). Involvement of the costophrenic angle (CPA) was also negatively correlated with the percent vital capacity (% VC; r = -0.448, p %26lt; 0.01). Pleural thickness and the craniocaudal and horizontal extension of pleural thickening, as determined by chest computed tomography (CT), were also negatively correlated with % VC (r = -0.226, p %26lt; 0.05; r = -0.409, p %26lt; 0.01, and r = -0.408, p %26lt; 0.01, respectively). Conclusions: DPT develops after a long latency period following occupational asbestos exposure and causes marked respiratory dysfunction. The extension of DPT should be evaluated by chest CT, and chest X-ray would be important for the evaluation of the involvement of the CPA.

• 出版日期2014-10