What types of tests or exams led to a diagnosis of asbestosis?
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What tests and studies are used to evaluate asbestosis?
Breathing abnormalities can be identified with lung function tests (pulmonary function tests or PFTs) or exercise tests that are performed at specialized laboratories. Asbestosis can produce both obstruction of airflow and restriction of lung inflation. In addition, the disease can affect the ability to transfer oxygen into the blood. With advanced disease, patients may have markedly reduced blood oxygen at rest and may need supplementary oxygen.
X-ray abnormalities include thickening of the lining of
the lungs and tiny lines marking the lower portions of the
lungs. However, up to 20% of patients have completely
normal-appearing chest X-rays. These patients may
demonstrate more subtle changes on computerized X-ray
studies (computerized tomography, or CT scans). Up to 30%
of patients with a normal chest X-ray who have been exposed
to asbestos will have an abnormal high resolution (high
definition) CT. The CT scan may be very useful in
separating true asbestosis from other conditions that may
have similar findings. However, even a CT scan may not
identify disease of the lining of the lung (pleural
disease) in patients with asbestosis. The proper role of
CT scanning has not been fully established.
Laboratory testing studies may be abnormal (certain antibodies
and markers of inflammation), but they do not specifically
Occasionally, a biopsy and microscopic examination of the lung is used to diagnose asbestosis.
Under microscopic examination, certain coated fibers (asbestos bodies) can be seen in association with a pattern of scarring. The amount of both coated and uncoated (transparent) asbestos has been linked to the severity of asbestosis. Because other particles may resemble asbestos, a conclusive identification may require scanning electron microscopy. Currently, detection of asbestos fibers in the lung tissue and fluids (sputum, secretions) can be used to make the diagnosis, along with a history of asbestos exposure and characteristic
X-ray or CT results.
The currently available commercial form of asbestos, chrysotile, does not form asbestos bodies as easily as previously used fibers.