Question

All of the following features are seen in asbestosis EXCEPT:

• A. Diffuse pulmonary interstitial fibrosis
• B. Fibrous pleural thickening
• C. Emphysema
• D. Calcific pleural plaques

Hint:

Asbestosis causes lower lobe interstitial fibrosis, pleural thickening and calcific pleural plaques. Emphysema is a different disease process, not a feature of asbestosis.

Answer 1

The Correct Option is C

Step 1: Recall what asbestosis is.
Asbestosis is a chronic pneumoconiosis caused by long-term inhalation of asbestos fibers, most often in workers exposed during mining, insulation work or shipbuilding. It mainly damages the lower lobes of the lungs.

Step 2: List the classic findings of asbestos-related lung disease.
Inhaled asbestos fibers reach the small airways and alveoli, where they trigger chronic inflammation and progressive scarring. This produces diffuse interstitial fibrosis, worst in the lower and subpleural zones. The pleura itself reacts by forming fibrous pleural thickening and, very often, discrete calcific pleural plaques on the parietal pleura, which are considered a hallmark of past asbestos exposure.

Step 3: Check option 1, diffuse pulmonary interstitial fibrosis.
This is the defining lesion of asbestosis itself, so it IS a feature.

Step 4: Check option 2, fibrous pleural thickening.
Diffuse fibrous thickening of the pleura is a well recognised finding after heavy asbestos exposure, so it IS a feature.

Step 5: Check option 4, calcific pleural plaques.
Calcified plaques on the parietal pleura, often seen on chest X-ray as holly leaf shaped densities, are one of the most specific markers of asbestos exposure. This IS a feature.

Step 6: Check option 3, emphysema.
Emphysema is destruction of alveolar walls with permanent air space enlargement, and it is linked to smoking and alpha-1 antitrypsin deficiency, not to asbestos fiber deposition. Asbestosis causes fibrosis and scarring, which is the opposite pattern to the airspace destruction of emphysema. Emphysema is not part of the standard description of asbestosis.

Step 7: Final answer.
The three genuine features of asbestosis are interstitial fibrosis, pleural thickening and calcific pleural plaques. Emphysema is not one of them.
\[ \boxed{\text{Emphysema}} \]