[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [General pathology](https://durgical.com/en/general-pathology/) › [Lung](https://durgical.com/en/general-pathology/areas/lung/) › Asbestos-related disease # Asbestos-related disease - Lesion Asbestos fibres scar the lower lungs, make pleural plaques, and cause lung carcinoma and mesothelioma decades after exposure. Updated Nov 12, 2026 ## Key points - Pleural plaques: well-defined, often calcified plaques of dense collagen on the parietal pleura and diaphragm domes; the most common lesion. - Asbestosis: diffuse interstitial fibrosis that starts in the lower lobes and subpleurally (opposite to coal and silica). - Asbestos bodies: golden-brown, beaded, dumbbell-shaped fibres coated with iron and protein (a type of ferruginous body); Prussian blue positive. - Lung carcinoma risk rises several-fold with asbestos and multiplies with smoking. - Mesothelioma: latency of decades; smoking does not add to its risk. - Amphiboles (crocidolite) are more pathogenic than serpentine chrysotile. ## What it is Asbestos is a group of fibrous silicates once widely used in construction, insulation, brakes and shipbuilding. The fibres reach the alveoli, resist clearance and keep macrophages activated. The result is a family of diseases: pleural plaques (the commonest), effusions, diffuse interstitial fibrosis (asbestosis), lung carcinoma and malignant mesothelioma, with long latency. Smoking multiplies the lung cancer risk but not the mesothelioma risk. ## Structure - Asbestosis: fibrosis around respiratory bronchioles and alveolar ducts that spreads into alveoli; UIP-like pattern with fibroblastic foci and honeycombing. - Asbestos bodies in the fibrotic areas distinguish it from other fibrosis. - Pleural plaque: pearly white, discrete plaque; microscopy shows acellular, basket-weave hyalinised collagen, often calcified. - Associated carcinoma or mesothelioma with typical features. ## Step by step - Long, thin fibres reach the distal lung and cannot be fully engulfed by macrophages (frustrated phagocytosis). - Macrophages stay activated, release oxidants, IL-1 and TGF-β, and some fibres become coated with iron (asbestos bodies). - Fibroblasts lay down collagen around bronchioles and ducts, extending into a diffuse lower-lobe fibrosis. - Fibres migrate to the pleura and cause plaques, effusions and, over decades, mesothelioma. - Fibres adsorb carcinogens (as in tobacco smoke) and generate free radicals: tumour initiation and promotion. - The scarring narrows pulmonary arteries: pulmonary hypertension and cor pulmonale. ## Markers - Asbestos bodies (Prussian blue) ## Clinical notes - Dyspnoea appears 10 to 30 years after exposure; lower-zone linear opacities and honeycombing on imaging. - Plaques are usually silent and seen as calcified densities on the chest film. - Asbestos is banned in many countries; Colombia banned it by law in 2019, but exposure from old buildings and products persists. ## Memory aid Asbestos goes to the bottom and the boundary: lower lobes and pleura. ## Test yourself Think of the answer, then tap the question to see it. ## What is the most common manifestation of asbestos exposure? Pleural plaques: well-circumscribed, often calcified plaques of dense collagen on the parietal pleura and diaphragm. ## How does the distribution of asbestosis differ from silicosis? Asbestosis starts in the lower lobes and subpleurally, whereas silicosis and coal disease favour the upper zones. ## Does smoking increase the mesothelioma risk of asbestos workers? No. Smoking multiplies their lung carcinoma risk but does not increase the risk of mesothelioma. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/general-pathology/asbestos-related-disease/) [More Pathology questions →](https://durgical.com/en/practice/?f=pathology) ## Connections ## Related 6 - [Air pollution and occupational exposures](https://durgical.com/en/general-pathology/air-pollution-and-occupational-exposures/) - [Chemical carcinogens: initiation, promotion and the table to know](https://durgical.com/en/general-pathology/chemical-carcinogens-initiation-promotion-and-the-table-to-know/) - [Pleural tumours: mesothelioma and solitary fibrous tumour](https://durgical.com/en/general-pathology/pleural-tumours-mesothelioma-and-solitary-fibrous-tumour/) - [Coal workers' pneumoconiosis and silicosis](https://durgical.com/en/general-pathology/coal-workers-pneumoconiosis-and-silicosis/) - [Lung carcinoma: pathogenesis and precursors](https://durgical.com/en/general-pathology/lung-carcinoma-pathogenesis-and-precursors/) - [Idiopathic pulmonary fibrosis (UIP pattern)](https://durgical.com/en/general-pathology/idiopathic-pulmonary-fibrosis/) ## Related conditions 3 - [Pneumoconioses (silicosis, asbestosis, coal workers' pneumoconiosis)](https://durgical.com/en/conditions/pneumoconioses/) - [Malignant pleural mesothelioma](https://durgical.com/en/conditions/malignant-pleural-mesothelioma/) - [Lung cancer](https://durgical.com/en/conditions/lung-cancer/) [← All of general pathology](https://durgical.com/en/general-pathology/) Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given. Sources: [Asbestos](https://medlineplus.gov/asbestos.html) (MedlinePlus, US National Library of Medicine, 2025); [Mesothelioma](https://medlineplus.gov/mesothelioma.html) (MedlinePlus, US National Library of Medicine, 2025). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/general-pathology/asbestos-related-disease/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/general-pathology/asbestos-related-disease/