Asbestos, due to its unique physical properties and abundance, was widely
used in commercial applications at the beginning of the 20th century. By the 1930s,
reports of respiratory illnesses in workers with occupational exposure to asbestos began
to surface. Inhalation of asbestos leads to a localized inflammatory response that
attempts to clear inhaled asbestos fibers. This inflammatory response and retained
asbestos fibers are central to the pathogenesis of asbestosis-related pulmonary disease.
Asbestos causes a range of pulmonary diseases ranging from benign, incidental pleural
abnormalities to progressive, fatal pulmonary fibrosis to malignant neoplasms of the
lung and pleura. The benign manifestations of asbestos exposure, the focus of this
chapter, can be grouped into pleural and parenchymal diseases. Asbestosis is a fibrotic,
parenchymal disease caused by asbestos exposure. After several decades from initial
asbestos exposure, patients develop dyspnea, exercise intolerance, and hypoxia with
restrictive physiology on pulmonary function testing similar to other interstitial lung
diseases. The most common pleural manifestation is pleural plaques, which are
localized areas of pleural fibrosis that are often found incidentally. While normally
asymptomatic, they are a marker of asbestos exposure. Other pleural manifestations
tend to be symptomatic and include diffuse pleural thickening and acute benign pleural
effusion. This chapter discusses pathogenesis, clinical presentation, radiographic and
physiologic manifestations, and management of benign asbestos lung diseases.
Keywords: Asbestosis, Pleural Plague, Pleural Thickening, Pneumoconiosis, Round Atelectasis.