Ameille J, Letourneux M
Hôpital Raymond Poincaré, Garches.
Rev Mal Respir. 1999 Jan;16 Suppl 2:S25-33.
Non malignant asbestos diseases are dominated numerically by pleural plaques. This form of circumscribed fibrosis of the parietal pleural is generally asymptomatic and its potential for evolution is weak. More rarely diffuse pleural fibrosis results from disease of the visceral pleura with a secondary fusion of the two pleural layers. Usually it follows a pleural effusion which resolves spontaneously. Its functional effects are sometimes important. The generalised practice of computerized tomographic scanning as a work up for asbestos related disease has revealed the frequent association of this diffuse pleural fibrosis with a particular form of peripheral pulmonary collapse called round atelectasis. Asbestosis or pulmonary fibrosis induced by the inhalation of asbestos has become rarer due to the improvement in working conditions in the asbestos industry. It develops following heavy exposure. The frequency of bronchopulmonary cancer is increased when asbestosis exists although it is not currently possible to say if the two disorders are independent and each is only conditioned by exposure to asbestos or if the two diseases are inextricably linked by the same physiopathological process.
非恶性石棉相关疾病在数量上以胸膜斑为主。这种壁层胸膜的局限性纤维化形式通常无症状,其进展的可能性较小。更罕见的是,弥漫性胸膜纤维化由脏层胸膜疾病导致两层胸膜继发性融合引起。通常它继发于自发消退的胸腔积液之后。其功能影响有时很重要。作为石棉相关疾病检查手段的计算机断层扫描的广泛应用显示,这种弥漫性胸膜纤维化常与一种特殊形式的周围性肺不张即圆形肺不张相关。由于石棉行业工作条件的改善,吸入石棉所致的石棉肺或肺纤维化已变得较为少见。它在大量接触后发生。存在石棉肺时支气管肺癌的发生率会增加,不过目前尚无法确定这两种疾病是否相互独立,各自仅由接触石棉所决定,还是这两种疾病通过相同的病理生理过程紧密相连。