Hammar S P
Diagnostic Specialities Laboratory, Bremerton, WA 98310.
Semin Diagn Pathol. 1992 May;9(2):102-9.
Asbestos is a fibrous silicate mineral that has been known for decades to cause pulmonary scarring, referred to as asbestosis. The simplest definition of asbestosis is the presence of pulmonary fibrosis as a result of accumulation of airborne asbestos in the lungs. Not infrequently, the terms "asbestos" and "asbestosis" are used incorrectly (interchangeably) by medical personnel, and sometimes pleural fibrosis caused by asbestos is incorrectly referred to as asbestosis. The earliest lesion of asbestosis, as defined by the CAP-NIOSH Committee is peribronchiolar fibrosis, although controversy exists as to how specific this lesion is with respect to causation by asbestos, and whether this lesion progresses to grade 4 asbestosis. In addition, some authorities in the field suggest that the term "asbestosis" be used only for diffuse interstitial fibrosis. The mechanism by which asbestos causes interstitial fibrosis remains poorly understood, and in recent years, pathologic changes such as organizing pneumonitis-bronchiolitis obliterans, and lymphocytic interstitial pneumonitis, have been described in persons occupationally exposed to asbestos, suggesting that the pulmonary lesions caused by asbestos represent a wider spectrum than had previously been appreciated. By defining areas of uncertainty, medical science will eventually clarify areas of disagreement concerning asbestosis which will eventually lead to a better understanding of this disease.
石棉是一种纤维状硅酸盐矿物，数十年来一直被认为会导致肺部瘢痕形成，即石棉肺。石棉肺最简单的定义是由于空气中的石棉在肺部积聚而导致的肺纤维化。医务人员常常错误地（互换地）使用“石棉”和“石棉肺”这两个术语，有时由石棉引起的胸膜纤维化也被错误地称为石棉肺。根据CAP-NIOSH委员会的定义，石棉肺最早的病变是细支气管周围纤维化，尽管对于该病变在石棉致病方面的特异性以及它是否会发展为4级石棉肺存在争议。此外，该领域的一些权威人士建议“石棉肺”一词仅用于弥漫性间质纤维化。石棉导致间质纤维化的机制仍知之甚少，近年来，在职业接触石棉的人群中描述了一些病理变化，如机化性肺炎 - 闭塞性细支气管炎和淋巴细胞性间质性肺炎，这表明石棉引起的肺部病变比以前认识的范围更广。通过界定不确定的领域，医学最终将澄清关于石棉肺的分歧领域，这最终将有助于更好地理解这种疾病。
