Rosenstock L, Hudson L D
Occup Med. 1987 Apr-Jun;2(2):383-407.
Pleural abnormalities are the most common disease manifestations of asbestos exposure and have both clinical and epidemiologic implications. Benign pleural processes include pleural thickening, which can be discrete (plaques) or diffuse, rounded atelectasis (pseudotumor), and benign exudative asbestos effusions. Asbestos is the most significant cause of diffuse malignant mesothelioma. Most patients with discrete pleural thickening have normal pulmonary function. Patients with extensive pleural involvement, however, can have significant restrictive impairment with no or only minimal interstitial disease. For any given radiological grade of parenchymal disease, pulmonary function is more impaired when pleural thickening is present. The presence of typical pleural changes can serve as a reliable marker for asbestos exposure in epidemiologic studies. Individuals with pleural plaques are more likely to develop parenchymal involvement than similarly exposed workers without pleural disease. Once present, pleural changes are likely to progress even in the absence of further exposure.
胸膜异常是石棉暴露最常见的疾病表现，具有临床和流行病学意义。良性胸膜病变包括胸膜增厚，可呈离散性（斑块）或弥漫性、圆形肺不张（假瘤）以及良性渗出性石棉胸腔积液。石棉是弥漫性恶性间皮瘤的最重要病因。大多数离散性胸膜增厚患者的肺功能正常。然而，胸膜广泛受累的患者可能会出现严重的限制性损害，而无或仅有轻微的间质性疾病。对于任何给定的实质性疾病放射学分级，存在胸膜增厚时肺功能受损更严重。典型胸膜改变的存在可作为流行病学研究中石棉暴露的可靠标志物。有胸膜斑块的个体比无胸膜疾病的类似暴露工人更易发生实质性受累。一旦出现胸膜改变，即使在无进一步暴露的情况下也可能进展。
