Source: Annual Congress 2002 - Asbestos and silica
Disease area: Thoracic oncology

Abstract

Asbestos exposure is associated with a number of thoracic conditions affecting both the lung parenchyma and the pleura. These include asbestosis, pleural plaque and mesothelioma. Asbestos pleurisy with benign pleural effusion may occur and this may precede development of diffuse pleural thickening although this entity is often seen in the absence of prior effusions.
Pericardial involvement with parietal pericardial plaques is well recognised and mesothelioma primarily affecting the pericardium has been described.
Few cases of benign asbestos related pericardial disease have been reported although Davies, D. et al. Thorax 1991; 46:429-432 described 3 cases of constrictive pericarditis in asbestos workers.
We report 3 cases of pericardial effusion where, following exclusion of other causes, occupational asbestos exposure led to the diagnosis of asbestos related pericardial effusion. The length of time from first asbestos exposure to development of effusion was over 40 years in all cases. 2 patients had evidence of other asbestos related disease on thoracic CT. Both had calcified pleural plaques with one also having diffuse pleural thickening (this patient had a constrictive defect on formal lung function testing), both had subpleural fibrotic bands extending into the lung parenchyma. This predated development of pericardial effusion by 12 years in one patient.
All 3 patients have been followed up for at least 3 years with serial echocardiograms during which time no other cause for the effusion has been found and there has been no evidence of mesothelioma or constrictive pericarditis.

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Citations should be made in the following way:
T. J. Howell, E. Neville (Portsmouth, United Kingdom). Benign pericardial effusion associated with occupational asbestos exposure. Eur Respir J 2002; 20: Suppl. 38, 846

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