DIAGNOSING ASBESTOS-
RELATED LUNG CANCER
Blunting of the Costophrenic Angle in Asbestos-Exposed Persons

Blunting of the costophrenic angle in asbestos-exposed persons is a common finding.

Crow’s feet are fibrotic strands reaching into the lung from a "shrinkage center" in the visceral pleura. CT scan will beautifully show these lesions, which can reach deep into the lung.

Rounded atelectasis: Although rounded atelectasis was originally described in association with pleural effusions and after therapeutic pneumothorax, there is no doubt that asbestos is the principal cause today.

However, any effusion, no matter what the cause, can result in a rounded atelectasis. The classic mechanism of rounded atelectasis is that described by Hanke: within a pleural effusion a part of the lung becomes atelectatic and adheres to another part of the lung.

When the exudate is resorbed, the adhesions remain, and when the adjacent parts of the lung expand, some bronchi will be folded, and thus part of the lung cannot refill with air - it has become "trapped."

Another mechanism is that a fibrotic changes involving the peripheral part of the lung contracts, forcing part of the lung to become atelectatic.

Courtesy of The EPA

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