A 60-year-old man is admitted for elective hernia repair. He has a 40- pack-per-year smoking history and worked as a construction worker for 20 years. He complains of shoness of breath and occasional blood-streaked sputum. His ECG shows lateral wall ischemia. The findings on his chest x-rays are due to
The lateral film of the patient shows marked calcification in the right posterior sulcus from the top almost to the bottom of the lung; there is also heavy calcification along the lateral pleural surfaces and some calcification along the diaphragm, primarily on the right The chest x-ray shows dense bilateral pleural plaques and diaphragmatic calcification characteristic of asbestos-related disease. Pleural plaques, malignant mesothelioma, asbestosis, and lung cancer occur after a long latency period. Asbestos-related pleural effusions are often bloody, exudative, and difficult to differentiate from those caused by trauma, neoplasm, or thromboembolic disease. Diagnosis is based on history of occupational exposure and exclusion of other causes. Chronic bronchitis is a clinical diagnosis, and the chest radiograph and clinical picture are not suggestive of CHF. Empyema presents as a pleural effusion or a loculated pleural-based opacity and not with diffuse bilateral calcification.
Chronic bronchitis
Empyema
Environmental occupational exposure
Congestive hea failure
Respiratory system