Asbestos-related apical pleural fibrosis

The involvement of the apical pleura is unfrequent in diffuse pleural thick ening secondary to asbestos exposure. Most often diffuse pleural thickening is accompanied by an obliteration of the costophrenic angle and the poster ior and paraspinous pleural surfaces of the pleura are involved to the grea test extent. Unlike this typical form, we observed in five patients exposed to asbestos an apical pleural fibrosis, uni or bilateral, accompanied with lung retraction, hilar ascension and tracheal attraction. Apical pleural t hickening with upper lobe changes in asbestos-exposed persons should be reg arded as due to the asbestos exposure, after exclusion of other causes like tuberculosis and the apex tumors. Usually the evolution of the lesions is slowly progressive over several years or even decade, and results in mild r estrictive defect.