A 60-year-old man presents with dyspnea on exertion and a nonproductive cough. He has never smoked, but he worked as a shipbuilder, with known asbestos exposure approximately 20 years ago. To which of the following conditions is this patient especially predisposed?
A. ARDS
B. Goodpasture syndrome
C. Idiopathic pulmonary fibrosis
D. Idiopathic pulmonary hemosiderosis
E. Malignant mesothelioma of the pleura
The answer is E. Asbestosis is caused by inhalation of asbestos fibers, characterized by yellow-brown, rod-shaped ferruginous bodies with clubbed ends that stain positively with Prussian blue. Asbestosis results in a marked predisposition to malignant mesothelioma of the pleura or peritoneum. Exposure to asbestos is also a risk factor for primary lung carcinoma, as well as for carcinoma of the oropharynx, esophagus, and colon. The risk of primary lung carcinoma is greatly increased in cigarette smokers with exposure to asbestos.