Question

Recognized features of asbestosis do NOT include

• A. Calcification of the pleura
• B. Egg-shell calcification of hilar lymph nodes
• C. Clubbing of the fingers
• D. Restrictive pattern of ventilatory defect shown by pulmonary function tests

Hint:

One of these findings actually belongs to a different pneumoconiosis, not to asbestos exposure.

Answer 1

The Correct Option is B

Step 1: Understanding the Question:
This is an 'except' question asking which listed finding is NOT a true feature of asbestosis, the interstitial lung disease caused by inhaling asbestos fibres.

Step 2: Key Concept or Approach:
Asbestosis causes progressive interstitial fibrosis. Its recognised features are pleural plaques that often calcify, clubbing of the fingers from chronic hypoxia and fibrosis, and a restrictive pattern on pulmonary function testing (reduced lung volumes with a preserved or increased FEV1/FVC ratio). Egg-shell calcification of hilar lymph nodes, in contrast, is a finding of silicosis (and occasionally sarcoidosis or treated tuberculosis), caused by silica-laden macrophages depositing calcium around the periphery of enlarged nodes - it is not a feature of asbestos-related disease.

Step 3: Working Through the Options:
Calcification of the pleura is a genuine and common finding in asbestos exposure, seen as pleural plaques. Egg-shell calcification of hilar lymph nodes is a silicosis finding, not an asbestosis one, making it the correct 'except' answer. Clubbing of the fingers is a recognised feature of the interstitial fibrosis of asbestosis. A restrictive ventilatory defect on pulmonary function tests is the expected physiological finding in any fibrosing interstitial lung disease, including asbestosis.

Step 4: Conclusion:
Egg-shell calcification of hilar lymph nodes is NOT a recognised feature of asbestosis - it belongs to silicosis.