Diagnosis

Asbestosis can be difficult to diagnose because its signs and symptoms are similar to those of many other types of respiratory diseases.

Physical exam

As part of your evaluation, your doctor discusses your health history, occupation and exposure risk to asbestos. During a physical exam, your doctor uses a stethoscope to listen carefully to your lungs to determine if they make a crackling sound while inhaling.

A variety of diagnostic tests might be needed to help pinpoint the diagnosis.

Imaging tests

These tests show images of your lungs:

• Chest X-ray. Advanced asbestosis appears as excessive whiteness in your lung tissue. If the asbestosis is severe, the tissue in both lungs might be affected, giving them a honeycomb appearance.
• Computerized tomography (CT) scan. CT scans combine a series of X-ray views taken from many different angles to produce cross-sectional images of the bones and soft tissues inside your body. These scans generally provide greater detail and might help detect asbestosis in its early stages, even before it shows up on a chest X-ray.

Pulmonary function tests

These tests determine how well your lungs are functioning. Pulmonary function tests measure how much air your lungs can hold and the airflow in and out of your lungs.

During the test, you might be asked to blow as hard as you can into an air-measurement device called a spirometer. More-complete pulmonary function tests can measure the amount of oxygen being transferred to your bloodstream.

Diagnostic procedures

In some situations, your doctor might remove fluid and tissue for testing to identify asbestos fibers or abnormal cells. Tests may include:

• Bronchoscopy. A thin tube (bronchoscope) is passed through your nose or mouth, down your throat and into your lungs. A light and a small camera on the bronchoscope allow the doctor to look inside your lungs' airways for any abnormalities or to get a fluid or tissue sample (biopsy) if needed.
• Thoracentesis. In this procedure, your doctor injects a local anesthetic and then inserts a needle through your chest wall between your ribs and lungs to remove excess fluid for lab analysis and to help you breathe better. Your doctor might insert the needle with the help of ultrasound guidance.