title: Asbestos-related pleural and lung fibrosis in patients with retroperitoneal fibrosis.
abstract: BACKGROUND
  Retroperitoneal fibrosis (RPF) is a rare fibroinflammatory disease that leads to hydronephrosis and renal failure. In a case-control study, we have recently shown that asbestos exposure was the most important risk factor for RPF in the Finnish population. The aim of this study was to evaluate the relation of asbestos exposure to radiologically confirmed lung and pleural fibrosis among patients with RPF.
  
  
  METHODS
  Chest high-resolution computed tomography (HRCT) was performed on 16 unexposed and 22 asbestos-exposed RPF patients and 18 asbestos-exposed controls. Parietal pleural plaques (PPP), diffuse pleural thickening (DPT) and parenchymal fibrosis were scored separately.
  
  
  RESULTS
  Most of the asbestos-exposed RPF patients and half of the asbestos-exposed controls had bilateral PPP, but only a few had lung fibrosis. Minor bilateral plaques were detected in two of the unexposed RPF patients, and none had lung fibrosis. DPT was most frequent and thickest in the asbestos-exposed RPF-patients. In three asbestos-exposed patients with RPF we observed exceptionally large pleural masses that were located anteriorly in the pleural space and continued into the anterior mediastinum.Asbestos exposure was associated with DPT in comparisons between RPF patients and controls (case-control analysis) as well as among RPF patients (case-case analysis).
  
  
  CONCLUSIONS
  The most distinctive feature of the asbestos-exposed RPF patients was a thick DPT. An asbestos-related pleural finding was common in the asbestos-exposed RPF patients, but only a few of these patients had parenchymal lung fibrosis. RPF without asbestos exposure was not associated with pleural or lung fibrosis. The findings suggest a shared etiology for RPF and pleural fibrosis and furthermore possibly a similar pathogenetic mechanisms.
authors.affiliation: Department of Respiratory Medicine, Tampere University Hospital, Tampere, Finland. toomas.uibu@saunalahti.fi
authors.forename: Toomas
authors.initials: T
authors.lastname: Uibu
authors.forename: Ritva
authors.initials: R
authors.lastname: Järvenpää
authors.forename: Jari
authors.initials: J
authors.lastname: Hakomäki
authors.forename: Anssi
authors.initials: A
authors.lastname: Auvinen
authors.forename: Eero
authors.initials: E
authors.lastname: Honkanen
authors.forename: Kaj
authors.initials: K
authors.lastname: Metsärinne
authors.forename: Pekka
authors.initials: P
authors.lastname: Roto
authors.forename: Heikki
authors.initials: H
authors.lastname: Saha
authors.forename: Jukka
authors.initials: J
authors.lastname: Uitti
authors.forename: Panu
authors.initials: P
authors.lastname: Oksa
mesh_terms: D000368:Aged; D001194:Asbestos / Q000009:adverse effects*; D001195:Asbestosis / Q000150:complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D016022:Case-Control Studies; D004781:Environmental Exposure; D005260:Female; D005355:Fibrosis / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010994:Pleura / Q000473:pathology*; D010995:Pleural Diseases / Q000209:etiology* / Q000473:pathology; D011658:Pulmonary Fibrosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D012185:Retroperitoneal Fibrosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D014057:Tomography, X-Ray Computed
chemical_list: D001194:Asbestos