American Board of Internal Medicine (ABIM) Certification Practice Exam

What imaging finding is characteristic of asbestosis?

1. Ground-glass opacities

2. Pleural effusion

3. Pleural plaques

4. Interstitial lung disease

The correct answer is: Pleural plaques

The characteristic imaging finding of asbestosis is the presence of pleural plaques. These plaques are typically seen as well-defined areas of calcification located on the parietal pleura and can sometimes extend onto the diaphragm and mediastinal pleura. Pleural plaques are a result of the body's response to asbestos exposure and serve as a marker of past asbestos exposure, although they are usually asymptomatic and do not cause significant respiratory impairment. In addition to pleural plaques, asbestosis is primarily recognized for causing interstitial lung disease, which includes a restrictive pattern of lung disease on pulmonary function tests. However, pleural plaques specifically serve as a distinctive imaging marker that helps differentiate asbestosis from other forms of lung disease. While pleural effusions can occur in various pulmonary conditions, including those caused by asbestos exposure, they are not specific to asbestosis. Ground-glass opacities are more indicative of pulmonary edema, infections, or inflammatory processes rather than asbestosis specifically. Interstitial lung disease encompasses a broader category of disorders and does not pinpoint the unique signature features associated with asbestosis, such as pleural plaques. Therefore, the presence of pleural plaques on imaging studies is the definitive and characteristic finding associated with asbest