On chest radiography, asbestosis is described as which appearance?

• A. Ground-glass appearance of the heart border
• B. Eggshell calcifications of hilar lymph nodes
• C. Reticular and nodular opacities
• D. Pleural effusions

Answer: (A)

Asbestosis shows interstitial fibrosis on chest radiographs, producing a pattern of reticular and nodular opacities, usually greatest in the lung bases and subpleural regions, and can progress to honeycombing with advanced disease. Ground-glass appearance along the heart border is not typical for asbestosis; that finding is more often seen with edema or diffuse inflammatory processes. Eggshell calcifications of hilar lymph nodes point to silicosis, not asbestosis. Pleural effusions can occur with asbestos exposure, but the defining radiographic feature is the reticular and nodular interstitial pattern.