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Asbestosis; Idiopathic pulmonary fibrosis; differential diagnosis
Introduction. Idiopathic pulmonary fibrosis and asbestosis are both pulmonary interstitial diseases that may present overlapping clinical aspects in the full-blown phase of the disease. For both clinical entities the gold standard for diagnosis is histological examination, which however poses ethical problems for its execution, especially when performed for preventive or forensic purposes.
Objective. To evaluate clinical, anamnestic and radiological criteria for the differential diagnosis between asbestosis and idiopathic pulmonary fibrosis, allowing to discriminate the two pathologies, which, even if clinically similar, present extremely different prognostic and therapeutic perspectives.
Methods. Two illustrative clinical cases of idiopathic pulmonary fibrosis are reported, in which the differential diagnosis between the two pathologies have been made through the study of occupational exposure to asbestos, the onset and progression of clinical symptoms, and through the identification of specific radiological elements through chest HRCT.
Results. Diagnosis of idiopathic pulmonary fibrosis could be made, considering the absence of significant exposure to asbestos, early onset and rapid progression of dyspnea and restrictive ventilatory defect, in association with a pulmonary radiological pattern characterized by peculiar elements such as honeycombing.
Discussion. The diagnostic procedure carried out to make a differential diagnosis with asbestosis, allows to provide practical clinical elements to facilitate the differentiation between the two pulmonary fibrosis, fundamental in the occupational field.
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