Which asbestos-related lung disease is characterized by interstitial fibrosis?

• A. Pulmonary hypertension
• B. Hypersensitivity pneumonitis
• C. Goodpasture syndrome
• D. Asbestosis

Answer: (D)

Interstital fibrosis due to asbestos exposure defines this disease. Chronic inhalation of asbestos fibers triggers ongoing inflammation and scar formation in the lung interstitium, most prominent in the lower lungs, leading to a restrictive pattern of lung impairment and progressive dyspnea. On tissue, you’d see ferruginous bodies—beaded iron-coated asbestos fibers encased by macrophages—which are a classic histologic clue. The latency can be decades, and smoking can worsen progression.

This distinction matters because the other options describe processes that are not fibrotic scarring from asbestos: pulmonary hypertension is a vascular condition, hypersensitivity pneumonitis is an immune-mediated interstitial disease often with granulomas, and Goodpasture syndrome is an autoimmune anti-GBM–mediated pulmonary hemorrhage.