Honeycombing, a Typical Appearance of Lungs Affected by Asbestos Exposure


On chest radiographs or CT scans, several imaging findings of thoracic diseases have been referred to as symbols, signs, or naturalistic images. These associations are helpful for healthcare professionals to distinguish and describe prominent thoracic formations through the assimilation of concepts.

One of these radiological features associated with naturalistic figures is honeycombing in the lungs, which often indicates lung affections caused by long-term exposure to hazardous materials, such as asbestos. Moreover, honeycombing is the imaging hallmark of widespread pulmonary fibrosis, a typical consequence of asbestos exposure; the description "honeycomb lung" often indicates a clear case of interstitial lung disease, a condition associated with asbestos fibers in the lungs.

Honeycombing forms when dense collagen fibers deposit and destroy the normal alveolar structure. On X-rays, honeycomb cysts appear as enlarged airspaces irregular in size, surrounded by thick walls, and stacked upon one another. These cysts are typically 3-10 mm in diameter but can be as large as 2.5 cm. Imagistic tests show lung abnormalities caused by the inhaled asbestos fibers as areas with increased density as a result of alveoli filling up with:

  • fluid
  • blood
  • pus
  • cells (including tumor cells)
  • other substances

These pathologic processes will appear as opacities on chest X-rays described by formations such as:

  • Consolidation - a diffuse, ill-defined pattern.
  • Interstitial formations - the damaged supporting tissue shows fine or coarse reticular patterns or small nodules.
  • Nodules or masses - individual or multiple lesions.
  • Atelectasis - a collapse in a part of the lung resulting in volume loss and increased density.

Though the honeycomb pattern represents a lung destroyed by fibrosis, seen in numerous end-stage interstitial lung diseases, it's also characteristic of usual interstitial pneumonia and typical for idiopathic pulmonary fibrosis - both diseases linked to extended asbestos exposure. Recognition of honeycomb change is imperative as it is associated with a poor prognosis.

Progression of Honeycombing in the Lungs Behind Veterans' Degrading Health

Although most cases of honeycomb lungs are characteristic of chronic lung diseases, the pattern can also occur in acute interstitial pneumonia and diffuse alveolar damage cases tied to longtime toxic exposure. A honeycomb lung progresses by the day or week, and the result is often fatal.

In some cases, the honeycomb pattern may differ from the initial feature, and it can occur as early as one week after the onset of symptoms of an asbestos-related disease such as interstitial pneumonia. The presence of patchy ground-glass opacity usually precedes honeycomb lungs. Over time, chronic bronchitis sets in and dilates the bronchioles gradually in the area of the ground-glass opacity, developing in honeycombing categorized into:

  • microcystic honeycombing - denotes tiny cysts
  • macrocystic honeycombing - refers to lung cysts bigger than 4 mm in diameter

Generally, honeycombing is a sign of severe, end-stage fibrosis. However, radiologists may face an additional challenge in pinpointing the disease behind honeycombing because different chronic processes can mimic honeycomb lungs. In some cases, the pattern occurs in a combination of affections like emphysema, acute inflammation, and pulmonary embolism, giving an appearance of honeycombing seen in pulmonary fibrosis.

Regular Medical Examinations Help Diagnose Asbestos Diseases on Time

The complexity of diseases resulting from asbestos exposure makes their diagnosis challenging in most cases because of their similarity in symptoms to other less severe respiratory disorders. Many doctors misinterpret the symptoms, reach an inexact diagnosis, and advise unfitting treatments, wasting precious time. Like with all severe diseases, time is of the essence when it comes to dealing with an asbestos condition. To expedite the diagnostic process, veterans should request a second or a third doctor's opinion outside the VA that can ensure a thorough evaluation of their illness. Openly speaking about the service in the Navy and the risk of asbestos exposure on naval vessels built before the 1980s can set the premises for an accurate check-up and could lead to discovering non-cancerous asbestos diseases such as:

Even if benign asbestos illnesses don't qualify a veteran for compensation, they should be observed, as they may develop into cancer. With periodic chest X-rays and pulmonary function tests, any malignant transformation can be noticed, and an asbestos cancer diagnosis will qualify veterans to file claims. A cancer diagnosis upturns everyone's life and can blur the notion of time. Still, veterans dealing with asbestos-related malignancies should keep in mind that eligibility has a statute of limitations of up to five years from the date of diagnosis. The families of deceased veterans can file a claim for three years from the date of the loved one's passing.

We Offer Assistance to Veterans in Filing a Claim for Compensation to Which They May Be Entitled

Former service members of the Navy, Air Force, U.S. Army Transport Service, Coast Guard, or Merchant Marine who served between World War II and the late 1970s qualify for compensation from asbestos trust funds and the VA if they have proof of asbestos exposure and a diagnosis with the following asbestos-related cancers:

If your medical papers document any of these malignancies and you wish to take legal action, an asbestos attorney can guide you through the filing process and ensure the success of your case. We can help by putting you in contact with specialized lawyers who are ready to assist you in getting the lawful compensation you may be entitled to.

If you have a cancer diagnosis please contact us

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