Parenchymal asbestosis can lead to lung cancer within a short time frame: more frequent follow-up surveillance is needed than currently recommended.

To cite: Murlidhar V. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2015209425 DESCRIPTION A 65-year-old non-smoker and former worker of the Hindustan Composites Asbestos factory, Mumbai, was screened at the Occupational Health and Safety Centre, Mumbai, which has helped diagnose and compensate occupational diseases including asbestosis since 1988. He had 28 years of exposure to asbestos as a worker in the textileplating department, a dusty section of the factory. He was asymptomatic and had no relevant clinical signs. His chest X-ray showed evidence of asbestosis: ILO (International Labour Organization) grading s/s; 1/0 (figure 1). Nine months later, he developed dyspnoea and a repeat X-ray (figure 2) and a positron emission tomography (PET)-CT (figure 3) showed evidence of lung cancer in the hilar region of the left lung infiltrating into the left bronchus and the