Pleural thickening

Pleural thickening is an increase in the bulkiness of one or both of the pulmonary pleurae.

Pleural thickening
Macroscopic appearance of a pleural plaque.
SpecialtyRespirology

Causes
CategoryDisease[1]Features[1]
Infection After empyema
After tuberculosis
  • Commonly forming an apical pleural cap
  • Non-progressive
  • Rarely extensive, with sheet-like calcifications
Active infection with mycobacteria other than tuberculosis, or chronic pulmonary aspergillosis
  • Slowly progressive
  • Apical distribution
  • Cavitations
Non-infectious inflammation Asbestosis
After pleurodesis
  • Diffuse
  • Non-progressive
After hemothorax
  • Usually basolateral distribution
  • May have calcification
  • Non-progressive
After drugs, such as methysergide or bromocriptine
Cancer-related Primary cancer, mainly mesothelioma
Metastasis or invasion, mainly from lung cancer
  • Progressive
  • Nodular changes
  • Lung tumors

Pleural plaques

Pleural plaques are patchy collections of hyalinized collagen in the parietal pleura.[2] They have a holly leaf appearance on X-ray.[1] They are indicators of asbestos exposure, and the most common asbestos-induced lesion.[3] They usually appear after 20 years or more of exposure and never degenerate into mesothelioma. They appear as fibrous plaques on the parietal pleura, usually on both sides, and at the posterior and inferior part of the chest wall as well as the diaphragm.[4]

See also

References
  1. Unless otherwise specified in boxes, reference is: Laura-Jane Smith; Jerry Brown; Jennifer Quint (2015). Eureka: Respiratory Medicine. JP Medical Ltd. ISBN 9781907816727.
  2. Torigian, Drew A.; Lau, Charles T.; Miller, Wallace T. (2011). Chapter 68 - Pleural Diseases in Radiology Secrets Plus. pp. 478–485. doi:10.1016/B978-0-323-06794-2.00068-7.
  3. Myers R (July 2012). "Asbestos-related pleural disease". Curr Opin Pulm Med. 18 (4): 377–81. doi:10.1097/MCP.0b013e328354acfe. PMID 22617814. S2CID 28152429.
  4. American Thoracic Society (September 2004). "Diagnosis and initial management of nonmalignant diseases related to asbestos". Am. J. Respir. Crit. Care Med. 170 (6): 691–715. doi:10.1164/rccm.200310-1436ST. PMID 15355871.
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