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Pleural thickening
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Pleural thickening

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Pleural thickening
Asbestosis - Fibrous pleural plaque (7468458430).jpg
Macroscopic appearance of a pleural plaque.
Specialty Respirology

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

Causes

Category Disease Features
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
  • Associated with asbestosis
  • Progressive thickening
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. They have a holly leaf appearance on X-ray. They are indicators of asbestos exposure, and the most common asbestos-induced lesion. 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.

See also


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