US EPA

3077688 

Journal Article 

Focal pleural thickening mimicking pleural plaques on chest computed tomography: tips and tricks 

Alfudhili, KM; Lynch, DA; Laurent, F; Ferretti, GR; Dunet, V; Beigelman-Aubry, C 

2016 

Yes 

British Journal of Radiology
ISSN: 0007-1285
EISSN: 1748-880X 

BRITISH INST RADIOLOGY 

LONDON 

89 

1057 

20150792 

English 

26539633 

10.1259/bjr.20150792 

WOS:000368418500032 

Diagnosis of pleural plaques (PPs) is commonly straightforward, especially when a typical appearance is observed in a context of previous asbestos exposure. Nevertheless, numerous causes of focal pleural thickening may be seen in routine practice. They may be related to normal structures, functional pleural thickening, previous tuberculosis, pleural metastasis, silicosis or other rarer conditions. An application of a rigorous technical approach as well as a familiarity with loco-regional anatomy and the knowledge of typical aspects of PP are required. Indeed, false-positive or false-negative results may engender psychological and medico-legal consequences or can delay diagnosis of malignant pleural involvement. Correct recognition of PPs is crucial, as they may also be an independent risk factor for mortality from lung cancer in asbestos-exposed workers particularly in either smokers or former/ex-smokers. Finally, the presence of PP(s) may help in considering asbestosis as a cause of interstitial lung disease predominating in the subpleural area of the lower lobes. The aim of this pictorial essay is to provide a brief reminder of the normal anatomy of the pleura and its surroundings as well as the various aspects of PPs. Afterwards, the common pitfalls encountered in PP diagnosis will be emphasized and practical clues to differentiate actual plaque and pseudoplaque will be concisely described.