Pleural plaque

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Pleural plaque
Diagnosis in short

Micrograph of a pleural plaque. H&E stain. (WC/Nephron)

LM hyaline (fibrosis) material +/-calcifications
LM DDx fibrosing pleuritis‎‎, malignant mesothelioma - especially desmoplastic mesothelioma
Gross white pleural lesions
Site pleura

Associated Dx asbestosis, malignant mesothelioma
Clinical history exposure to asbestos
Prevalence uncommon
Radiology pleural thickening
Prognosis benign
Clin. DDx malignant mesothelioma, metastatic carcinoma

A pleural plaque is a benign fibrous thickening of the pleura. It is strongly associated with asbestos exposure.[1]

General

  • May be due to other causes.[2]

Other asbestos-related pleural disease:[1]

Gross

  • Thickened (or calcified) plaques.[2]
  • White.

DDx:

Images

Microscopic

Features:[3]

Notes:

  • Usually associated with asbestosis fibres in the lung (85% of cases).[3]
    • Plaque burden seems to be associated with the number asbestos bodies found; many plaques... suggest many asbestosis bodies.

DDx:

Images

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Pleura, Left Lung, Biopsy:
- Fibrous pleuritis/pleural plaque (fibrous tissue with mild chronic inflammation 
  and calcifications).
- NEGATIVE for evidence of malignancy.

See also

References

  1. 1.0 1.1 Myers, R. (Jul 2012). "Asbestos-related pleural disease.". Curr Opin Pulm Med 18 (4): 377-81. doi:10.1097/MCP.0b013e328354acfe. PMID 22617814.
  2. 2.0 2.1 Clarke, CC.; Mowat, FS.; Kelsh, MA.; Roberts, MA.. "Pleural plaques: a review of diagnostic issues and possible nonasbestos factors.". Arch Environ Occup Health 61 (4): 183-92. doi:10.3200/AEOH.61.4.183-192. PMID 17867573.
  3. 3.0 3.1 Roberts, GH. (May 1971). "The pathology of parietal pleural plaques.". J Clin Pathol 24 (4): 348-53. PMID 5556121.