Pleural plaque

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

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

General

• May be due to other causes.

Other asbestos-related pleural disease:

• Diffuse pleural thickening.
• Benign asbestos-related pleural effusions (BAPEs).
• Malignant mesothelioma.

Gross

• Thickened (or calcified) plaques.
• White.

DDx:

• Metastatic carcinoma.

Images

• 

  Fibrous pleural plaque. (WC/Rosen)

• Pleural plaque (utah.edu).

Microscopic

Features:

• Hyaline material +/- calcification.

Notes:

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

DDx:

• Fibrosing pleuritis‎‎.
• Desmoplastic mesothelioma.

Images

• 

  PP - extremely low mag. (WC)

• 

  PP - very low mag. (WC)

• 

  PP - low mag. (WC)

• 

  PP - intermed. mag. (WC)

• 

  PP - high mag. (WC)

• 

  PP - low mag. (WC)

• 

  PP - low mag. (WC)

• 

  PP - low mag. (WC)

• 

  PP - intermed. mag. (WC)

• 

  PP - intermed. mag. (WC)

www

• Pleural plaque (utah.edu).

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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

• Asbestosis - lung has fibrosis.
• Malignant mesothelioma.
• Ferruginous bodies.