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]
- Diffuse pleural thickening.
- Benign asbestos-related pleural effusions (BAPEs).
- Malignant mesothelioma.
Gross
- Thickened (or calcified) plaques.[2]
- White.
DDx:
- Metastatic carcinoma.
Images
Fibrous pleural plaque. (WC/Rosen)
.jpg)
Microscopic
Features:[3]
- Hyaline material +/- calcification.
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
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)
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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.
References
- ↑ 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.
- ↑ 2.0 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.
- ↑ 3.0 3.1 Roberts, GH. (May 1971). "The pathology of parietal pleural plaques.". J Clin Pathol 24 (4): 348-53. PMID 5556121.