Asbestos plaques - Example 1

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Asbestos plaques - Example 1

  • Calcified plaques are associated with previous exposure to asbestos and are almost invariably asymptomatic
  • They appear as irregularly-shaped areas of calcific density (as white as bone) and should not be mistaken for areas of consolidation
  • Pleural plaques are a benign entity (do not lead to cancer or mesothelioma) and their presence does NOT equate to the diagnosis of ‘asbestosis’
  • Note: Asbestosis is fibrosis of the lung caused by the presence of asbestos fibres in the lungs themselves – it may have similar appearances to the fibrosis seen on the previous page

Asbestos plaques - Example 2

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Asbestos plaques - Example 2

  • Pleural plaques may have a well-defined edge
  • Some plaques may be very large
  • The plaques form in the parietal pleura, including that of the mediastinum (arrowheads) and diaphragm (asterisk)

Asbestos plaques - Example 3

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Asbestos plaques - Example 3

  • When seen en face they may be difficult to see – as is the left upper zone plaque in this image
  • The diaphragm is often the best place to look for plaques where they lie in the plane of the X-ray beam

Mesothelioma - Image 1 - Pleural effusion

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Mesothelioma - Image 1 - Pleural effusion

  • Mesothelioma frequently presents as a pleural effusion – often a lot smaller than the effusion in this image

Mesothelioma - Image 2 - Post chest drain

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Mesothelioma - Image 2 - Post chest drain

  • (Same patient as image above)
  • The effusion in the image above was drained
  • Lobulated thickening of the pleura became visible
  • The left lung is reduced in volume
  • These are the typical features of mesothelioma
  • Note: Pleural metastases (usually from an adenocarcinoma) may have similar appearances to mesothelioma