Pleural plaque on a chest Xray

• pleural plaques - circumscribed areas of hyaline fibrous tissue on the surface of pleura - develop in direct response to the presence of fibres
• are often found as an incidental finding on chest Xray; more common in individuals exposed to fibrous materials e.g. asbestos, erionite (environmentally) and possibly ceramic fibres
  • in occupational groups exposed to asbestos
    • some studies have found a plaque prevalence of more than 50%
      • they are benign asbsestos pleural disease
      • there is evidence that shows no relation between plaque surface and cumulative asbestos exposure (2) -the surface of the pleural lesions was not related to cumulative asbestos exposure, or to smoking history or time since first exposure. Neither the presence nor the extent of the plaques was correlated with lung function parameters
      • asymptomatic and no alteration of lung function unless there is accompanying interstitial fibrosis
      • the presence of pleural plaques per se does not qualify for prescribed disease status or for industrial injuries benefit (1)
      • risk of mesothelioma - this relates to the history of asbestos exposure and not to the presence of pleural plaques - in general, the finding of pleural plaques on a chest X-ray in a patient with a history of asbestos exposure does not require formal follow-up and the patient can be reassured (1)

Reference:

1. Pulse (2003), 63 (45),96.
2. Am J Respir Crit Care Med. 2001 Mar;163(3 Pt 1):705-10.