Radiological features of asbestos‐related visceral pleural changes

Abstract

The radiological manifestations of asbestos-related visceral pleural changes are described. Generally, visceral pleural reactions follow the mesothelial cells response to various injurious substances, including asbestos, and even saline. The changes are nonspecific. They may occur subsequent to pleural reactions associated with many conditions, which include tuberculosis, viral pleurisy, malignancy and lymphoma, lupus, or rheumatoid-induced effusions, cardiac failure, and pulmonary embolism, among other etiologies. The failure to absorb the fibrinous exudate on the visceral pleural surface can lead to the development of diffuse fibrosis of the serosal surface, interlobar pleural thickening, localized pleural filaments (strands), subpleural wedge, and lenticular-shaped masses, and could be the forerunner of lobular atelectasis (pseudotumor) formation. Some of the features are recognized on posteroanterior chest radiographs and the counterparts corroborated with the use of routine and high-resolution computed tomography studies.

Asbestos‐related pleural diseases: Dimensional criteria are not appropriate to differentiate diffuse pleural thickening from pleural plaques

“…However, there is now a large consensus that DPT is the radiographic expression of thickening and fibrosis of the visceral pleura, often associated with fusion of the parietal pleura, following clearance of benign asbestos-related pleural effusion [Hillerdal et al, 1990;Schwartz, 1991;Solomon, 1991;Miller et al, 1993;Rudd, 1996;Consensus Report, 1997;Gevenois et al, 1998;Chailleux and Letourneux, 1999;Peacock et al, 2000]. Several studies have confirmed that DPT is preceded by a benign asbestos pleural effusion [Martensson et al, 1987;Miller and Miller, 1993].…”

Mesothelioma and Asbestos-Related Pleural Diseases

“…DPT results from the fibrosis of the visceral pleura, with fusion to the parietal pleura [41]. Many studies showed that DPT is a consequence of BAPE [3,42,43,44].…”

“…However, there is no fusion of the 2 pleural layers in pleural plaques. While pleural plaques are frequently bilateral and discrete localized lesions, DPT is rarely bilateral and often covers a wide area of the pleural surface [41]. DPT due to asbestos exposure rarely calcifies [20].…”

Semantics and the Application of the ILO Classification: The Need for Recording Visceral Pleural Manifestations Separately

“…-Technologic advances in radiography, e.g., highresolution computed tomography (HRCT) of the lungs, allow separation and recognition of parietal from visceral pleural reactionS. I , 2 The application of this knowledge has been the means of identifying and separating these manifestations on the chest radiograph.…”

“…3 -6 Recognizable visceral pleural reactions on the chest radiograph include interlobar fissural thickening; interlobar plaque formation, with or without calcification; pleural strand formation; diffuse pleural thickening, with or without calcification, and 10bular atelectasis. 2 Thickening of pulmonary interlobar fissures can occur as an isolated phenomenon and is related to the duration of asbestos exposure. However, other asbestos-associated pleural or parenchymal abnormalities occur in as many as 69% of men with thickened fissures.…”