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Respiratory Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Ian Pavord, Nayia Petousi, Nick Talbot
Pleural thickening can be a result of: Fibrosis following pleurisy, recurrent/chronic effusions or empyemaFibrosis following thoracotomyFibrosis associated with asbestos exposureAsbestos-related pleural plaques (Figure 6.8)Secondary tumour metastasesMalignant mesothelioma (Figure 6.8c)
Case 17
Published in Andrew Solomon, Julia Anstey, Liora Wittner, Priti Dutta, Clinical Cases, 2021
Andrew Solomon, Julia Anstey, Liora Wittner, Priti Dutta
Pleural plaques occur in up to 60% of people exposed to asbestos and are usually asymptomatic. They are benign and do not affect lung function but may be an independent risk factor for mesothelioma. Pleural thickening may also occur after asbestos exposure although there are many other causes. Severe pleural thickening may cause shortness of breath and a restrictive defect on spirometry.
Lung transplantation for cystic fibrosis and bronchiectasis
Published in Wickii T. Vigneswaran, Edward R. Garrity, John A. Odell, LUNG Transplantation, 2016
Early reports14 suggested no increased risk associated with previous surgery, but publication bias undoubtedly existed. We examined the specific issue of pleurodesis for pneumothorax in patients with CF and found more bleeding and longer operations but no impact on survival.15 Although pleural thickening can be identified on a radiograph or computed tomography scan, we found radiologic appearance to be a poor predictor of surgical difficulty. Another specific report on recipients with CF came to the same conclusion.16
Diagnosis of asbestos-related lung diseases
Published in Expert Review of Respiratory Medicine, 2019
Edward J. A. Harris, Arthur Musk, Nicholas de Klerk, Alison Reid, Peter Franklin, Fraser J. H. Brims
Diffuse pleural thickening (DPT) occurs in approximately 5–14% of asbestos-exposed workers, depending on their exposure levels. Pleural thickening is not exclusively related to asbestos exposure and other causes (such as old haemothorax, tuberculosis, and empyema) should be considered in the absence of an asbestos exposure history. A study from the United Kingdom reported that 40% of subjects with DPT had BAPE prior to a presentation [50]. It is usually differentiated from CPP on plain CXR by the obliteration of the costophrenic angles. On CT imaging it is easier to differentiate it from extensive CPP by its involvement of both parietal and visceral pleura and is generally a more continuous area of thickening compared to CPP. DPT may be associated with round (rolled) atelectasis and parenchymal bands or ‘crows feet’ on x-ray imaging. On pulmonary function testing, lung volumes are usually found to be reduced and gas transfer (DLCO) is usually normal with a high value when corrected for alveolar volume (KCO) [45], reflecting extra-pulmonary restriction. Progressive exertional shortness of breath is the most common presentation. Physical examination may be normal and the presence of pain should lead to consideration of pleural malignancy. Biopsy of DPT (either CT or ultrasound guided) is non-specific, demonstrating architectural distortion and extracellular protein deposition with findings similar to pleural fibrosis from other causes.
Asbestos dust concentrations and health conditions of workers at asbestos-cement corrugated sheet production manufacturers in Vietnam: a nationwide assessment
Published in International Journal of Occupational Safety and Ergonomics, 2023
Hang Thi Le, Hoa Thi Dinh, Tam Thi Ngo
Table 5 shows that the percentage of workers with thickened pleural lesions and/or pleural calcifications with suspected asbestos-related lesions was 0.5%, of which workers in occupational group 1 had the highest rate of 2.1%, followed by group 2 and group 3 accounting for 0.3 and 0.3%, respectively. This difference was statistically significant (p < 0.05). However, pleural thickening lesions were localized and small in size. The percentage of workers with thickened pleural lesions and/or pleural calcifications was highest in the group with 20–29 years of experience (accounting for 4.3%), followed by the group with 10–19 years of experience (accounting for 0.3%). This difference was statistically significant (p < 0.01).
The role of pleurodesis in respiratory diseases
Published in Expert Review of Respiratory Medicine, 2018
Rachel M. Mercer, Maged Hassan, Najib M. Rahman
On chest computed tomography, pleurodesis manifests itself as pleural thickening. In cases where talc had been used, areas of high attenuation in the pleura are seen (Figure 1) [12]. These lesions tend to be clustered around the posterior costo-phrenic recess and near the diaphragm, reenforcing the idea that talc simply distributes according to gravity after pleural procedures [13]. In patients treated with talc slurry, the high attenuation densities appear as clusters/nodular areas, while, in patients treated with talc poudrage, it appears as fine linear deposits [13]. Multiloculated pleural collections are more commonly seen after talc pleurodesis than after other agents [12–14].