Multiple Pleural Plaques

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Abstract
The radiological features of 12 cases of multiple pleural plaques are presented. Some of their chest radiographs show, instead of the usual holly leaf calcified plaque, a multinodular type of calcification which may be confused with tuberculosis. Only part of a plaque may be calcified, and some plaques show only a soft tissue density. Serial films of one case show only soft tissue density plaques at one stage, but subsequently linear calcification develops. In another case with no apparent calcification a pre-operative radiological diagnosis of multiple pleural plaques such as occur in asbestosis was confirmed at thoracotomy performed for an apical tumour. This is believed to be the first recorded pre-operative diagnosis in a case showing soft tissue density plaques only. The faintness of such lesions helps to distinguish them from intra-pulmonary nodules; this may be called the “faint shadow sign”. The relationship to asbestos inhalation and the significance of the plaques are discussed.