title: Focal pleural thickening mimicking pleural plaques on chest computed tomography: tips and tricks.
abstract: Diagnosis of pleural plaques (PPs) is commonly straightforward, especially when a typical appearance is observed in a context of previous asbestos exposure. Nevertheless, numerous causes of focal pleural thickening may be seen in routine practice. They may be related to normal structures, functional pleural thickening, previous tuberculosis, pleural metastasis, silicosis or other rarer conditions. An application of a rigorous technical approach as well as a familiarity with loco-regional anatomy and the knowledge of typical aspects of PP are required. Indeed, false-positive or false-negative results may engender psychological and medico-legal consequences or can delay diagnosis of malignant pleural involvement. Correct recognition of PPs is crucial, as they may also be an independent risk factor for mortality from lung cancer in asbestos-exposed workers particularly in either smokers or former/ex-smokers. Finally, the presence of PP(s) may help in considering asbestosis as a cause of interstitial lung disease predominating in the subpleural area of the lower lobes. The aim of this pictorial essay is to provide a brief reminder of the normal anatomy of the pleura and its surroundings as well as the various aspects of PPs. Afterwards, the common pitfalls encountered in PP diagnosis will be emphasized and practical clues to differentiate actual plaque and pseudoplaque will be concisely described.
authors.affiliation: 1 Radiodiagnostic and Interventional Radiology, CHUV-University Hospital, Lausanne, Switzerland.
authors.forename: Khalid M
authors.initials: KM
authors.lastname: Alfudhili
authors.affiliation: 2 Department of Radiology, National Jewish Health, Denver, CO, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Lynch
authors.affiliation: 3 Department of Radiology, Centre Hospitalier Universitaire de Bordeaux, Pessac, France.|4 Cardiothoracic Center, Radiology Department, Inserm 1065, Université de Bordeaux, Bordeaux, France.
authors.forename: Francois
authors.initials: F
authors.lastname: Laurent
authors.affiliation: 5 Radiology Department, Centre Hospitalier Universitaire A Michallon, Grenoble, France.|6 INSERM U 823, Institut A Bonniot, Grenoble, France.|7 Université Grenoble Alpes, Grenoble, France.
authors.forename: Gilbert R
authors.initials: GR
authors.lastname: Ferretti
authors.affiliation: 1 Radiodiagnostic and Interventional Radiology, CHUV-University Hospital, Lausanne, Switzerland.
authors.forename: Vincent
authors.initials: V
authors.lastname: Dunet
authors.affiliation: 1 Radiodiagnostic and Interventional Radiology, CHUV-University Hospital, Lausanne, Switzerland.
authors.forename: Catherine
authors.initials: C
authors.lastname: Beigelman-Aubry
mesh_terms: D001195:Asbestosis / Q000000981:diagnostic imaging; D006801:Humans; D010994:Pleura / Q000000981:diagnostic imaging*; D010995:Pleural Diseases / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed