Overview
Pleural plaques are localized areas of fibrous thickening within the parietal pleura, often asymptomatic but indicative of prior asbestos exposure. They are commonly identified incidentally on imaging studies and are associated with an increased risk of pleural malignancy 1.Diagnosis
Imaging: Chest radiography or CT scans often reveal pleural plaques as linear, calcified or non-calcified opacities.
Thoracic Ultrasound-Guided Pleural Biopsy: Useful for definitive diagnosis when malignancy or other specific conditions are suspected.
- Diagnostic Yield: Overall yield is 85.58% (95% CI: 81.57-89.58%) for pleural diseases 1.
- Guidance Techniques: Conventional TUSPB has a yield of 78.97%; contrast-enhanced ultrasound (CEUS)-guided biopsies show higher yield at 98.24% 1.Management
Primary Management: Asymptomatic pleural plaques generally require no specific treatment.
Monitoring: Regular imaging follow-up recommended to monitor for complications such as pleural thickening progression or development of malignancy 1.Special Populations
No Specific Guidance: The provided abstracts do not offer specific recommendations for management in pregnancy, pediatrics, elderly, or patients with comorbidities 1.Key Recommendations
Use Thoracic Ultrasound-Guided Biopsy for Suspected Malignancy: When malignancy is suspected, consider TUSPB for definitive diagnosis due to its diagnostic yield (Evidence: Moderate 1).
Regular Imaging Follow-Up for Asymptomatic Patients: Monitor asymptomatic patients with pleural plaques via periodic imaging to detect potential complications (Evidence: Expert opinion 1).
CEUS-Guided Biopsy for Higher Diagnostic Yield: In cases where biopsy is necessary, consider CEUS-guided techniques for potentially higher diagnostic accuracy (Evidence: Moderate 1).References
1 Zhang Q, Deng MM, Li XL, Lu Y, Hou G. Thoracic ultrasound-guided real-time pleural biopsy in the diagnosis of pleural diseases: a systematic review and meta-analysis. Expert review of respiratory medicine 2023. link