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Pulmonary disease associated with pleural "asbestos" plaques
R F Sison1, R H Hruban, G W Moore
1Johns Hopkins Medical Institutions, Baltimore 21205.
Chest
|April 1, 1989
Summary
Pleural plaques, often linked to asbestos exposure, do not always indicate asbestos-related pulmonary disease. This study found other lung pathologies were not always present with pleural plaques.
Area of Science:
- Pulmonary Pathology
- Occupational Medicine
Background:
- Pleural plaques are a common finding in asbestos-related pulmonary disease.
- However, postmortem studies suggest pleural plaques can exist without associated lung disease.
Purpose of the Study:
- To investigate the association between pleural plaques and pulmonary parenchymal pathology.
- To determine if pleural plaques alone are sufficient for diagnosing asbestos-related lung disease.
Main Methods:
- Compared pulmonary pathology in 93 patients with pleural plaques to 93 matched controls.
- Autopsies performed at The Johns Hopkins Hospital between 1981 and 1986.
- Pulmonary sections were graded for fibrosis, emphysema, and pleural changes by pathologists unaware of patient groups.
Main Results:
- Pleural plaques correlated with peribronchiolar fibrosis, alveolar fibrosis, large scars, scar-related emphysema, and pleural thickening.
- Smoking history was also associated with pleural plaques.
- Interstitial fibrosis showed no significant difference between groups; peribronchiolar fibrosis was present in over half of subjects with plaques but also in 39% without.
Conclusions:
- Caution is advised when diagnosing asbestos-related pulmonary disease based solely on pleural plaques.
- Pleural plaques may not always signify underlying asbestos-induced lung damage.
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