J Korean Soc Radiol.  2017 Oct;77(4):245-248. 10.3348/jksr.2017.77.4.245.

Thoracolithiasis Mimicking a Pleural Plaque in a Patient with a History of Asbestos Exposure: A Case Report

• Cha YK
• Kim JS
• Choi JH
• Han KM

• KMID: 2392122
• DOI: http://doi.org/10.3348/jksr.2017.77.4.245

Abstract

A freely mobile calcified or noncalcified nodule in the pleural cavity, known as thoracolithiasis, is quite rare. There are several reports of CT findings of thoracolithiasis, but there is no report of thoracolithiasis mistakenly considered as a pleural plaque in a patient with a history of asbestos exposure. We report a case of a 61-year-old man with a mobile pleural stone thoracoscopically confirmed as thoracolithiasis and which was regarded as a pleural plaque on CT scan in a patient with a history of asbestos exposure.

MeSH Terms

Asbestos*
Calculi
Humans
Middle Aged
Pleural Cavity
Tomography, X-Ray Computed
Asbestos

Figure

• 

  Fig. 1 Thoracolithiasis Mimicking a Pleural Plaque in a 61-year-old man with a History of Asbestos Exposure. A. Contrast-enhanced chest CT scan obtained at the level of the lung base shows a 13-mm sized non-calcified well-defined ovoid nodule (arrow) in the medial portion of the left lower hemithorax. Multiple non-calcified pleural plaques are also noted on the left posterior costal and diaphragmatic pleura (arrowheads). B. Chest CT scan obtained below the level of the carina shows discrete calcified and non-calcified pleural plaques (arrowheads) in the left hemithorax. C. On follow-up evaluation performed eight years later, non-enhanced chest CT shows lateral migration of a pleural nodule (arrow) in the left lower hemithorax and there is newly developed peripheral calcification within the nodule. Pleural plaques are seen again on the left diaphragmatic pleura (arrowheads). D. In the surgical field, a 2 × 1.5 cm sized whitish ovoid hard mass is found floating freely in the pleural cavity (arrow). Whitish pleural plaques are also seen on the parietal pleura (arrowheads). E. Histologic evaluation reveals fatty necrotic tissue (arrows) surrounded by hyalinized fibrous tissue (hematoxylin and eosin; original magnification, × 40).

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