Subpleural fat pads in patients exposed to asbestos: distinction from non-calcified pleural plaques

Our plain-English summary of Subpleural fat pads in patients exposed to asbestos: distinction from non-calcified pleural plaques, by E.N. Sargent, W.D. Boswell, P.W. Ralls, et al (Radiology, 1984).

The study

• Authors: E.N. Sargent, W.D. Boswell, P.W. Ralls, A. Markovitz
• Journal: Radiology
• Published: 1984;152(2):273-7
• Cited by: 58 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 000572).

Abstract

Thirty patients with known asbestos dust exposure were studied because of uncertainty as to whether or not the pleural changes observed on the radiographs were due to plaques or subpleural fat. The CT scans confirmed that the changes were due to subpleural fat in 14 cases (48%). Characteristic subpleural fat shadows on radiographs and CT scans are described, and the importance of differentiating fat from plaques for medico-legal reasons is emphasized.

In plain English

This study, from the LAC/USC Medical Center in Los Angeles, looked at 30 patients (29 men and 1 woman, aged 41 to 65) who had been exposed to asbestos dust and were involved in compensation and medico-legal matters. Their standard chest X-rays showed pleural changes that could have been non-calcified pleural plaques, normal fat lying beneath the pleura (subpleural fat), or both. To reach a definite diagnosis, all 30 were examined with CT scans. On CT, 14 patients (47%) were considered to have only subpleural fat. Ten (33%) had definite pleural plaques. In 2 of these, fat was also present, and in 5 there was calcification that the X-rays had not shown convincingly. Four had no evidence of either plaques or fat. Two (7%) had shadows that could not be attributed with certainty to either. The authors observed no relationship between body size and subpleural fat deposits. They described how fat and plaques look on X-rays and CT, and emphasized the importance of telling fat from plaques for medico-legal reasons. The article does not name the asbestos fiber types involved.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Descriptive case series: patients whose chest X-rays showed uncertain pleural shadows were all examined further with CT, followed by a discussion of how to tell the shadows apart on imaging
• Who was studied: 30 patients (29 men, 1 woman, aged 41 to 65, average 55) involved in compensation and medico-legal matters arising from asbestos dust exposure, studied by the Departments of Radiology and Medicine, LAC/USC Medical Center, Los Angeles. The dates of the study are not given.
• Exposure: Asbestos dust exposure. Fiber types, products, jobs and doses are not described.
• Main results:
  • On CT, 14 of the 30 patients (47%) were considered to have only subpleural fat
  • 10 of the 30 patients (33%) had definite pleural plaques. In 2 of these, fat was also present; in 5, there was calcification not shown convincingly on the X-rays.
  • 4 of the 30 patients had no evidence of either plaques or fat. In 2 (7%), the shadows could not be attributed with certainty to either plaques or fat.
  • Among the 14 patients with subpleural fat, the authors observed no relationship between body size and subpleural fat deposition
• The authors' conclusion: The authors described characteristic subpleural fat shadows on X-rays and CT and emphasized the importance of differentiating fat from plaques for medico-legal reasons

Topics

The National Library of Medicine indexes this study under subjects our site covers: Pleural plaques and thickening.

Medical terms in this study, explained in our Lexicon: Pleural Plaques, CT Scan.

Related studies

• Calcified interlobar pleural plaques: visceral pleural involvement due to asbestos — E.N. Sargent, J.S. Felton, et al. (1981)
• Calcified plaques on mediastinal pleural reflections associated with asbestos dust exposure: four case reports — A. Solomon, G.K. Sluis-Cremer, et al. (1984)
• Calcified plaque in the superior portion of the major fissure. An unusual manifestation of asbestos exposure — S.B. Rupp, H. Jolles (1989)
• Impact of body mass index on the detection of radiographic localized pleural thickening — T.C. Larson, A. Franzblau, et al. (2014)
• Pleural plaques: a signpost of asbestos dust inhalation — E.N. Sargent, G. Jacobson, et al. (1977)
• Multiple pleural plaques. II — H.C. Anton (1968)

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