Surgical implications of parietal pleural plaques

Our plain-English summary of Surgical implications of parietal pleural plaques, by P.C. Pairolero, P.H. Bernatz, E.G. Harrison (The Surgical Clinics of North America, 1973).

The study

• Authors: P.C. Pairolero, P.H. Bernatz, E.G. Harrison
• Journal: The Surgical Clinics of North America
• Published: 1973;53(4):867-73
• Cited by: 3 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. 001314).

In plain English

The authors reviewed the records of all patients diagnosed with isolated parietal pleural plaques after thoracotomy (surgery opening the chest) between January 1, 1950, and August 1, 1972. There were 10 patients, all male, aged 43 to 71 years. None had significant respiratory symptoms, and only one reported asbestos exposure: 2 years in a brake-lining factory. All had surgery because routine chest X-rays showed an unexplained mass. No mass showed calcification on X-ray. Needle biopsies in three patients obtained too little tissue for diagnosis. At surgery, all had multiple discrete plaques, typically 3 to 5 mm thick and 1 to 10 cm across. Under the microscope, five showed focal calcification. A few ferruginous bodies (dust fibers coated with an iron-protein complex) were found in the plaque tissue of one patient, who had no history of asbestos exposure, and in no other patient. The authors called their series small. They concluded that a limited thoracotomy appeared the most expedient way to diagnose plaques that are extrapleural and not calcified, with no further treatment indicated once diagnosed.

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: Case series: retrospective review of the authors' own surgical patients' records, with pathology re-examination of the plaque tissue
• Who was studied: 10 male patients aged 43 to 71 years (median 62.5) diagnosed with isolated parietal pleural plaques after thoracotomy between January 1, 1950, and August 1, 1972. The article does not state the institution or location.
• Exposure: Only one patient reported asbestos exposure: 2 years working in a brake-lining factory. No fiber type is named.
• Main results:
  • None of the 10 patients had significant respiratory symptoms.
  • In no patient was calcification seen in the mass on X-ray, and no patient had X-ray evidence of disease on both sides.
  • The mass was on the lateral chest wall in six patients and near the dome of the diaphragm in four.
  • Needle biopsy in three patients did not yield enough tissue for diagnosis.
  • At thoracotomy all patients had multiple discrete raised plaques, ranging from 1 to 10 cm in greatest diameter.
  • Under the microscope, focal calcification was seen in five patients.
  • Iron granules and a few ferruginous bodies were found in the plaque tissue of one patient, who had no history of asbestos exposure.
  • No ferruginous bodies were found in the plaques of the other patients.
  • Two of the three lung biopsies showed slight interstitial fibrosis. One of these two patients had a history of asbestos exposure.
  • No ferruginous bodies were found in the lung tissue.
  • All cultures of plaques and lungs were negative for fungus and bacteria.
• The authors' conclusion: The authors concluded that a limited thoracotomy appeared to be the most expedient way to diagnose pleural plaques that are extrapleural and not calcified, and that no further treatment would be indicated once the diagnosis is made.
• Limitations the authors state:
  • The authors noted their series was small.

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.

Related studies

• 'Black Spots' and hyaline pleural plaques on the parietal pleura of 150 urban necropsy cases — K. Mitchev, P. Dumortier, et al. (2002)
• Asbestos-related lesions of the pleura: parietal plaques compared to diffuse thickening studied with chest roentgenography, computed tomography, lung function, and gas exchange — G. Hillerdal, P. Malmberg, et al. (1990)
• The pathology of parietal pleural plaques — G.H. Roberts (1971)
• The serratus anterior muscle on chest radiographs — D. Gilmartin (1979)
• Black spots of the parietal pleura: morphology and formal pathogenesis — K.M. Müller, I. Schmitz, et al. (2002)
• Aetiology of pleural plaques — V. Rous, J. Studený (1970)

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