A 70-year-old man with a history of asbestos exposure presents with progressive dyspnea. Chest CT shows bilateral, well-defined, pleural-based dense plaques along the posterolateral chest wall and diaphragmatic surface, with calcifications. Which of the following is the most likely diagnosis?
- A Malignant mesothelioma
- B Rounded atelectasis
- C Pleural plaques (benign asbestos-related) ✓
- D Pleural metastases
Correct answer: C. Pleural plaques (benign asbestos-related)
Explanation
Bilateral, well-defined, dense pleural plaques in a posterolateral and diaphragmatic distribution with calcifications are classic for benign asbestos-related pleural plaques. These are the most common manifestation of asbestos exposure and are typically asymptomatic. Malignant mesothelioma would show nodular or diffuse pleural thickening, often with effusion. Rounded atelectasis is a focal mass-like pleural-based opacity with a comet-tail sign. Pleural metastases usually present with effusion and nodular deposits.
Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.