Presentation
Previous manual laborer with shoulder pain and shortness of breath.
Patient Data
Multiple bilateral symmetric pleural calcified plaques demonstrating an irregualr nodular 'Holly leaf-like' appearance.
The plaque distribution invloves the hemidiaphragms, paravertebral and anterolateral parietal pleura.
There is relative sparing of the apices and costophrenic sulci.
No large round atelectasis indentified.
Background hyperinflated lungs.
Case Discussion
Calcified "holly leaf" pleural plaques occur as a consequence of prior prolonged exposure to asbestos, usually in an occupational setting.
The distribution of pleural thickening and plaques is helpful in determining etiologic cause, with a symmetric distribution favoring asbestos-related disease, whereas asymmetric involvement is less likely asbestos-related.
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