Asbestos-related lesions of the pleura: parietal plaques compared to diffuse thickening studied with chest roentgenography, computed tomography, lung function, and gas exchange.

Lung function tests, tests of working capacity with gas exchange, and computed tomography (CT) with density measurements with the patient supine and prone were performed in 23 males with asbestos-related bilateral pleural lesions. Two had pulmonary asbestosis grade 1/0 or more; all the others had normal lung parenchyma. On x-ray, the pleural lesions were divided into plaques involving only the parietal pleura There was a and diffuse pleural fibrosis of various degrees involving the visceral pleura. There was a good correlation between the findings at plain chest roentgenography and CT, but more lesions were seen on the CT scan. However, a few pleural plaques seen on conventional films were not observed at CT. Individuals with plaques had slightly lowered lung function compared to reference subjects. Bilateral diffuse pleural fibrosis was associated with a marked decrease in pulmonary function. The two patients with radiologically evident pulmonary asbestosis were found in this group. Decreased lung function was also observed in subjects with pleural fibrosis of only grade 1 (involving less than one fourth of the hemithorax) and a normal exercise capacity. The study shows the importance of differentiation between various asbestos-related pleural lesions.