Journal Information
Vol. 11. Issue 5.
Pages 487-497 (September - October 2005)
Share
Share
Download PDF
More article options
Vol. 11. Issue 5.
Pages 487-497 (September - October 2005)
Artigo de Revisão\Revision Article
Open Access
Placas pleurais relacionadas com o asbesto: Revisão da literatura
Asbestos-related pleural plaques: a literature review
Visits
5218
G.S.P. Meirelles1,
Corresponding author
meirelles@fleury.com.br

Instituição / Departamento: Grupo Interinstitucional para Estudo das Doenças Relacionadas ao Asbesto. UNIFESP/EPM, INCOR/ HCFMUSP e UNICAMP. Brasil. Endereço para correspondência: Dr. Gustavo de Souza Portes Meirelles – Rua Doutor Diogo de Faria, 1077 / 102 – Vila Clementino – 04037-003 – São Paulo –SP, Brasil gustavo.
, J.I. Kavakama2, D. Jasinowodolinski3, L.E. Nery4, M. Terra-Filho5, R.T. Rodrigues6, J.A. Neder7, E. Bagatin8, G. D’ippolito9
1 Doutor em Radiologia pela Universidade Federal de São Paulo – Escola Paulista de Medicina (UNIFESP/EPM). São Paulo – SP, Brasil.
2 Médico assistente da Coordenação de Imagem do Instituto do Coração (INCOR) e supervisor do Grupo de Tórax do Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (INRAD HC-FMUSP). São Paulo – SP, Brasil.
3 Médico do Sector de Radiologia Torácica do Centro de Medicina Diagnóstica Fleury. São Paulo - SP, Brasil.
4 Professor adjunto da Disciplina de Pneumologia da Universidade Federal de São Paulo – Escola Paulista de Medicina (UNIFESP/EPM). São Paulo – SP, Brasil.
5 Professor associado da Disciplina de Pneumologia do INCOR do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP). São Paulo – SP, Brasil.
6 Professor do Departamento de Diagnóstico por Imagem da Universidade Federal de São Paulo – Escola Paulista de Medicina (UNIFESP/EPM). São Paulo – SP, Brasil.
7 Professor Doutor do Sector de Função Pulmonar e Fisiologia Clínica do Exercício (SEFICE) da Disciplina de Pneumologia da Universidade Federal de São Paulo – Escola Paulista de Medicina (UNIFESP/EPM). São Paulo – SP, Brasil.
8 Professor assistente da Área de Saúde Ocupacional – Departamento de Medicina Preventiva e Social da Faculdade de Ciências Médicas da Universidade Estadual de Campinas (UNICAMP). Professor adjunto da Disciplina de Pneumologia da Faculdade de Medicina de Jundiaí – SP, Brasil.
9 Professor visitante do Departamento de Diagnóstico por Imagem da Universidade Federal de São Paulo – Escola Paulista de Medicina (UNIFESP/EPM). São Paulo – SP, Brasil.
Ver más
This item has received

Under a Creative Commons license
Article information
Resumo

As placas pleurais (PP) são espessamentos focais da pleura, consideradas marcadores de exposição ao asbesto. Geralmente encontradas na ausência de alterações pulmonares, podem envolver a pleura parietal, diafragmática e, menos comummente, mediastinal. Embora a radiografia simples de tórax seja o método mais comummente utilizado no diagnóstico das PP, a tomografia computadorizada é o exame de imagem com maiores sensibilidade e especificidade, especialmente quando empregada a técnica de alta resolução. As PP geralmente não causam sintomas, mas ainda existem controvérsias quanto à relação entre as mesmas e índices de exposição ao asbesto, alterações funcionais pulmonares e risco de desenvolvimento de neoplasias.

Rev Port Pneumol 2005; XI (5): 487-497

Unitermos:
Asbesto
pleura
anormalidades
tomografia computadorizada por raios-X
pneumo-conioses
doenças ocupacionais
Abstract

Pleural plaques (PP) are considered to be hallmarks of asbestos exposure. They constitute focal thickenings of the pleura and are commonly seen in patients without lung disease. They can involve parietal, diaphragmatic and mediastinal pleura. Chest x-ray is frequently used for PP diagnosis, but computed tomography, especially when used the high-resolution technique, is the imaging exam with the greatest sensibility and specificity. PP are almost always asymptomatic, but there are some controversial about their relationship with asbestos exposure indexes, pulmonary functional alterations and risk of neoplasias.

Rev Port Pneumol 2005; XI (5): 487-497

Key-words:
Asbestos
pleura
abnormalities
HRCT
pneumoconioses
occupational diseases
Full text is only aviable in PDF
Referências
[1.]
R. Bégin.
Asbestos-related lung diseases.
Occupational Lung Disease, pp. 219-238
[2.]
R. Bégin, J.M. Samet, R.A. Shaikh.
Asbestos.
Occupational and environmental respiratory disease, pp. 293-321
[3.]
K.I. Kim, C.W. Kim, M.K. Lee, K.S. Lee, C.K. Park, S.J. Choi, et al.
Imaging of occupational lung disease.
Radiographics, 21 (2001), pp. 1371-1391
[4.]
R.N. Jones.
Pleural plaques: diagnostic problems and significance.
Indoor Built Environ, 6 (1997), pp. 106-113
[5.]
M.R. Becklake.
Asbestos-related diseases of the lung and other organs: their epidemiology and implications for clinical practice.
Am Rev Respir Dis, 114 (1976), pp. 187-227
[6.]
Y. Karakoca, S. Emri, A.K. Cangir, Y.I. Baris.
Environmental pleural plaques due to asbestos and fibrous zeolite exposure in Turkey.
Indoor Built Environ, 6 (1997), pp. 100-105
[7.]
T. Hiraoka, M. Ohkura, K. Morinaga, N. Kohyama, K. Shimazu, M. Ando.
Anthophyllite exposure and endemic pleural plaques in Kumamoto.
Japan. Scand J Work Environ Health, 24 (1998), pp. 392-397
[8.]
Critérios de Helsinki - Encontro Internacional de Especialistas em Doenças Relacionadas ao Asbesto. Asbestos, asbestosis, and cancer: the Helsinki criteria for diagnosis and attribution.
Scand J Work Environ Health, 23 (1997), pp. 311-316
[9.]
L. Meurman.
Asbestos bodies and pleural plaques in a Finnish series of autopsy cases.
Acta Pathol Microbiol Scand, 181 (1966), pp. 1-83
[10.]
R. Kiviluoto.
Pleural calcification as a roentge-nologic sign of non-occupational endemic antho-phyllite-asbestosis.
Acta Radiol, 194 (1960), pp. 1-67
[11.]
G. Hillerdal.
The pathogenesis of pleural plaques and pulmonary asbestosis: possibilities and impossibilities.
Eur J Respir Dis, 61 (1980), pp. 129-138
[12.]
A.N. Leung, N.L. Muller, R.R. Miller.
CT in differential diagnosis of diffuse pleural disease.
AJR Am J Roentgenol, 154 (1990), pp. 487-492
[13.]
W.B. Gefter, E.F. Conant.
Issues and controversies in the plain-film diagnosis of asbestos-related disorders in the chest.
J Thorac Imaging, 3 (1988), pp. 11-28
[14.]
X. Gallardo, E. Castaner, J.M. Mata.
Benign pleural diseases.
Eur J Radiol, 34 (2000), pp. 87-97
[15.]
C. Peacock, S.J. Copley, D.M. Hansell.
Asbestos-related benign pleural disease.
Clin Radiol, 55 (2000), pp. 422-432
[16.]
G. Hillerdal.
Pleural plaques: incidence and epidemiology, exposed workers and the general population.
Indoor Built Environ, 6 (1997), pp. 86-95
[17.]
J. Van Cleemput, H. De Raeve, J.A. Verschakelen, J. Rombouts, L.M. Lacquet, B. Nemery.
Surface of localized pleural plaques quantitated by computed tomography scanning: no relation with cumulative asbestos exposure and no effect on lung function.
Am J Respir Crit Care Med, 163 (2001), pp. 705-710
[18.]
R.N. Jones, T. McLoud, S.D. Rockoff.
The radiographic pleural abnormalities in asbestos exposure: relationship to physiologic abnormalities.
J Thorac Imaging, 3 (1988), pp. 57-66
[19.]
G.L. Delclos, R.K. Wilson, B.L. Bradley.
Influence of smoking on radiographic profusion and pleural changes in asbestos-exposed subjects.
J Occup Med, 32 (1990), pp. 577-581
[20.]
R.N. Jones, J.E. Diem, J.M. Hughes, Y.Y. Hammad, H.W. Glindmeyer, H. Weill.
Progression of asbestos effects: a prospective longitudinal study of chest radiographs and lung function.
Br J Ind Med, 46 (1989), pp. 97-105
[21.]
I.L. Organization.
Guidelines for the Use of the ILO International Classification of Radiographs of Pneumo-conioses.
(1980),
[22.]
I.L. Organization.
Guidelines for the Use of the ILO International Classification of Radiographs of Pneumo-conioses.
(2000),
[23.]
S.L. Wain, V.L. Roggli, W.L. Foster Jr..
Parietal pleural plaques, asbestos bodies, and neoplasia. A clinical, pathologic, and roentgenographic correlation of 25 consecutive cases.
Chest, 86 (1984), pp. 707-713
[24.]
T.C. McLoud.
Conventional radiography in the diagnosis of asbestos-related disease.
Radiol Clin North Am, 30 (1992), pp. 1177-1189
[25.]
G. Hillerdal, A. Lindgren.
Pleural plaques: correlation of autopsy findings to radiographic findings and occupational history.
Eur J Respir Dis, 61 (1980), pp. 315-319
[26.]
G. Hillerdal.
Nonmalignant pleural disease related to asbestos exposure.
Clin Chest Med, 6 (1985), pp. 141-152
[27.]
D.A. Henry.
International Labor Office Classification System in the age of imaging: relevant or redundant.
J Thorac Imaging, 17 (2002), pp. 179-188
[28.]
T.C. McLoud.
CT and MR in pleural disease.
Clin Chest Med, 19 (1998), pp. 261-276
[29.]
L. Kreel.
Computer tomography in the evaluation of pulmonary asbestosis. Preliminary experiences with the EMI general purpose scanner.
Acta Radiol Diagn (Stockh), 17 (1976), pp. 405-412
[30.]
N. Al Jarad, N. Poulakis, M.C. Pearson, M.B. Rubens, R.M. Rudd.
Assessment of asbestos-induced pleural disease by computed tomography— correlation with chest radiograph and lung function.
Respir Med, 85 (1991), pp. 203-208
[31.]
W.R. Webb, N.L. Müller, D.P. Naidich.
Asbestosis and asbestos-related disease.
High-resolution CT of the lung, 3rd ed., pp. 236-257
[32.]
A.C. Friedman, S.B. Fiel, M.S. Fisher, P.D. Radecki, A.S. Lev-Toaff, D.F. Caroline.
Asbestos-related pleural disease and asbestosis: a comparison of CT and chest radiography.
AJR Am J Roentgenol, 150 (1988), pp. 269-275
[33.]
J.G. Im, W.R. Webb, A. Rosen, G. Gamsu.
Costal pleura: appearances at high-resolution CT.
Radiology, 171 (1989), pp. 125-131
[34.]
D.R. Aberle, G. Gamsu, C.S. Ray, I.M. Feuerstein.
Asbestos-related pleural and parenchymal fibrosis: detection with high-resolution CT.
Radiology, 166 (1988), pp. 729-734
[35.]
P.A. Gevenois, P. De Vuyst, S. Dedeire, J. Cosaert, R. Vande Weyer, J. Struyven.
Conventional and high-resolution CT in asymptomatic asbestos-exposed workers.
Acta Radiol, 35 (1994), pp. 226-229
[36.]
K. Wernecke.
Ultrasound study of the pleura.
Eur Radiol, 10 (2000), pp. 1515-1523
[37.]
B. Christen, W. Wegmann, P. Vogt.
Clinical pathology and histology of pleural plaques.
Indoor Built Environ, 6 (1997), pp. 79-85
[38.]
H.D. Roach, G.J. Davies, R. Attanoos, M. Crane, H. Adams, S. Phillips.
Asbestos: when the dust settles an imaging review of asbestos-related disease.
[39.]
D.I. Fielding, J.L. McKeon, W.A. Oliver, K. Matar, I.G. Brown.
Pleurectomy for persistent pain in benign asbestos-related pleural disease.
Thorax, 50 (1995), pp. 181-183
[40.]
S.J. Copley, A.U. Wells, M.B. Rubens, F. Chabat, R.E. Sheehan, A.W. Musk, et al.
Functional consequences of pleural disease evaluated with chest radiography and CT.
[41.]
G. Hillerdal, P. Malmberg, A. Hemmingsson.
Asbes-tos-related lesions of the pleura: parietal plaques compared to diffuse thickening studied with chest roentgenography, computed tomography, lung function, and gas exchange.
Am J Ind Med, 18 (1990), pp. 627-639
[42.]
D.A. Schwartz, L.J. Fuortes, J.R. Galvin, L.F. Burmeister, L.E. Schmidt, B.N. Leistikow, et al.
Asbestos-induced pleural fibrosis and impaired lung function.
Am Rev Respir Dis, 141 (1990), pp. 321-326
[43.]
J. Bourbeau, P. Ernst, J. Chrome, B. Armstrong, M.R. Becklake.
The relationship between respiratory impairment and asbestos-related pleural abnormality in an active work force.
Am Rev Respir Dis, 142 (1990), pp. 837-842
[44.]
H.V. Fridriksson, H. Hedenstrom, G. Hillerdal, P. Malmberg.
Increased lung stiffness of persons with pleural plaques.
Eur J Respir Dis, 62 (1981), pp. 412-424
[45.]
D.E. Fletcher.
A mortality study of shipyard workers with pleural plaques.
Br J Ind Med, 29 (1972), pp. 142-145
[46.]
W. Weiss.
Asbestos-related pleural plaques and lung cancer.
Chest, 103 (1993), pp. 1854-1859
[47.]
E.B. Gottschall.
Occupational and environmental thoracic malignancies.
J Thorac Imaging, 17 (2002), pp. 189-197
[48.]
G. Gamsu, C.J. Salmon, M.L. Warnock, P.D. Blanc.
CT quantification of interstitial fibrosis in patients with asbestosis: a comparison of two methods.
AJR Am J Roentgenol, 164 (1995), pp. 63-68
[49.]
D.W. Cugell, D.W. Kamp.
Asbestos and the pleura: a review.
Chest, 125 (2004), pp. 1103-1117
[50.]
C.R. Woolf.
Changing patterns of asbestos-related pulmonary diseases.
Occupational Lung Disease, pp. 239-245
[51.]
M. Tiitola, L. Kivisaari, A. Zitting, M.S. Huuskonen, S. Kaleva, A. Tossavainen, et al.
Computed tomography of asbestos-related pleural abnormalities.
Int Arch Occup Environ Health, 75 (2002), pp. 224-228
[52.]
A. Broderick, L.J. Fuortes, J.A. Merchant, J.R. Galvin, D.A. Schwartz.
Pleural determinants of restrictive lung function and respiratory symptoms in an asbestos-exposed population.
Chest, 101 (1992), pp. 684-691
[53.]
L.C. Oliver, E.A. Eisen, R. Greene, N.L. Sprince.
Asbestos-related pleural plaques and lung function.
Am J Ind Med, 14 (1988), pp. 649-656
[54.]
A. Tossavainen.
International expert meeting on new advances in the radiology and screening of asbestos-related diseases.
Scand J Work Environ Health, 26 (2000), pp. 449-454
[55.]
G.S.P. Meirelles, J.I. Kavakama, D. Jasinowodolinski, L.E. Nery, M. Terra-Filho, R.T. Rodrigues, et al.
Proposta de um modelo de quantificação pela tomografia computadorizada de alta resolução das placas pleurais em trabalhadores expostos ao asbesto.
Rev Imagem, (2005),
[56.]
G.S.P. Meirelles.
Quantificação pela tomografia computadorizada de alta resolução das placas pleurais em trabalhadores expostos ao asbesto [Doutoramento].
Universidade Federal de São Paulo, (2004),
[57.]
N.L. Muller.
Imaging of the pleura.
Radiology, 186 (1993), pp. 297-309
Copyright © 2005. Sociedade Portuguesa de Pneumologia/SPP
Pulmonology
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?