Pleural tags

Last revised by Mostafa Elfeky on 21 Sep 2021

Pleural tags refer to slender bridges of soft tissue seen on CT scans that extend between masses in the lungs and the pleura

Pathology 

They result from interlobular septal thickening of the lung. These septa may be distorted and reoriented or maybe normal in course. The septa are however abnormally thickened which can occur from a number of processes

  • localized edema (possibly related to lymphatic obstruction)
  • tumor extension within or outside of lymphatic vessels
  • inflammatory cells
  • fibrosis

The associated fibrosis can be either the desmoplastic reaction caused by a neoplasm or associated with an inflammatory response to benign disease. 

There is development of overlying puckering to the pleural surface due to anatomic continuation between septa and the visceral pleura. 

Subtypes

They have sometimes been classified into three types

  • type 1: one or more linear pleural tag
  • type 2: one or more linear pleural tag with soft tissue component at the pleural end
  • type 3: one or more soft tissue cord-like pleural tag

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