Holly leaf pleural plaques

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Shortness of breath. Previous manual laborer. History of coronary artery bypass graft.

Patient Data

Age: 70 years
Gender: Male
x-ray

Multiple bilateral calcified pleural plaques of 'leaf-like' appearance, with a central predominance.

Hyperinflated lungs.

Case Discussion

Pleural plaques are invariably due to prolonged exposure to asbestos.  For this reason, men are mainly affected due to the nature of the traditional blue-collar jobs in which those exposed were employed.

The plaques can take on a holly leaf appearance (holly leaf sign).

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