Pathology of the Pleura and Mediastinum

2018 Edition
| Editors: Timothy Craig Allen, Saul Suster

Localized Pleural Fibrosis

  • Christopher P. MarquezEmail author
  • Timothy Craig Allen
Reference work entry


Apical cap; Apical scar; Nodular pleural plaque; Pleural nodule; Pleural plaque


Localized pleural fibrosis is a term used to describe focal areas of dense fibrous tissue within the pleura, which include pleural plaques and apical caps. Pleural plaques are well known for their association with asbestos exposure; however, other medical conditions thought to be associated in their development include: empyema, hemothorax, rib fracture, and tuberculosis (TB). Occupational exposure to erionite, man-made vitreous fibers (MMVF), and silicates have also been implicated in the development of pleural plaques. Apical caps are subpleural scars of elastic tissue at the thoracic apices and historically were considered to be caused by TB; however, the etiology of most apical caps is unknown. Other more rare causes include: infection other than TB, radiation, trauma, and vascular abnormalities. Apical caps may be the result of localized ischemia.

Clinical Features

  • Incidence


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References and Further Reading

  1. Cagle, P. T., et al. (2004). Color atlas and text of pulmonary pathology (1st ed.). Philadelphia: Lippincott Williams & Wilkins.Google Scholar
  2. Churg, A., Cagle, P. T., & Roggli, V. L. (2006). AFIP atlas of tumor pathology series 4: Tumors of the serosal membranes (Vol. 3). Silver Spring: ARP Press.Google Scholar
  3. Clarke, C. C., Mowat, F. S., Kelsh, M. A., & Roberts, M. A. (2006). Pleural plaques: A review of diagnostic issues and possible nonasbestos factors. Archives of Environmental & Occupational Health, 61, 183–192.CrossRefGoogle Scholar
  4. Yi, E., & Aubry, M. C. (2010). Pulmonary pseudoneoplasms. Archives of Pathology & Laboratory Medicine, 134, 417–426.Google Scholar
  5. Zitting, A. J., Karjalainen, A., Impivaara, O., Tossavainen, A., Kuusela, T., Mäki, J., & Huuskonen, M. S. (1995). Radiographic small lung opacities and pleural abnormalities as a consequence of asbestos exposure in an adult population. Scandinavian Journal of Work, Environment & Health, 21, 470–477.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of PathologyThe University of Texas Medical BranchGalvestonUSA