111. " Pleural plaques.”
This woman patient had herself never worked with asbestos but merely ( over 7 years) cleaned the clothing of those people who had worked with asbestos.
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- Here, on the right-hand side, at the paravertebral area, a calcification is discernible. Possible diagnosis?
(Click here for the answer) This anamnesis is very suspicious. Together with the morphological findings : asbestosis.
As a result of the pleural reaction to asbestos, one may distinguish the following factors :
- the diffuse thickening of the pleura ( decades-long underestimation in radiology : dismissed as totally banal rind-type thickening ; only acknowledged by pathologists ) as well as
- "pleural plaques” ( for details, see Otto ; Jend);
The latter so-called hyaline plaques are typical in both their elongation and thickness as well as in accordance with the closing of their exposition .They cannot be detected before the fifth year of the exposition start and they further calcify after a subsequent five years. This calcification affects the parietal surface rather than the complete thickness of the plaques, which contains parts from both of the pleural sheets.
112. This new patient has pleural plaques 20 years after being exposed to asbestos ( Heating pipes insulation).
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- - Which professions are especially at risk ? - How many patients suffer later on from a Mesothelioma ? - When must we expect the maximum of asbestos-related Mesothelioma cases?
(Click here for the answer) - Builders, carpenters, electricians
- Between 5-10%
- 2020
113. New patient. Condition with known asbestos exposure.
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- MR in coronar projection. The right lung cased entirely around by "foreign” tissue structures. Possible diagnosis?
(Click here for the answer) Pleural Mesothelioma ( for details, see Hering ; Jend)
114. New patient.
As radiologists, we are, as regards this particular thorax film, in many areas of Europe, quite helpless. But, in some areas and some hospitals, one recognizes this very well indeed.
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- So, what does one ask the patient? Diagnosis?
(Click here for the answer) Occupational disease? Exposure? Duration of exposure? -
Silicosis.
This case involves a miner who toiled at the rock face for 15 years. The way in which miners have been exposed, has been well recorded and documented : quite often a professional disease has already been acknowledged.
115. A case study as regards the "multi-faceted findings behind silicosis”.
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As well as the
- silicotic homogeneously consolidated
areas in the right upper region. In this country they call the closely packed shadows "Ballungsherde”. There also exist
- pleural thickening and
- multiple mid-to-finely flecked opacities in the periphery of the lungs.
The radiologist, who - just as I - is not trained in the study of pneumokoniosis, should not attempt to carry out a medical assessment. He should, however, be able to reach a basic conclusion. One must know where one may be able to access a competent and definitive reference work.