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Pleural fibrosis and calcinosis
Last reviewed: 07.07.2025
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[ Postinflammatory pleural fibrosis and calcification
Pleural inflammation usually causes acute pleural thickening. In most cases, this subsequently disappears almost completely, but in some patients, some pleural thickening persists, usually without causing clinical manifestations or deterioration of lung function. Sometimes the lung is enclosed in a “shell” of dense fibrous pleural capsule, which limits lung expansion, pulling the mediastinum toward the diseased side and deteriorating its function. In this case, chest radiography shows asymmetry of the lungs with thickened pleura (armored lung). Differential diagnosis of localized pleural thickening and encapsulated accumulations of pleural effusion can be difficult with radiography, but CT can assess the condition of the entire pleural surface.
Postinflammatory pleural fibrosis may calcify in some cases. Calcifications are visualized as radiodense lesions on chest radiography; visceral pleural involvement is almost always noted. Postinflammatory calcification is invariably unilateral.
Asbestos-related
Asbestos exposure may result in a central, patch-like pleural fibrosis, sometimes with calcification, which is usually seen more than 20 years after exposure. Any pleural or pericardial surface may be affected, but asbestos-induced pleural deposits are usually seen in the lower two-thirds of the chest and are bilateral. Calcification most often affects the parietal diaphragmatic pleura, which may be the only sign. Dense pleural fibrosis may also follow asbestos exposure.