Citation, DOI, disclosures and article data
Citation:
Radswiki T, Silverstone L, Weerakkody Y, et al. Apical cap. Reference article, Radiopaedia.org (Accessed on 06 Jul 2024) https://doi.org/10.53347/rID-11143
Apical caps cover the lung apices and often bilateral. They can be chronic, due to fibrosis or acute due to pleural or extra-pleural fluid.
Epidemiology
The frequency of chronic apical pleural thickening increases with age 3. There may be a slightly greater male predilection 7.
Pathology
Apical caps increase in frequency with age and are usually caused by pleural and/or pulmonary fibrosis which displaces extrapleural fat. Chronic ischemia may cause plaque-like elastotic fibrosis of the visceral pleura/subpleural lung 9.
Upper lobe fibrosis such as pleuroparenchymal fibroelastosis can cause thick apical pleural caps 9.
Acutely, infection, neoplasm and trauma can cause pleural or extra-pleural fluid collections which are more likely to be unilateral. Aortic rupture can be associated with a left apical cap due to hematoma 9.
Causes and associations include:
Distribution
It is often bilateral but if unilateral may be more common on the right 7.
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1. McLoud TC, Isler RJ, Novelline RA et-al. The apical cap. AJR Am J Roentgenol. 1981;137 (2): 299-306. doi:10.2214/ajr.137.2.299 - Pubmed citation
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2. Gerald de Lacey et.al. The Chest X-Ray: A Survival Guide. Saunders Ltd. ISBN:0702030465. Read it at Google Books - Find it at Amazon
-
3. Light RW. Pleural Diseases. LWW. ISBN:145117599X. Read it at Google Books - Find it at Amazon
-
4. Yousem S. Pulmonary Apical Cap. Am J Surg Pathol. 2001;25(5):679-83. doi:10.1097/00000478-200105000-00018 - Pubmed
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5. Simeone JF, Minagi H, Putman CE. Traumatic disruption of the thoracic aorta: significance of the left apical extrapleural cap. (1975) Radiology. 117 (2): 265-8. doi:10.1148/117.2.265 - Pubmed
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6. Sureka B, Thukral B, Mittal M, Mittal A, Sinha M. Radiological Review of Pleural Tumors. Indian Journal of Radiology and Imaging. 2013;23(04):313-20. doi:10.4103/0971-3026.125577 - Pubmed
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7. Saito A, Hakamata Y, Yamada Y et al. Pleural Thickening on Screening Chest X-Rays: A Single Institutional Study. Respir Res. 2019;20(1):138. doi:10.1186/s12931-019-1116-9 - Pubmed
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8. Hallifax R, Talwar A, Wrightson J, Edey A, Gleeson F. State-Of-The-Art: Radiological Investigation of Pleural Disease. Respir Med. 2017;124:88-99. doi:10.1016/j.rmed.2017.02.013 - Pubmed
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9. Bankier A, MacMahon H, Colby T et al. Fleischner Society: Glossary of Terms for Thoracic Imaging. Radiology. 2024;310(2):e232558. doi:10.1148/radiol.232558 - Pubmed
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