Thoracolith

Last revised by Yuranga Weerakkody on 12 Jul 2021

Thoracoliths (or thoracolithiasis if multiple) are benign intrapleural loose bodies. They are rare, calcified pleural-based nodules that are almost always incidental. They are usually considered mobile, and more common on the left.

They have a reported incidence of less than 0.1%. 

The exact etiology is unknown and theories include 1,2:

  • calcified fibrin body
  • degenerated pleural lipoma
  • old tuberculosis
  • foreign body granuloma
  • dropped pleural or pericardial fat

There may be predilection towards the lower thoracic region 4.

These may been seen small solitary distinct nodules in the pleural space. Most range in size from 5 to 15 mm (median 8 mm) and tend to be rounded to ovoid and smoothly marginated. 

They can often be mobile between serial scans.

In some situations (e.g. if small) they may mimic

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