Bilateral lower lobe round atelectasis due to asbestos pleural disease
Presentation
Chronic cough.
Patient Data
Multiple calcified pleural plaques are present, involving both hemidiaphragms pathognomonic of asbestos exposure. Bilateral lower lobe opacities are typical for round atelectasis: 1) they are round, 2) adjacent to an abnormal pleural surface, 3) are associated with volume loss and 4) demonstrate a comet tail appearance, with bronchovascular structures swirling into the opacities. No definite lung fibrosis to suggest asbestosis.
Case Discussion
The findings of round atelectasis are what you would expect given the name and the fact that it was originally described in association with asbestos pleural disease: 1) opacities are round, 2) next to abnormal pleura, 3) have volume loss and 4) show a comet tail appearance as described above. This combination makes malignancy unlikely, but at many institutions, they are followed for 2 years to exclude cancer.
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