Definition
The pleural rind or pleural callosity is a benign thickening of the pleura. Pleural rind can be diagnosed by means of ultrasound, X-ray or computed tomography – magnetic resonance imaging. They are not always accompanied by symptoms, but in some cases they can restrict breathing capacity. If a pleural rind is visible on imaging, it should usually be checked as it cannot be reliably distinguished from malignant pleural mesothelioma. If a pleural mesothelium were present, it would be distinguished from the pleural rind by its relatively rapid growth.
Causes
The causes of a thickening of the pleura are in most cases inflammatory processes, for example an inflammation of the pleura or an inflammatory pleural effusion (water accumulation in the pleural gap, i.e. in a small space in the area between the two leaves of the pleura). A relatively common cause of inflammation of the pleura is an inflammation accompanying pneumonia. Tuberculosis (consumption) can also lead to the development of a pleural callosity. The pleural rind is a kind of scarring after multiple strong irritation of the affected area. Although it is rather rare for a pleural rind to develop after surgery, it may be the case if inflammatory processes have occurred in the area of the pleura after the operation.
Diagnosis
A pleural callosity cannot be diagnosed from the outside, i.e. without imaging techniques. Imaging can be done, for example, by ultrasound, x-ray of the burst cage, magnetic resonance imaging of the lungs (MRI) or computed tomography (CT) of the chest. Due to the radiation exposure and the high costs involved, the first two methods are usually used to diagnose pleural callous. However, it is not uncommon for a pleural rind to be found by chance.
Associated symptoms
A pleural rind can – depending on its extent – lead to adhesions in the lungs. It can thus impair the expansion of the lung. This can be noticed by the person affected by shortness of breath.
A lung function examination can reveal the lack of expansion. Often, however, pleural rind does not cause any symptoms and is a purely incidental finding. In rare cases, a pleural rind can cause a diaphragmatic hypertension.
In the case of a diaphragmatic elevation, the diaphragm on one side of the chest is higher than it would normally be. In many cases, a diaphragmatic hypertension is not accompanied by symptoms and is often only noticed by chance in the X-ray image. Pain rarely occurs in the context of a pleural rash. More often, mild shortness of breath may occur. In the case of pronounced findings, however, pain can also occur in the area of the rib cage, where the callus is located.
