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Pleural Plaque H013

Last amended 
7 November 2022

In this section

Current RMA Instruments
Reasonable Hypothesis SOP105 of 2022
Balance of Probabilities SOP 106 of 2022
Changes from previous Instruments

SOP Bulletin 233

 ICD Coding
  • ICD-10-AM Code: J92.0
Brief description

This is a condition affecting the pleura (the membrane covering the lung and lining the thoracic cavity), manifesting as a flat fibrous thickening which has a border which is sharply circumscribed. ‘Pleural plaques’ are a different clinical entity and diagnosis to ‘diffuse pleural thickening’.

Confirming the diagnosis

This diagnosis is based on radiologist reporting of plain chest X-rays or CT [Computerised tomography] scans or MRI [Magnetic resonance imaging] scan of the chest.  In someone with a high body mass index extrapleural fat may mimic pleural plaque on chest X-ray and a CT scan may be required to confirm the diagnosis.

The relevant medical specialist is a respiratory physician.

Additional diagnoses covered by SOP
  • Asbestos related pleural plaque

Conditions excluded from SOP
  • Asbestosis*
  • Diffuse pleural thickening – This indicates inflammation from conditions such as: lung infection; trauma with pleural haemorrhage; radiation; pulmonary infarction; lung neoplasia, intentional chemical or surgical pleurodesis and also can occur with asbestos exposure.
  • Fibrosing interstitial lung disease*
  • Mesothelioma*

* another SOP applies

Clinical onset

Pleural plaques are nearly always asymptomatic and are usually found incidentally on chest X-ray or other chest imaging.  Clinical onset will be at the time of diagnosis. 

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  Pleural plaques do not require treatment.  Management that might alter the course of the condition would be advice to avoid further asbestos exposure.