Benign bilateral or unilateral apical soft tissue thickening on radiographs; usually < 5 mm thick

Increased incidence with age

Lower border usually sharply marginated; no adjacent bony destruction

Apical lung scarring, visceral pleural thickening, and hypertrophy of extrapleural fat on CT

Normal variant that can be confused with other diseases

Bilaterally symmetric apical extrapleural soft tissue thickening on radiographs

Hypertrophy of extrapleural fat apparent on CT

In supine position or loculated effusion

Other signs of pleural effusion on supine view

Upper lung fibrocavitary consolidation; often associated calcification and bronchiectasis

Large or small airway stenosis

In contrast to primary tuberculosis, pleural effusions and lymphadenopathy uncommon

CT commonly shows extensive extrapleural fatty hyperplasia as result of chronic inflammation

Ipsilateral arm and shoulder pain; ± Horner syndrome (ipsilateral miosis, ptosis, and anhydrosis)

Slow growth of asymmetric apical pleuropulmonary thickening highly suggestive

Associated rib or vertebral destruction; invasion of adjacent vessels or nerves

Chronic endemic fungal pneumonia closely resembles fibrocavitary, post-primary tuberculosis

Pulmonary opacities corresponding to radiation ports

Time course important

Upper lung mass-like fibrosis, ± cavitation

Associated perilymphatic micronodules (< 4 mm): Subpleural, centrilobular, peribronchovascular, along interlobular septa

Interlobular septal thickening

Symmetric hilar and mediastinal lymphadenopathy, ± calcification

Nodules from silicosis or coal worker’s pneumoconiosis coalesce into biapical mass-like consolidation, ± cavitation

Lateral margin parallels chest wall, sharply defined

Tendency to migrate centrally; peripheral lung becomes emphysematous

Hilar and mediastinal lymphadenopathy, ± eggshell calcification

So-called “apical cap”

Arterial or venous hemorrhage, most often from blunt or penetrating trauma

History/signs of blunt or penetrating trauma

Active contrast extravasation suggests significant vascular injury

Most common primary tumors: Lung cancer, breast cancer, lymphoma

Associated ipsilateral moderate to large pleural effusion

Other areas of nodularity in pleura or interlobar fissures

Smoothly marginated, extrapleural nodule or mass

Paravertebral tumors may extend into neuroforamina; local remodeling of bone

Most often solitary; multiplicity characteristic of neurofibromatosis type 1 (von Recklinghausen disease)

Characteristically, hyperintense on T2 with central low signal; variable enhancement

Irregular, nodular mass in patient with history of asbestos exposure

Circumferential pleural thickening, mediastinal pleural involvement, or thickness > 1 cm suggestive of malignant pleural disease