Usually with pleural plaques, you think of two possible diagnoses: metastatic cancer and tuberculosis.
But which is the more likely culprit?* That kind of depends on both your patient and your geographic location.
If this had been in my native Virginia – I’d “assume/ guess” metastatic cancer (since my patient population is usually older, high rate of smoking, other risk factors for cancer).
But luckily (who ever thought I’d be saying luckily) in my current location (Northern Mexico) in this patient (with multiple risk factors for infectious disease but no asbestos exposure) – tuberculosis is the more likely diagnosis.
* Prior to formal tissue pathology results, which confirmed tuberculosis in this patient.
** I apologize for the lack of formal references, but I was unable to find any comprehensive literature (available as free articles).
Radiology Reference on-line article