This x-ray shows opacity in the right lower lung zone and pleural thickening on the right side. A CT scan confirms pleural effusion on the right lung with thickening and fibrotic changes in the right middle and lower lobes. Pleural thickening represents the end stage of various inflammatory processes like infection or asbestos exposure, and can cause ventilatory impairment. It appears as a band of soft tissue density parallel to the chest wall, and is seen as homogenous echogenic layer on ultrasound if over 1cm thick.