Pleural thickening occurs when the pleura, the protective membrane surrounding the lungs, becomes thickened and hardened. Common causes include asbestos exposure, which can cause scarring of the pleura, as well as infections, inflammation, blood clots, radiation, and tumors. Symptoms may include a tight feeling or pain in the chest. Pleural thickening is diagnosed using chest x-rays or CT scans. While no treatment is usually needed, regular monitoring by a doctor is recommended, especially if symptoms change or worsen. Maintaining lung health through exercise and avoiding smoking is also important.

1. Disease/Illness
GUIDE TO PLEURAL THICKENING
What is Pleural Thickening? What causes Pleural Thickening?
ƒ The pleura - two layered protective Tiny asbestos fibres settle in the lung
membrane surrounding the lung tissues and irritate the pleura causing
ƒ The lungs - a pair of organs in the chest scarring and hardening. The scarring is
that control breathing. They take in irreversible.
oxygen from the air that we breathe and
remove carbon dioxide from the blood However, a number of other possible causes
ƒ Pleural thickening - thickening and exist and pleural thickening is less
hardening of the pleura specific to asbestos exposure than pleural
plaques eg:
Pleural thickening occurs in 2 forms:
ƒ Infections in the pleural space such as
ƒ Diffuse pleural thickening extends over a tuberculosis can cause thickening of the
large area and may restrict expansion pleura
of the lungs ƒ Inflammation of the pleura without
ƒ Pleural Plaques - localised areas of infection can cause thickening of the
pleural thickening/calcification which do pleura eg same symptom of rheumatoid
not usually interfere with breathing arthritis
ƒ Injury. Pleural thickening can develop
following injury to the chest region such
as bony fractures to the ribs
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2. Disease/Illness
ƒ Certain medications can cause What are the symptoms of
thickening of the pleura, although drug Pleural Thickening?
induced pleural thickening is generally
quite uncommon. However, a host of Occasionally reports state that extensive
drugs that can cause thickening of the pleural plaques can cause a tight feeling or
pleura do exist, eg Ergoline drugs even pain across the chest. Research
including bromocriptine and indicates that in some cases lung function is
methysergide, often used to treat restricted due to the advanced nature of the
symptoms such as cluster headaches, pleural plaques/pleural thickening.
migraines and Parkinson’s disease
ƒ Blood clot in the artery in the lung The lining of the lungs allows the lungs to
(pulmonary embolism). A pulmonary expand and dilate smoothly during breathing.
embolism can interrupt blood supply to Where the pleura have extensive calcification
parts of the lungs causing the tissues to or thickened, this process is often impaired
die (necrosis). Pleural Thickening can and affects lung function.
occur as part of the healing process
ƒ Radiation eg radiotherapy treatment can Pleural plaques and pleural thickening in the
effect and thicken the pleura of patient absence of asbestosis or malignance are
with lung cancer usually monitored, but not treated.
ƒ Tumours. Benign and malignant tumours
may invade the pleura and this gives the If victims of pleural plaques or pleural
appearance of pleural thickening. The thickening start to notice other symptoms
pleura is a very thin membrane and is such as breathlessness, see your doctor
usually not visible on x-rays of the chest. immediately.
Anything that increases the tissue
thickness of the pleura will appear on x- Diagnosing Pleural Thickening?
rays as pleural ‘thickening’. This can
occur when there is fibrosis of the pleura The main method of diagnosing pleural
as in asbestos related pleural thickening thickening include plain x-rays or CT scans
or when tumour tissue invades the pleura. (computerised tomography scans). Normally,
Even simple inflammation of the tissue the pleura appear as a thin white lining
cells may cause infiltration of the pleura around the lung. In pleural thickening there
and result in the thickening of the will be localized increases in the thickness
membrane of this whiteness surrounding the lung. This
change in thickness will clearly show up on
CT-sans.
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3. Disease/Illness
Treatment of Pleural Thickening? Recommendations
ƒ By definition, pleural thickening is ƒ If you suffer from pleural thickening
regarded as benign and usually no you should attend your doctor regularly
treatment is offered for monitoring, especially if you notice a
ƒ Various tests are conducted during the change or increase in symptoms
diagnosis stage to determine whether ƒ If you are a smoker, it is very important
the condition that is suffered is pleural that you stop smoking immediately as
thickening and thus benign, or in fact a smoking will increase the chance of the
malignant condition such as malignant condition developing into lung cancer
mesothelioma ƒ Regular exercise may help to retain lung
function and general fitness levels
Diffuse bilateral pleural thickening may cause
symptoms of breathlessness and a tight
This guide contains information on current legal
feeling across the chest. issues applicable at the time of printing. Note
there may have been changes subsequently
which have not been incorporated in to the
In addition pleural thickening is occasionally material. This guide is intended for information
accompanied by pleural effusion. If this is the purposes only and its content should not be
applied to any particular set of facts or relied
case treatment of the pleural effusion upon without legal or other professional advice.
For further information on how we can help you
involves drainage of the chest and the use of please contact:
antibiotics or anti-inflammatory drugs.
Emma Costin
Partner
Tel: 0844 858 3600
Email: emma.costin@simpsonmillar.co.uk
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Telephone 0844 858 3200
© Copyright Simpson Millar LLP 2008