A graphic lung showing pleural thickening of the lung lining and some potentially causes of it.

Pleural Thickening Connection to Mesothelioma and Asbestos

Pleural thickening (PT) happens when scar tissue surrounds the lining of the lungs causing it to become thicker. The purpose of the pleural lining is to give the lungs a protective layer and essentially cushion the organs. As the lining thickens and creates more of a layer over the lungs, people can start to experience shortness of breath. How a person begins to develop this can be from any single or combination of events. It may include trauma, inflammation, infection, radiation, and even asbestos exposure.

With PT, a person can experience it either focal or diffuse. Both forms cause thickening of the lung linings, but they are different based on the extent of scar tissue. In focal thickening, the area which is affected is constricted to one area of the lining. Diffuse pleural thickening has spread throughout the lining, creating a layer of scar tissue surrounding the lungs. PT has been connected to asbestos exposure and mesothelioma. This happened through the discovery that those exposed to asbestos experienced pleural thickening as a complicated side effect.

How do Doctors Diagnose Pleural Thickening? 

Doctors can diagnose this relatively easily by examining a person’s chest cavity. By using technology and imaging tests to diagnose, such as X-rays, PET scans, MRIs, and CT scans, doctors can quickly notice the scar tissue causing a pleural thickening. All of these options can be used, but they typically aren’t all used to diagnose. A doctor may call for an X-ray and CT scan but may not need the extra MRI or PET scan images to diagnose.

X-Ray Imaging Scans

X-rays are one of the most well-known imaging scans that can produce quick, efficient images of what is happening inside a person’s body for doctors to examine. By using a chest X-ray to look for pleural thickening, a radiologist is searching for certain abnormalities. Telltale signs of thickening include wedge-shaped apexes or deformed areas at the top portions of the lungs. Thickening of the lining can occur as biapical pleural scarring, or on both apexes and apical pleural thickening, on one side of the lungs.

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A chest X-ray showing the healthy lungs of a person.
This chest X-ray shows what a person’s normal chest cavity should look like in the absence of pleural thickening.

A chest X-ray showing pleural thickening, or wedge-shaped deformities at the tops of the lungs.
This chest X-ray shows a person who has pleural thickening. At the top right, there is evidence of wedge-shaped deformities, an indication of PT.

PET Scans and MRIs

A positron emission tomography (PET) scan examines the inside of the body using a radioactive glucose tracer. The tracer is given to a person through an IV needle, and the radioactivity settles in the organs and tissues, creating an image for doctors to read. A magnetic resonance imaging (MRI) scan uses radio waves and magnets to take a closer look at organs and structures in the body, such as muscles. Locating a medical center near you that performs these scans will help your diagnosis process move faster.

Both of these imaging tests allow doctors to closely examine the body at the tissue and organ level, whereas an X-ray can only look at the body’s bones and cavities. A PET scan has been used to discriminate between malignant or benign pleural thickening accurately. The main difference between the two is malignant PT shows evidence there is something else happening to the body, such as cancer growing. Benign pleural thickening can occur without the impending threat of cancer and rather occurs from previous trauma or infections. Diffuse pleural thickening is often found as a result of extended asbestos exposure and should be examined immediately. PET and MRI scans are both viable options when examining the tissues to see if PT is occurring.

CT Scans

A computed tomography (CT) scan is another alternative imaging scan that looks at the body through a series of X-rays. These X-ray images are taken from multiple angles to secure a good look at all areas of the body which need to be examined. CT scans can diagnose pleural diseases because of the scan’s ability to capture images of the abnormalities. If an X-ray isn’t conclusive enough, a CT scan may be ordered to view the questionable area further from other angles.

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What is the Common Cause of Pleural Thickening? 

The causes of pleural thickening can be tied to a lot of previous exposures or health issues. Asbestos exposure is among the most common causes and has been linked to many pleural diseases among thickening. A person who was exposed to asbestos consistently has a higher likelihood of contracting mesothelioma and having PT than a person who wasn’t exposed. It is important to note that PT does not always mean a person has mesothelioma, but it is a key finding in those who have cancer.

Pleural thickening can also be the result of past infections, inflammation, radiation treatment, and other trauma to the ribs and chest. The scar tissue that forms thickening multiples because of the irritations.  It is not uncommon to have PT, and it doesn’t always link to more serious diseases and cancers. It is something to keep in mind when finding out you have PT and making sure your case won’t lead to more health issues in the future.

Top Thickening Symptoms

A person with normal lungs and pleural lining can breathe smoothly without any strain. For those who have Plerual Scaring, the scar tissue that has built up in the lining will begin to strain the person while breathing. Therefore, the top pleural thickening symptom is respiratory issues or shortness of breath. The extent of the feeling of breathlessness will vary from person to person. As the disease progresses, the simplicity of breathing will become harder as the pressure on the lungs builds.

Severe forms of PS may lead to a pleural effusion. This happens when excess fluid builds up in between the pleura and outside of the lungs. Extended asbestos exposure is a known cause of pleural effusion, although this is one of the lesser-known causes. Other symptoms can include a persistent cough and chest pain related to breathlessness. All aspects of breathing can become painful and seem less automatic.

What Treatments can be Done for Pleural Thickening? 

There are, unfortunately no treatments that can eradicate the damage of pleural thickening. There are a few options for those who are looking to ease their symptoms. Oxygen therapy is one option doctors may prescribe to patients. Those with less severe cases may receive an inhaler which they can use whenever they are experiencing difficulty breathing. More advanced cases of pleural thickening may need a portable oxygen concentrator to have a consistent supply of oxygen.

Once you have it, pleural thickening is a lifelong condition and isn’t typically the singular cause of a person’s prognosis. A person with PT should visit their doctor frequently to monitor their condition as it progresses. Pleural thickening life expectancy depends on whether or not you develop other diseases from it, such as cancer. Some cases of PT may turn into the development of mesothelioma and ensuring you are diagnosed quickly is important in the battle with cancer. Your doctor may also advise you to exercise and work your lungs to ensure their capacity and maintain a well-balanced diet to support overall health.

Pleural Parenchymal Scarring – Does it Always Get Worse?

Pleural parenchymal scarring is a form of scarring on the lungs that may occur with pleural thickening. This scarring can occur in any area of the lungs and directly affects the function of tissues. The presence of scarring doesn’t always mean there is a malignant component. Some scarring can be benign and doesn’t have an effect on the person. Pleural thickening doesn’t always get worse, if the scarring is minimal or you are managing it so it doesn’t affect your body more you can maintain a healthy status. Once parenchymal scarring and PT become widespread, the person will begin to feel symptoms of breathlessness and chest pain, among other signs.

To navigate a newly found diagnosis of pleural thickening, you may have questions regarding how you got the disease, what your options for treatment are, and how you can afford treatments financially. If your PT is caused by asbestos exposure, you may be able to receive financial compensation for your unlawful exposure. We encourage you to speak with our patient advocates to learn about pleural thickening, asbestos exposure, and any other questions you have regarding your symptoms and finding a potential diagnosis.

Mesothelioma Support Team

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