Bilateral Apical Pleural Thickening of the Lung

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Pleural thickening is a disease of the lungs that is caused by scarring that causes the pleura to thicken. The pleura is a thin membrane covering both lungs. This disease is also known as diffuse pleural thickening (DPT).

Pleural thickening in the lungs is often caused by breathing asbestos dust and fibers into the lungs. While the body can prevent larger dust particles from entering the lungs, some smaller particles can get through the nasal passages and get into the lungs. The natural defenses of the body can get larger asbestos fibers out, but some fibers are son little they can get deep into the lungs.

Below is more information about bilateral apical pleural thickening.

Tiny Asbestos Fibers Can Cause Pleural Thickening

Some asbestos particles are so small they cannot be seen with the eye. Workers who said they could see clouds of asbestos dust at work could not see the millions of tiny particles that can bypass the body’s defenses and get into the lungs.

Tiny asbestos particles may measure just microns in size. They can go through the respiratory system into the alveoli, penetrate cell walls, and get into the pleura. If the tiny asbestos fibers get into the lung and the pleura, pleural thickening often occurs.

Pleural thickening usually causes victims to feel tightness in the chest and breathlessness. These symptoms are caused by reduced lung function as the pleura becomes thicker over months and years. Pleural thickening can be in one lung (unilateral pleural thickening) or in both lungs (bilateral apical pleural thickening). (

Localized areas of thickening are called pleural plaques, which do not usually interfere with your lung function or cause breathlessness. Pleural plaques can occur with pleural thickening, but they involve less scarring and cause much less impairment of the lungs. Pleural thickening often occurs on the pleura’s visceral layer, which lines our lungs. Plaques often occur on the parietal pleura, which lines our rib cage.

Bilateral apical pleural thickening often happens after the patient has pleural effusion, which is a fluid build-up of fluid in the pleural space.

The Causes of Bilateral Apical Pleural Thickening in the Lungs

The most common cause of pleural thickening in one or both lungs is asbestos exposure. Asbestos occurs naturally and was used widely in construction and manufacturing for decades until the late 1990s. Asbestos was used for fireproofing and insulating buildings, especially in pipe insulation, ceiling tiles, boilers, and spray coating for walls and ceilings.

Workers who were employed in industries where asbestos was used are more likely to develop bilateral apical pleural thickening. Some of the most common jobs where this disease occurs are:

  • Plumbers, heating and ventilation workers
  • Sheet metal workers
  • Energy plant workers
  • Building inspectors
  • Vehicle body builders and repairers
  • Motor mechanics
  • Shipbuilding workers
  • Railway engineering workers
  • Electricians and electrical fitters
  • Pipefitters
  • Railway engineers

You also can develop pleural thickening in one or both lungs if you resided with a person who worked with asbestos on the job. This can happen if asbestos fibers are carried home on clothes and inhaled by others. Some victims who have pleural thickening do not know how they came in contact with asbestos. They might not have known they were exposed to it at home from their loved one.

Symptoms of Bilateral Apical Pleural Thickening

If you suffer from pleural thickening in one or both lungs, you will probably experience these symptoms:

  • Shortness of breath
  • Tightness in the chest
  • General pain in the chest that often happens after even mild physical exertion

Depending on how the disease progresses, bilateral apical pleural thickening can be a severe disease that affects your quality of life.

In the early stages, pleural thickening has no symptoms. As the disease gets worse, you may feel chest pain and shortness of breath.

In one clinical study looking at people with moderate or several pleural thickening, 95% of patients said they had shortness of breath. Sixty-five percent said they were moderately short of breath, and 11% said they were severely short of breath.

Pleural thickening affecting one or both lungs also can lead to restrictive lung disease. This prevents the lungs from expanding fully. Because of this, patients have lower lung volume and usually need to work more to breathe.

Bilateral Apical Diagnosis

Doctors have several methods to diagnose pleural thickening. On chest scans, pleural thickening shows as a shadow in the pleural area.

The condition is most often diagnosed with a chest X-ray, but a diagnosis from a CT scan is better. Some clinical studies show that when compared to an X-ray, a CT scan is better able to see pleural thickening, asbestosis, and pleural plaques. CT scans also can see earlier signs of pleural thickening with scar tissue just 1 mm or 2 mm thick.

It should be noted that some compensation claims for pleural thickening may only be valid if the patient’s lungs show blunting of the costophrenic angle. This is a gap under the base of the lowest part of the lung, where the diaphragm and the base of the ribs meet. Gravity causes fluid to build up in this gap under the lung. The fluid pushes one or both lungs up. This blunts the costophrenic angle and reduces lung capacity.

With some patients, doctors will do a positron emission tomography (PET) scan. This test can distinguish between pleural mesothelioma and pleural thickening. Both conditions can be present simultaneously. Pleural thickening in the patient does not confirm a mesothelioma diagnosis. However, it can be a sign of asbestos exposure.

Physicians may be able to obtain an early diagnosis for mesothelioma patients with PET and CT scans. Getting a mesothelioma diagnosis as early as possible leads to a better prognosis and more treatment options.

Treating Bilateral Apical Pleural Thickening

Pleural thickening cannot be cured. After the damage has been done, it cannot be reversed. But it is vital to have this health condition diagnosed because it can cause more health problems.

There is hope, though, and treatment is available. Most doctors offer therapies to reduce symptoms. They may prescribe pain drugs, and breathing exercises can help to improve lung capacity.

Note that smoking will decrease your lung function. Doctors will always recommend that you stop smoking as soon as you have pleural thickening diagnosed. By quitting smoking, you can also reduce the chances of developing worse lung diseases.

File a Pleural Thickening Claim Today

If you were exposed to asbestos and are having trouble breathing, it is critical to speak to your healthcare professional for an official diagnosis. With over $30 billion available for asbestosis, lung cancer and mesothelioma, victims are able to access asbestos trust funds to help cover financial compensations related to asbestos-related diseases without ever filing a lawsuit.