Pleural thickening, which is also known as diffuse pleural thickening, is a disease of the lungs where excessive scarring makes the pleura thicker. The condition can cause severe chest pain and make breathing difficult and is a severe condition. Pleural thickening is one of the most common signs of asbestos exposure.
Below is more information that is important to know if you have been exposed to asbestos and have pleural thickening. (Asbestos.com)
What Is Pleural Thickening?
Pleural thickening is a disease that is caused by asbestos exposure. A build-up of scar tissue is the cause of pleural thickening.
Pleural thickening in the early stages does not have any symptoms. But as more pleural thickening occurs around your lungs, it becomes more difficult for them to expand for a deep breath.
As pleural thickening gets worse, patients often experience chest pain and breathlessness, which is called dyspnea. Essential facts to know about pleural thickening include:
- Symptoms include difficulty breathing and chest pain.
- The disease is caused by asbestos exposure and is related to pleural effusions.
- Pleural thickening also may be caused by other conditions that inflame the lung lining.
- The inflammation can be effectively treated with medications and pulmonary rehabilitation.
How Serious Is Pleural Thickening?
Pleural thickening can be a serious condition, especially when it gets into the later stages. However, having pleural thickening is not enough to confirm that you have pleural mesothelioma. But pleural thickening can be a sign of a major medical problem and also asbestos exposure.
Catching mesothelioma in the early stages is critical because it can lead to more treatment options. Therefore, patients with pleural thickening caused by asbestos exposure should have cancer screening annually.
Later stages of pleural thickening can close off the space between the layers of pleura. This action can encase the lung entirely and lead to restrictive lung disease. Patients may have lower lung volume and need to work harder to breathe.
Note that pleural thickening should not be mistaken for pleural plaques; this is another condition that is caused by exposure to asbestos.
Causes of Pleural Thickening
The most common cause of pleural thickening is exposure to asbestos for long periods of time. When you inhale asbestos dust, the tiny fibers may become embedded in the pleura.
The embedding of asbestos fibers may cause an inflammatory response by the body that causes an accumulation of fluid in the pleural space. This fluid build-up is called pleural effusion. The collection of scar tissue is called pleural thickening.
A review of clinical studies on the subject found pleural thickening happens in 5% to 13% of workers who were exposed to asbestos. Pleural thickening can occur within only one year of asbestos exposure. But it also may not happen until many years later.
In most pleural thickening case, it may take 15 to 20 years from the first asbestos exposure until your doctor’s diagnosis of pleural thickening.
Any health problem that leads to pleural inflammation can cause pleural thickening. That is why it is important to share any history of asbestos exposure with your doctor. This discussion with your healthcare provider will ensure that you have an accurate diagnosis as soon as possible.
Some other causes of pleural thickening are:
- Empyema – this is an accumulation of pus in your pleura that is caused by infection
- Hemothorax – a build-up of blood in the pleura caused by injury to the chest
- Coronary artery bypass
- Exposure to radiation
These other health conditions are more likely to be called apical pleural thickening, which means only one side or lung is affected. Pleural thickening caused by asbestos exposure is more often diagnosed as biapical pleural thickening. This condition usually damages both lungs.
Common Signs of Pleural Thickening
If you suffer from pleural thickening, you will find that breathlessness is the most common symptom. An early clinical study of patients with pleural thickening found that 95% said they had breathlessness; 65% said they had moderate breathlessness, and 11% said they suffered from severe breathlessness.
A 2017 clinical study found that reduced lung capacity and reduced breathing ability for 37 patients with diffuse pleural thickening, compared to 21 control subjects that did not have the disease.
Other symptoms of pleural thickening to be aware of include:
- Difficulty getting a deep breath
- Trouble breathing with even mild physical activity
- Pain in the chest when trying to take a deep breath
- Pain when you cough
- Chronic, dull chest pain
- Lower pulmonary function
Pleural Thickening Diagnosis
Most doctors diagnose pleural thickening with imaging studies. These include X-rays, MRIs, and CT scans:
- X-ray imaging: Pleural thickening is usually seen with a chest X-ray. Pleural thickening will show on the image as a shadow on your pleura. The shadow will extend over 25% of your chest wall.
- CT scan: Pleural thickening may be viewed on computed tomography scans. CT scans may be used to diagnose asbestosis and pleural plaques. A CT scan can be used to detect early stages of pleural thickening where scar tissue is 1-2 mm thick.
- MRI and PET scans: Physicians can use PET (positron emission tomography scan) and MRI (magnetic resonance imaging scan) to see the difference between pleural thickening and pleural mesothelioma. These two conditions can affect the patient simultaneously.
Treating Pleural Thickening
Pleural thickening treatment is usually only symptomatic and supportive care. But some reports indicate that pleurectomy surgery can be useful in severe pleural thickening cases. This surgery is aggressive and is normally used on patients who have been diagnosed with pleural mesothelioma. The procedure involves taking out sections of the pleura that surround the lungs.
In most pleural thickening cases, physicians will offer treatments that help with the patient’s particular symptoms. For instance, there are effective prescription drugs, such as steroids and bronchodilators that can make breathing more comfortable. The best treatments for pleural thickening reduce symptoms and enhance the quality of life.
A 2015 Australian clinical study showed that pulmonary rehabilitation could boost the quality of life for patients with respiratory diseases related to dust exposure, such as pleural thickening.
Pulmonary rehabilitation involves doing moderately intense exercise training to help the patient to overcome difficulty breathing. This treatment also helps you to stay active physically, which will improve your overall health.
If you smoke, quitting this harmful habit is critical after a pleural thickening diagnosis. Smoking reduces the function of your lungs. It also boosts the risk of developing other lung diseases.
It is essential to talk to your physician about the best ways to quit smoking as soon as possible. Healthcare providers can offer several support options and treatments, such as drugs and nicotine replacement to reduce your urge to smoke. Taking these critical steps can enhance the odds of quitting smoking permanently.
- Pleural Thickening. (n.d.). Retrieved from https://www.asbestos.com/mesothelioma/pleural-thickening/