Pleural Thickening and Asbestos

Mesothelioma and Pleural Thickening

Pleural thickening is a thickening of the pleura caused by asbestos exposure, infections or lung injuries. It can cause chest pain, shortness of breath and reduced lung function. While it’s often benign, it may signal pleural mesothelioma, requiring imaging tests for diagnosis and symptom control.

Pleural thickening can occur in different areas of the pleura. These include the parietal pleura (the lining of the thoracic cavity), the pleural space (the space between the two layers), and the visceral pleura (the layer surrounding the lungs). In most cases, pleural thickening will not affect life expectancy.

Doctors use imaging scans, like CT and MRI scans, to check for scarring and the location of the pleural thickening. These tests help doctors identify the type of pleural thickening. They can also find out if the pleural thickening may lead to mesothelioma.

Mesothelioma survivor Paul F. was first diagnosed with pleural thickening. Over 10 years later, doctors told him had pleural mesothelioma. His job at a factory likely exposed him to asbestos and led to both his pleural thickness and pleural mesothelioma.

Types of Pleural Thickening

Pleural thickening has two main types: Focal and diffuse. Within these groups, some cases can be benign, malignant or other subtypes.

The following are subtypes of diffuse pleural thickening, which can be benign or malignant.

Pleural thickening can develop in different parts of the lung, on one side or both. Your doctor may use these terms when referring to your case.

What Causes Pleural Thickening?

Asbestos exposure is a main cause of pleural thickening. However, diseases that cause severe inflammation of the pleura or injuries can also cause pleural thickening.

Asbestos dust has microscopic fibers that lodge in the pleura when inhaled. The stuck fibers cause inflammation, leading to fibrous scar tissue buildup. This eventually can lead to pleural thickening.

It’s important to discuss your health history with your doctor, so they’re aware of your risk of pleural thickening. If you have a history of asbestos exposure, discuss it with your provider. Ask about screenings for asbestos-related diseases like mesothelioma.

A review of multiple studies published in the Journal of Occupational Medicine and Toxicology found that pleural thickening occurred in 5% to 13.5% of asbestos-exposed workers. These workers developed pleural thickening 3-34 years after their first exposure to asbestos.

What Are the Symptoms of Pleural Thickening?

The most common symptoms of pleural thickening are breathlessness, chest pain and coughing. These symptoms are like those of pleural mesothelioma. Some patients experience many other symptoms.

The American Journal of Industrial Medicine in 2023 published a study on pleural thickening. Researchers said patients can experience “progressive decline in pulmonary function…Pleural thickening plays a role in declining vital capacity in those with prolonged or unusual [asbestos] exposures.”

How Is Pleural Thickening Diagnosed?

To help ensure an accurate diagnosis, it’s vital to share your history of possible asbestos exposure with your doctor. If you’re unsatisfied with your screening results, you can always get a second opinion on your diagnosis.

X-ray Imaging Scans

Pleural thickening is usually spotted through a chest X-ray. In fact, it’s commonly found in routine chest X-rays along the edges of the lung.

Fat along the pleura (extrapleural fat) may also look like pleural thickening, which may lead to a misdiagnosis. Because of this, X-ray images are not the most accurate. To confirm a pleural thickening diagnosis, other imaging techniques may be used.

CT Scans

CT scans are the main way to diagnose pleural thickening. This method measures pleural thickening under 1 centimeter. It can also help diagnose early cases.

PET Scans and MRIs

Doctors can use PET and MRI scans to tell apart pleural thickening from pleural mesothelioma. CT scans are important because they can start pleural mesothelioma patients on early treatment if caught early.

Jim McWhorter

Verified Asbestos.com Survivor

Pleural Thickening Was a Sign of Survivor’s Mesothelioma Journey to Come

Jim McWhorter was told an injury-prompted X-ray was clear, but pleural thickening was noted in his record. A later surgery found tumors. It turns out that the pleural thickening led to his pleural mesothelioma diagnosis.

Jim McWhorter

Verified Asbestos.com Survivor

Read Jim’s Story

Pleural Thickening Treatment

Pleural thickening has no cure. Supportive treatment is all that is available. The best options are to quit smoking, stay active and do rehab. 

Severe cases of pleural thickening may benefit from surgery such as pleurectomy. People with severe breathing issues may use portable oxygen tanks.

Doctors Who Treat Pleural Thickening

Pulmonologists and pleural specialists have the expertise to diagnose and treat pleural thickening. They can recommend follow-up care and watch your condition for signs of progression.

If you need assistance finding a pleural specialist, our Patient Advocates at The Mesothelioma Center can match you with a top doctor near you. Our team of Patient Advocates has been helping patients find doctors since 2006.

Common Questions About Pleural Thickening

Does pleural thickening lead to mesothelioma?

Pleural thickening alone is not enough to confirm that you have asbestos cancer. However, it can be a sign of significant asbestos exposure and indicate a high risk for mesothelioma. Advanced pleural thickening can cause restrictive lung disease with severe breathing difficulty.

Can smoking cause pleural thickening?

Asbestos is the primary cause of pleural thickening. There are data that point to a correlation between smoking and the progression of pleural thickening. Smoking limits lung function and is proven to be a cause of other respiratory diseases, such as lung cancer.

Can pleural thickening affect your lifespan?

In most cases, pleural thickening will not affect lifespan. But this condition may be a sign of a more serious underlying condition such as malignant pleural mesothelioma or other cancer. Your doctor will determine how serious your pleural thickening is with diagnostic tests.

Have there been any asbestos lawsuits related to pleural thickening?

Yes, Miller v. Armstrong World Industries Inc. in 1991 was a precedent-setting court case. Raymond Miller was an insulator who used asbestos products and eventually developed pleural thickening. The Armstrong World Industries Asbestos Trust now accepts claims from individuals who experienced health effects from the company’s asbestos-containing products.

Is pleural thickening serious?

Pleural thickening is not always a serious condition. But if it’s left untreated, it can advance into other, more dangerous stages such as encasement of the lung. This condition causes restrictive lung disease. Pleural thickening is also a sign of significant asbestos exposure, which is a risk factor of pleural mesothelioma.

What is the difference between benign and malignant pleural thickening?

Benign pleural thickening means cancer tumors did not lead to the thickened tissue. Fibrous tissue that builds on top of itself is the cause. Meanwhile, malignant pleural thickening is caused by pleural mesothelioma or cancer that spread from another location.

Recommended Reading