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Home > Mesothelioma articles > Benign pleural disease as a type of asbestos-related disease

Benign pleural disease as a type of asbestos-related disease

Benign pleural diseases include

  • Pleural Plaques
  • Pleural Fibrosis
  • Pleural Effusion

One of the effects of inhaled asbestos fibres is to irritate and inflame the pleura of the lung. The pleura is the double-sided lining of the outer part of the lung: one side lines the outside of the lung tissue itself, the other lines the inner part of the chest wall. The pleura helps the lung glide over the chest wall as it expands and contracts during breathing.

Asbestos fibres can irritate and thicken the pleura. This thickening can be widespread (known as diffuse thickening) or it can occur in patches, known as plaques. The inflamed pleura can also secrete fluid into the pleural cavity – the space between the two pleural layers. This is known as pleural effusion. These are not dangerous or fatal conditions, although they may interfere with the expansion and contraction of the lungs and restrict breathing.

If there is pleural effusion, it can be drained to relieve the breathlessness. A doctor passes a needle through the chest wall into the pleural cavity under local anaesthetic and drains the fluid. The procedure may need to be repeated if the fluid gathers again.

Pleural disease is characterized by scarring or thickening of the lungs' pleural membrane and is indicative of heavy or prolonged asbestos exposure. The pleura is a thin membrane that surrounds the outside of the lungs and provides a smooth, lubricated surface against which the lungs can expand and contract. Repeated asbestos exposure can cause the fibers imbedded in the lungs to work outwards and invade the surrounding pleura membrane.

Once in the pleura, asbestos causes several changes to this membrane. Often, calcification, or plaque, will begin to form on the surface of the pleura. In other cases, the pleural membrane thickens or fluid builds up around it, sometimes restricting the lungs' movement and making breathing more difficult. These conditions are forms of pleural disease.

Pleural disease is treatable and not necessarily a danger in and of itself. Pleural disease does, however, put the patient at much greater risk of developing more serious asbestos-related diseases, like mesothelioma.

Early discrimination between benign and malignant pleural diseases is vital for the treatment and prognosis of a patient. Imaging is traditionally performed with CT or MRI, with an accuracy of 50%–75%. PET has proven to be superior as a diagnostic tool in several malignancies. In this prospective study, PET results in patients with pleural abnormalities on CT were compared with histologic results.

Eligible patients had pleural thickening on CT and were medically fit for surgical diagnostic procedures. All patients underwent PET. Qualitative assessment led to a PET score of 1 (definitely normal), 2 (probably normal), 3 (probably abnormal), or 4 (definitely abnormal). PET scores of 1 or 2 indicated a negative PET finding, whereas PET scores of 3 or 4 indicated a positive PET finding. Pathologic verification techniques included thoracocentesis, thoracoscopy, or open pleural biopsy at thoracotomy.

In summary

A benign pleural disease is an asbestos-related disease which still has something of mystery to experts, since they don't know why some asbestos workers get one of several benign diseases of the pleura while others are not affected by the terrible consequences of Asbestos.

The pleural cavity is the space between the lungs and the chest wall, which has an small amount of pleural fluid in the normal non-diseased state. The pleura is the epithelium that lines this cavity. Asbestos fibers can reach this part of the body.

The parietal pleura, which is connected to the chest wall, is highly sensitive to pain. Meanwhile, the visceral pleura, which is connected to the lung and other visceral tissues, is not sensitive to pain.

The function of pleura and pleural fluid is to reduce friction between the lungs and the inside of the chest wall during breathing. Asbestos fibers make difficult this. A benign pleural condition usually does not progress and is not fatal. These conditions include pleural plaques, diffuse pleural fibrosis and benign pleural effusion.

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