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Pleural diseases

The pleura is a large, thin sheet of tissue that wraps around the outside of your lungs and lines the inside of your chest cavity. Between the layers of the pleura is a very thin space. Normally it is filled with a small amount of fluid. The fluid helps the two layers of the pleura glide smoothly past each other as your lungs breathe air in and out.

Disorders of the pleura include:

  • Inflammation of the pleura that causes sharp pain with breathing
  • This is caused by viral or bacterial infection.

Pleural effusion
  • Excess fluid in the pleural space
  • This may be blood stained, pus, serous fluid
  • Causes: Bacterial infection, tuberculosis, malignancy, inflammation, excessive volume from heart failure, kidney or liver disorder, low protein state, perforation of thoracic organs (chylothorax, oesophageal rupture)

  • Build-up of air or gas in the pleural space
  • Causes: traumatic, iatrogenic or spontaneous.
  • A tension pneumothorax is a particular type of pneumothorax where the air may enter (though a defect of the chest wall, lung, or airways) on inspiration, but cannot exit on expiration. Each breath increases the amount of trapped air in the chest cavity, leading to further lung compression. This is often an urgent situation and may progress to a medical emergency if there is compromise of the venous return to the heart causing hypotension and rarely shock.

  • Build-up of blood in the pleural space
  • Chest injury is the most common cause

Treatment focuses on removing fluid, air, or blood from the pleural space, relieving symptoms, and treating the underlying condition.

Other pleural diseases:

  • Pleural calcified fibrous pseudotumor
  • Pleural plaques: discrete fibrous or partially calcified thickened area which can be seen on X-rays of individuals exposed to asbestos. Although pleural plaques are themselves asymptomatic, in some patients this develops into pleural thickening.
  • Pleural endometriosis
  • Pleural tumours may be benign (i.e. solitary fibromas) or malignant in nature. Pleural Mesothelioma is a type of malignant cancer associated with asbestos exposure.

Worried about Pleural disease?
Visit our lung specialist today.