Benign & Malignant pleural conditions

The pleura is a space between the lungs and chest wall that can fill with fluid at times.

Pleural conditions might be caused by fexposure to asbestos, a mineral fiber that was widely used in construction and as a fire retardant. Fluid in the pleural space may also be caused by certain infectious or inflammatory problems or by the spread of other cancers to the pleura.

In addition, there are tumors that can grow from the pleura, both benign and malignant.

There are three types of pleural conditions:

• Pleural plaque. This is the hardening of the pleura. When asbestos fibers enter the lungs they cause the pleura to become thick and scaly. This condition rarely inhibits lung health.
• Pleural tumors. Both benign and malignant tumors can grow in the pleura.
• Pleural effusion. Various benign and malignant conditions can cause a build-up of pleural fluid in the pleural cavity. The source of the fluid should be properly diagnosed and appropriate treatment pursued.

Risk Factors

People are at a higher risk for developing pleural conditions because of exposure to asbestos.

Symptoms 

Most of the time, pleural conditions are found on a chest X-ray. Symptoms of pleural conditions may include:

• chest pain
• breathing problems
• coughing

Diagnosis

When a patient presents with symptoms that might suggest pleural conditions, your doctor will use several diagnostic methods to make an accurate diagnosis.

1. Your doctor will ask for a complete medical history and will perform a thorough physical examination. Diagnostic tests may include:
   • Chest X-ray
   • CT scan
2. Your doctor may want to do further tests. These tests may include:
   • Thoracentesis. During this procedure, your doctor wants to withdraw the fluid in your chest. A needle is inserted into the chest and a small portion or all of the fluid is drawn out. This fluid is examined for potential malignancy and other conditions. This procedure is done in the office under local anesthesia.
   • VATS. During this procedure, you doctor wants to examine the pleural space. While you are under general anesthesia, your doctor will use a videoscope, inserted through two small incisions. Your doctor will remove the fluid and examine it for potential malignancies and other conditions. This procedure usually requires an overnight stay in the hospital. Learn more about VATS.
   • Thoracotomy. During this procedure, your doctor wants to get a very good look at your lungs and surrounding tissues. Your thoracic surgeon will open the chest with a small incision, and remove any abnormalities or lymph nodes for further examination in the lab. Learn more about a thoracotomy.

A Diagnosis of Pleural Conditions
After you have undergone any of these tests, your doctor may inform you that you have a pleural condition. As they can be benign or malignant, your treatment plan will vary.

Treatment
The treatment will depend on the diagnosis. In some instances, the treatment will be directed at controlling the symfptoms. In other cases, the treatment will be aimed at treating the underlying condition.

In benign cases, treatment may consist of putting medicine into the pleural cavity to keep the fluid from returning. Sometimes stripping scar tissue from the lung so it can fully expand and fill the pleural cavity is a treatment option.

In cases of malignant tumors, treatment may involve removing part of the pleura or part of the pleura or lung.