Pleural Effusion Symptoms & Diagnosis

Daniel Powers, MDDid you know that the first sign of asbestos exposure can be "water on the lung" (a pleural effusion - the pleura is a cellophane-like covering over the lungs - the visceral [organ] pleura [lining] and covering the chest cavity - the parietal [chest cavity] pleura [lining]). Unfortunately, most exposed workers never know they have such "water" accumulation.

It can occur many times. In some of these patients the sticky "water" causes the linings of the lung and chest cavity to stick/fuse together. This results in what is called diffuse [over a large area] pleural [lining of the lung and/or chest cavity] thickening [scarring], pleural thickening.  When one breathes, their lungs move in and out and up and down in the chest cavity. A small amount of lubricating fluid is present between the lungs with their linings and the chest wall with their linings. 

When there is diffuse pleural thickening, the linings stick together and the lungs cannot move freely in the chest cavity usually resulting in some degree of functional lung capacity loss - reduced ability to exchange oxygen.  Thus, even without scarring of the lungs known as asbestosis, the diffuse pleural thickening can make your breathing more difficult and your ability to function in everyday activities, less.

If you suffer from an asbestos related ailment such as Pleural Effusion and wish to learn more about your legal options, please Contact us immediately.

More About Pleural Effusion

Mesothelioma: a Brief Overview

The most lethal disease associated with asbestos is mesothelioma cancer, a swiftly moving carcinoma that has as one of its principal symptoms pleural effusion.  The disease can develop in a number of locations, including the lining of the sac around the heart and the lining of the abdominal wall; but by far the most common location for mesothelioma development is in the outer lining of the lungs, a membrane called the pleura. 

All of these linings or membranes that wrap organs and internal cavities are considered a single anatomical feature called the mesothelium.  It is viewed as one large membrane and it is the location where asbestos fibers create malignancy, whether it is in the abdomen (peritoneal mesothelioma); in the membrane around the heart (pericardial mesothelioma); or in the lining on the outside of the lungs (pleural mesothelioma).

Asbestos and Pleural Effusion

There is also a further division of the pleural mesothelium – that portion wrapped around the lungs is called the visceral pleura, while the lining of the chest wall is known as the parietal pleura.  These two surfaces have a thin layer of liquid between them that provides lubrication during the breathing process; because the pleural surfaces are separated by fluid they do not rub together with every breath.

In seventy percent or more of all mesothelioma cases, the cancer develops in the visceral pleura as inhaled asbestos fibers have worked their way through the lung wall and into the outer lining.  As time passes, the fibers become an irritant and eventually cause the growth of deformed malignant cells that begin reproducing at an uncontrollable rate.  This attack on the mesothelial cells causes pleural effusion, a principal symptom of mesothelioma cancer.  The malformed cells cause the pleural surfaces to thicken and an excess of fluid develops between them; these are the elements of pleural effusion.

Malignant Pleural Effusion

For most pleural mesothelioma patients, one of the first noticeable symptoms is pleural effusion chest pain.  The additional fluid creates pressure between the lungs and the chest wall, causing breathing difficulty and pain when the patient inhales.  When the doctor determines that the shortness of breath and chest pain are symptoms of pleural effusion, he will extract a sample of the fluid and test its characteristics in a lab. 

There are two types of fluid that develop in the pleural area; one is called an exudate and the other a transudate.  The first is associated with localized conditions such as cancer growth and the second with systemic failure such as congestive heart failure or cirrhosis.  Exudative pleural effusion indicates that the medical problem may be a viral infection, pneumonia or a cancerous condition in the pleural area.  If the medical problem is mesothelioma a tissue sample extracted through biopsy will confirm that the condition is malignant pleural effusion caused by cancerous mesothelial cells.

Pleural Effusion & Lung Cancer

Mesothelioma is not technically classified as lung cancer.  It is cancer of the lining of the lungs, which in its late stages may lead to development of a tumor or tumors within the lung.  Generally, pleural mesothelioma exhibits diffuse small tumors which cause the thickening of the pleural membrane and the development of exudative pleural effusion. 

However pleural effusion with lung cancer is a standard pairing of symptom and diagnosis as well.  Pleural effusion can also be symptomatic of pneumonia and other viral infections, which is one reason why mesothelioma is often not diagnosed until its late stages.  It shares symptoms with a number of other, much more common diseases. 

Mesothelioma lung cancer is a term that is often associated with pleural effusion; it should be noted that the disease also causes effusion, or fluid buildup, in those instances when it develops in the pericardial mesothelium around the heart or the peritoneal mesothelium on the abdominal wall.  According to the National Cancer Institute, malignant pleural effusions are caused most commonly by carcinomas of the breast, lung, gastrointestinal tract or ovary and by lymphomas; they are common to many diseases.

While lung cancer may or may not cause malignant pleural effusion, the symptom will develop with pleural mesothelioma on virtually all occasions except those rare instances when the disease is treated in its early stages.  Pairing asbestos with pleural effusion is unfortunately only one of many potential diagnoses and too often goes ignored until every other option is ruled out.

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