Pleural Diseases


The pleura is the membrane that lines the thoracic cavity and covers the lungs. The layers of the pleura contain a small amount of fluid that acts as a lubricant as one breathes in and out. The space between the layers is called the pleural cavity.

Types Of Pleural Diseases

Pleural effusion

This is excess fluid in the pleural cavity. This is one of the most common problems associated with the pleura. The most common cause is congestive heart failure. Other causes include lung cancer, pneumonia, tuberculosis, liver disease, pulmonary embolism. Pleural effusion generally causes no symptoms and, by itself, is not serious.


This is a buildup of blood in the pleural cavity. Chest trauma due to the accident is the most common cause, but cancer of the lung or pleura or open-heart surgery can also cause a hemothorax.


The accumulation of pus in the pleural cavity. This is a type of pleural effusion that is usually associated with pneumonia. The symptoms are those of pneumonia (cough, fever) in addition to shortness of breath and impaired breathing.

Pleural Tumors

Pleural tumors are cancerous tissues in the pleural cavity. Usually, pleural tumors are cancers that have spread from other areas of the body. Symptoms: Shortness of breath, chest pain, cough, unexpected weight loss.


Pleurisy is pain associated with inflammation of the pleural cavity. The most common cause is a viral infection, such as influenza. Other causes include bacterial and fungal infections, lung cancer, other diseases such as rheumatoid arthritis and mesothelioma, and reaction to certain medications. Symptoms of pleurisy may include a sharp pain when breathing, shortness of breath, a cough, fever and chills, rapid breathing, unexplained weight loss, and sore throat followed by joint swelling and soreness.


Pneumothorax is a buildup of air or gas in the pleural cavity around the lung that causes the lung to collapse. Chronic obstructive pulmonary disease, tuberculosis, and trauma are the most common causes. Symptoms: Shortness of breath, rapid breathing, chest pain when taking a deep breath (pleurisy), cyanosis (bluish discoloration of the skin), respiratory distress if large.


This disease may be suspected on the basis of medical history and findings on a physical examination. It is confirmed with a chest x-ray, which shows the interior of the chest cavity, and a CT scan—a series of images of the inside of the body, taken from different angles and depths, to reveal a high level of detail. To ensure that the blood vessels and organs show up clearly in these scans, the dye may be swallowed or injected into a vein during the performance of the scan. Certain blood tests may also be useful in determining the cause and severity of this disease.


The treatment of this disease is dictated by the condition and may vary from

Placement of a chest tube to evacuate air

  • Thoracentesis: draining fluid with a needle or a chest tube
  • Decortication: Opening the chest to remove the diseased pleura
  • Video-Assisted Thoracoscopic Surgery (VATS): Treatment for mechanical problems (fluid, air, or blood) focuses mainly on removing the fluid, air, or blood A minimally invasive alternative to open-chest surgery that involves less pain and recovery time. After you receive a sedative, your surgeon will make tiny incisions in your chest and then insert a fiber-optic camera called a thoracoscope. Images from the thoracoscope will give the pulmonologist important information that will help guide the appropriate treatment.
  • Abrading the pleural surface to achieve adherence to the lung to the chest wall may be required for recurrent pneumothorax.
  • Extrapleural pneumonectomy: In some cases of malignancy (mesothelioma), removal of all of the pleura, as well as the underlying lung, may be indicated.