What is Pleural Plaque, Pleural Thickening & Benign Pleural Disease?


Asbestos causes three types of benign pleural disease: pleural plaques, diffuse pleural thickening, and pleurisy with effusion. All are uncommon before 20 years after first exposure.

Benign pleural conditions do not turn into mesothelioma but people with pleural plaques or thickening are at increased risk of mesothelioma and lung cancer because of their past asbestos exposure. This can often lead to anxiety in many individuals.

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Pleural Plaques.pdf

Pleural Plaques


Pleural plaques are localized areas of thickening of the pleura by fibrous (‘scar’) tissue. They usually develop on the parietal pleura, that is the layer of pleura lining the chest cavity. Unless the plaques are very extensive and fused together over large areas they do not cause breathlessness. They very rarely cause chest pain.

No treatment is needed for pleural plaques.


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Pleural Thickening.pdf

Diffuse Pleural Thickening


Diffuse pleural thickening is more widespread thickening of the pleura by fibrous (‘scar’) tissue. It usually involves the visceral pleura, that is the layer of pleura applied to the lung. Adhesions between the lung and chest wall are common and these occasionally give rise to pain on taking a deep breath or coughing.

Pleural thickening may compress the underlying lung, a situation which is termed folded lung or rounded atelectasis or rolled atelectasis. The effect is similar to wearing a tight waistcoat. This causes breathlessness on exertion.

There is no medication which helps pleural thickening. Pleurectomy, i.e. surgical removal of the thickened pleura, may be attempted in patients with severe impairment of lung function.

A report by the Industrial Injuries Advisory Council (IIAC) (April 2016) – which took effect from 30 March 2017 – recommended a change to the list of prescribed diseases for which people can claim Industrial Injuries Disablement Benefit.

The council recommended modernising the definition of prescribed disease D9 (pleural thickening) by removing the requirement for “obliteration of the costophrenic angle”. This would enable CT scan evidence to be used more simply and directly in claims assessment. No change was proposed to the occupational coverage of prescribed disease D9 (pleural thickening)

Pleurisy with Effusion


Asbestos pleurisy is inflammation of the pleura. This may give rise to chest pain which is typically worse on taking a deep breath, coughing, or sneezing. Pleurisy is often associated with a pleural effusion, i.e a collection of fluid in the chest cavity. An effusion causes breathlessness. Episodes of pleurisy may occur repeatedly, sometimes months or years apart. Pleurisy usually resolves but may leave behind diffuse pleural thickening.

Pain relieving medication helps the pain. If the pleurisy is severe treatment with a steroid medication may help it to resolve.

Source: Dr Robin Rudd, MA MD FRCP, Consultant Oncologist


Reviewed by Dr Robin Rudd: March 2017