Pleural Mesothelioma

Pleural mesothelioma is the most common and accounts for approximately 75 percent of all mesothelioma cases diagnosed

Pleural mesothelioma is a specific form of mesothelioma that affects the pleura. The pleura is the outer lining of the lungs and chest cavity.

According to the SEER Database, which tracks cancer statistics, pleural mesothelioma is diagnosed most often in men age 60-80.

Pleural mesothelioma is also different from peritoneal mesothelioma in that it has a longer latency period, with symptoms presenting in 30-40 years after exposure to asbestos versus 20-30 years for peritoneal mesothelioma.


Specific symptoms of pleural mesothelioma include:

  • shortness of breath caused by pleural effusion
  • dry cough
  • fatigue
  • night sweats
  • weight loss


As with all mesotheliomas, an accurate diagnosis of pleural mesothelioma can be challenging. On initial examination by a doctor, 80 percent to 95 percent of patients show pleural effusion (excess fluid that accumulates in teh pleural cavity) on x-ray, the remaining percentage show little or no fluid. At first, the fluid is free-flowing, and is similar in appearance to that seen in other benign causes or in congestive heart failure, and because of this, these other possibilities are the first to be ruled out in the diagnostic process. Later, the effusion becomes “loculated,” or contained within a boundary in the pleural space, where the fluid does not move.

  • Computed tomography (CT) scans are more definitive, and may show not only the effusion, but the presence of pleural masses as well as the size certain lymph nodes.
  • Magnetic resonance imaging (MRI) is more sensitive in determining chest wall invasion and spread of disease through the diaphragm.
  • Positron emission tomogrophy (PET) may help in staging the disease for possible surgical resection by ruling out extension to the contralateral (opposite) lung or to other distant sites.
  • Video-assisted thoracoscopy surgery (VATS) is becoming a more common procedure. VATS has a diagnostic yield of >95 percent, and allows for pleural biopsy, drainage of fluid and pleurodesis. VATS also ensures adequate tissue samples to facilitate a definitive diagnosis.


There is currently no established staging system for pleural mesothelioma; however, staging can be done using the TNM system. This system refers to the status of the tumor (T), lymph nodes (N) and metastases (M).

There are general categories which may also be somewhat helpful in determining stage:

  • The first category shows a localized lesion able to be completely resected (entirely removed).
  • In the second category, the disease is contained within the abdominal cavity on peritoneal and organ surfaces where debulking (the removal of as much, but not all of the tumor) is possible.
  • Category three shows disease contained within the abdominal cavity with invasion of organs such as the colon or liver.
  • Category four shows disease extending outside the abdominal cavity.


Mesothelioma treatment is either designed to treat the immediate area of the primary mesothelioma growth or the whole body. Whole body treatments are called systemic treatments. Localised treatments include surgery and radiotherapy. Systemic treatments act on cancer cells no matter where they may be in the body and include chemotherapy.

Treatment options for pleural mesothleioma depend on a number of factors, including:

  • the stage of mesothelioma
  • pre-existing medical conditions
  • patient’s general fitness

Unfortunately, mesothelioma does not always respond to cancer treatments. Doctors and researchers are working to improve mesothelioma treatments all the time. You may be offered treatment as part of a clinical trial and not as a standard treatment. The results of the trials will be used to improve treatment in the future. There is information about taking part in clinical trials.

Legal Options

If you or a loved one have been diagnosed with mesothelioma, or if you are experiencing the symptoms associated with mesothelioma, you may have a claim against the manufacturers of these asbestos products.

Please contact us today by filling out the brief questionnaire, or by calling our toll free number (1-800-898-2034) for a free, no-cost, no-obligation legal evaluation of your case.

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