The visceral pleura is a thin layer of serous membrane tissue that adheres to the surface area of the lungs. A fluid produced by the pleural layers surrounds the lungs and covers the visceral pleura. Pleural fluid provides a cushion of lubricant for reduced respiration friction. A second outer pleural layer is called the parietal pleura, which attaches to the chest wall of the thoracic cavity and contains the lungs, pleural fluid, and the visceral pleura. Common disorders of the visceral pleura are mesothelioma, pleural fibrosis, and pleural effusion.
A cancer of the visceral pleura of the lungs is called mesothelioma. This cancer is named after the type of cell layer, mesothelium, that comprises the pleural layers around the lungs. Mesothelium also lines the surface of many other internal organs. This type of cancer is most commonly seen among asbestos workers.
Exposure to asbestos silicate molecules may also cause a condition called visceral pleural fibrosis. The thin pleura becomes thicker and less flexible. It may become difficult to breathe once the condition progresses. The damage is not usually reversible.
Visceral pleural invasion (VPI) of lung cancer cells is indicative of a poor prognosis for a person with lung cancer. Patients that are given this diagnosis may need further specialized cancer treatment. Some oncologists believe that adjuvant chemotherapy may be an effective means of treating VPI.
Pleurisy is the inflammation of the pleural layers. Cold weather and some infections may cause the pleural layer to become inflamed. A sharp burning pain occurs when breathing deeply. Steroid medications may relieve the inflammation and discomfort.
The ability to breathe comfortably may be inhibited by the overproduction of pleural fluid between the visceral pleura and the parietal pleura. Excess fluid surrounding the lungs is called pleural effusion. It is a serious medical condition that requires immediate treatment. Pleural effusion is a likely result of congestive heart failure, pulmonary embolism, cancer, or pneumonia.
Symptoms of pleural effusion are shortness of breath and chest pain. There may be edema, an accumulation of fluid under the skin that causes swelling, in the hands, legs, and feet of the person. Abdominal swelling may develop at the same time as the pleural effusion.
Treatment of pleural effusion depends on the cause of the condition. Medications called diuretics are sometimes prescribed to increase the fluid output of the body. The doctor may need to perform a procedure called thoracentesis to remove some pressure on the lungs. Pleural fluid is aspirated through a needle inserted between the ribs. Part of the fluid sample is tested for bacteria, allowing the physician to choose the most effective antibiotic for treatment.