Pleurisy and other pleural disorders affect the pleura, which is a large, thin sheet or membrane of tissue that is wrapped around the outside of the lungs and lines the inside of the chest cavity.
The pleura that line the chest is actually a very thin space that normally holds approximately 4 teaspoons of fluid that is used to keep the two layers of the pleura moving smoothly against one another as a person breathes. If this tissue becomes red or inflamed, that's called pleurisy. The sharp pain that happens with breathing occurs when the two layers of the pleura start rubbing directly against one another.
What is it? & Symptoms - Pleural effusion occurs when there is an abnormal build up of fluid in the pleural space. If the pleural tissues are already inflamed then the fluid will help alleviate the pain associated with the tissues rubbing against each other. But too much fluid can force the layer closest to the lungs against the lungs. Continual build up of fluid and pressure against the lung can cause it to collapse, resulting in difficulty breathing.
Causes - Infections, injuries, heart or liver failure, blood clots in the blood vessels of the lungs (pulmonary emboli), cancer, pneumonia, and medications can all cause the build up of fluid.
Diagnosis - Diagnostic methods usually include chest X-rays, laboratory testing of the fluid (thoracentesis), and a CT scan. The X-rays show the particular areas that are affected by the inflammation. The laboratory testing is needed to determine what kind of fluid has built up and the presence of any bacteria. If there is bacteria build up, the laboratory tests will show what kind of bacteria so the proper antibiotics may be administered. This fluid will also be examined for the amount and types of cells, and for the presence of cancer cells.
Other diagnostic tools include the use of a thoracoscope, which is a tube that when inserted into the chest cavity allows the doctor to visually examine the pleural space and obtain tissue samples. Thoracoscopy can also detect cancer and tuberculosis.