Medically Reviewed By
Karen Ritter, RN BSN
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What Is Pleural Fluid?
Pleural fluid is the fluid in between the layers of the pleura, also called the pleural space. The pleural space between the lungs and the chest wall serves as a buffer for the lungs to expand and contract as needed.
The pleura is where pleural mesothelioma forms. The pleura contains mesothelial cells, which can turn cancerous due to genetic mutations caused by asbestos fibers. These fibers can get stuck in the pleural tissue linings.
How a Pleural Fluid Analysis is Performed
Pleural fluid can contain mesothelial cells, which if cancerous can help doctors find evidence of pleural mesothelioma. There are not as many mesothelial cells in pleural fluid as there are in pleural tissue. Collecting pleural fluid with mesothelial cells is how to do a pleural fluid analysis.
Some people ask whether mesothelial cells are normal in pleural fluid. This is normal, mesothelial cells cover the surface of the lungs, the inside of the chest wall and around the heart. Between the pleura and chest wall is fluid (pleural fluid), so it’s common for mesothelial cells to be in this fluid.
What Are Pleural Effusions?
Pleural effusions are one of the symptoms of pleural mesothelioma. A pleural effusion is a buildup of fluid between the two tissue layers of the pleura.
Pleural effusions occur due to irritation and scar tissue developing from asbestos fibers. This irritation and scar tissue causes a disruption in the normal transfer of fluid across the mesothelial cells of the pleura, which forms pockets of fluid called pleural effusions.
The signs of a pleural effusion are a cough, chest pain and shortness of breath, some of which is due to the lungs having less of a buffer space to expand against the chest.
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Mesothelioma Pleural Fluid Analysis for Diagnosing Pleural Mesothelioma
A mesothelioma pleural fluid analysis can be used in the diagnostic process for pleural mesothelioma. However, using a fluid analysis is less definitive and effective than a tissue biopsy in diagnosing mesothelioma.
According to one study, a fluid biopsy accurately diagnosed 26% of mesothelioma cases. By comparison, tissue biopsies were accurate 98% of the time.
Thoracentesis for Pleural Mesothelioma
The main type of fluid biopsy for pleural mesothelioma is a thoracentesis. Doctors will pass a needle between the ribs into the pleural space followed by a thin catheter tube to collect pleural fluid.
Thoracentesis is also a pain-relief treatment for patients with severe pleural effusions who need the fluid removed for comfort and easier breathing.
Sources & Author
- About Pleural Effusion. Penn Medicine. Retrieved from: https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/pleural-effusion. Accessed: 02/09/2023.
- Tests for Malignant Mesothelioma. American Cancer Society. Retrieved from: https://www.cancer.org/cancer/malignant-mesothelioma/detection-diagnosis-staging/how-diagnosed.html. Accessed: 05/05/2020.
- Types of biopsies used to look for cancer. American Cancer Society. Retrieved from: https://www.cancer.org/treatment/understanding-your-diagnosis/tests/testing-biopsy-and-cytology-specimens-for-cancer/biopsy-types.html. Accessed: 05/05/2020.