Parietal Pleura
The lungs are surrounded by the pleurae, which are two membranes. The inner membrane is attached to the lungs and is known as the
visceral pleura, while the outer
pleura is attached to the chest wall and diaphragm and is known as the parietal pleura. In between the two is a thin, fluid-filled space, known as the pleural cavity or pleural space. The surfaces of the parietal and visceral pleurae slide smoothly against each other during respiration.
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Both the parietal pleura and the visceral pleura are covered with mesothelial cells, which are responsible for secreting the fluid that acts as lubrication to aid in respiration. Both pleural membranes are semipermeable, meaning that they allow passage of certain substances to a limited degree. The parietal pleura continuously lets out a small amount of fluid between the membranes, while the visceral pleura continuously drains a small amount of fluid back into the lymphatic system to be returned to the blood.
In the case of plural mesothelioma, asbestos fibers find their way into the smallest passageways of the lungs and pleura. This can cause a chemical reaction that is not currently understood, but is known to induce cancer. As the cancer reproduces and spreads, the parietal pleura and visceral pleura thicken, causing excess fluid to accumulate between them (this condition is known as pleural effusion). As pleural thickening expands and fluid accumulation continues, the breathing space diminishes, causing shortness of breath, which is often the first symptom of pleural mesothelioma.