Visceral Pleura
Two layers of membrane line the interior of the lungs. The outer layer of the lungs is the parietal
pleura and is attached to the chest wall. The
visceral pleura is the inner of the two layers, and unlike the parietal pleura, the visceral pleura is not sensitive to pain. There is a small space between the two layers called the pleural cavity or pleural space. Both pleural layers are made of the same kind of mesothelial cells that line the rest of the chest cavity. Mesothelial cells together form a tissue called
mesothelium that in turn makes a fluid that lubricates the internal organs making it easier for the lungs to expand in the chest, and which fills the pleural space and helps hold the lungs close to the chest wall allowing for better respiration. Normally this only requires a very small amount of plural fluid. When the fluid accumulates in the pleural space it is a condition call
pleural effusion and the cause must be determined. The fluid is drawn out of the body for testing with a needle in a procedure called
thoracentesis (1).
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In tests the visceral pleura has been shown to react to the presence of
asbestos fibers even if the fibers never make direct contact with the tissue (2). About 20% of people who are
exposed to large amounts of asbestos develop visceral pleural fibrosis (3). In everyday language pleural fibrosis is thickening of the visceral pleura. The thickening can be minor, or can develop into a thick casing of the lungs that can interfere with the lungs' ability to expand on inhalation. It also appears that people with pleural fibrosis have an enhanced likelihood of also getting
asbestosis, which is a thickening of the lung tissue itself, but even among people who work with asbestos, asbestosis is relatively rare (4).