A diagnosis of pleural fibrosis and/or pulmonary fibrosis can be made by carrying out one or more of the following:-
- Lung function tests
Diagnosing Pleural fibrosis
Generally pleural fibrosis is frequently diagnosed by accident or chance when a chest x-ray is performed.
Patients with severe pleural fibrosis tend to seek medical attention as they develop difficulty breathing. A doctor can diagnose the condition by undertaking a chest x-ray, a biopsy of the suspicious tissue and listening to the lungs.
Biopsies are often recommended even in mild cases to confirm that the fibrosis is benign rather than cancerous as the treatment for cancer is quite different in approach to that of pleural fibrosis.
It is often possible to see pleural calcification associated with pleural fibrosis. In pleural calcification small white plaques appear on the pleural membrane and can be an indicator of asbestos exposure.
X-ray showing pleural fibrosis
Diagnosing Pulmonary fibrosis
Pulmonary fibrosis is suggested by a progressive shortness of breath with exertion. Sometimes during examination when a Doctor uses a stethoscope they can hear crackling sounds in the chest caused by the pulmonary fibrosis. These crackles have very characteristic sounds.
A chest x-ray will then be undertaken which may include a CT scan which will provide a cross sectional picture of the lungs in a very detailed resolution.
Lung function testing can also assist in the diagnosis pulmonary fibrosis. The volumes of the lungs may be reduced as may the airflow in and out and a characteristic finding is a reduction in diffusing capacity. The diffusing capacity is the measure of the ability of the lungs to exchange gases (oxygen and carbon dioxide) into and out of the blood stream.
A diagnosis may also be confirmed by a lung biopsy. The most common type of biopsy is a video assisted thoracoscope which involves placing a small tube into the chest cavity through which biopsy samples can be obtained. Often if there is a clear indication from the other non invasive tests such as x-rays and lung function testing a biopsy will often not be necessary.