Pleural thickening

I am a 57 year-old woman who has been healthy and excercise regularly. (I run approximately 2 miles a day - 3 to 4 times a week.)  I recently had some tightness and discomfort in my chest and mentioned it to my doctor.  I thought that it was a reoccurance of costocondritus that I had many years ago.  My doctor ordered an x-ray and I received the results back stating that my "left lung has some pleural thickening."  It was suggested that I "have another x-ray in three months to see if it is a chronic issue."  I looked up this condition "on-line" and am very concerned and upset!  I have never been exposed to asbestos that I know of.  I am alarmed and wondering if I should just wait three months and see what a second x-ray shows or get a CT scan or some other diagnostic test done right away.  Also, I am wondering what else could cause this pleueral thickening.  (I had a chest cold when the x-ray was done.  Could that cause pleural thickening?)  Thank you.

[J.M. Keyes, MD]

Hi,

Pleural thickening is usually associated with asbestosis, but this sounds unlikely in you.  Other possible causes include tuberculosis, sarcoidosis, rheumatoid arthritis, benign and malignant tumors, injury to the pleura.
However, it is not uncommon to have a false diagnosis of pleural thickening on xray, when it is just fat outside the pleura.
I think if you are not having symptoms it is reasonable to wait and follow up, however Xray is not very reliable for a specific diagnosis of pleural thickening.  If it is still present on follow up, I would request a CT scan, and certainly if you are concerned or are having symptoms, it is reasonable to have a CT scan sooner for peace of mind.

Best of luck,
JMK MD