ABSTRACT
The pleural space exists between two layers of mesothelium that envelop the chest wall (parietal pleura) and lung (visceral pleura) (Figure 43.1). Normally this space contains an extremely thin layer of serous fluid that provides for lubrication and hydrostatic coupling between the visceral and parietal surfaces. Due to its contiguous nature, the pleural space allows malignancies involving pleural tissues the ability to rapidly spread to cover the entire surface of the chest wall, lung, mediastinum, and pericardium. The large surface area and the close proximity of the pleura to physiologically critical structures make cancers that involve the pleura among the most lethal and difficult-to-treat malignancies with which a clinician is faced.
