Can localized pleural thickening become cancerous?

Localized pleural thickening generally does not undergo malignant transformation. Pleural thickening is relatively common and typically refers to fibrosis resulting from fibrin deposition and granulation tissue proliferation secondary to pleural disease, leading to increased pleural thickness. It often represents the residual effect following resolution of exudative pleuritis or pleural effusion.

Pleural thickening may be classified as either localized or diffuse. Diffuse visceral pleural thickening can impair pulmonary respiratory function, whereas diffuse parietal pleural thickening may narrow the intercostal spaces. Common etiologies include pneumothorax, hemothorax, trauma, mesothelioma, tuberculous pleuritis, and purulent pleuritis.

Most cases of pleural thickening do not require specific treatment. Mild symptoms such as chest tightness often gradually improve or resolve through physiological compensation. Regular physical exercise—including chest-expanding movements and deep breathing—is recommended. In cases of extensive pleural thickening, surgical intervention may be considered when clinically indicated.