CLINICAL SIGNIFICANCE OF A HISTOPATHOLOGICAL EXAMINATION IN THE DIFFERENTIAL DIAGNOSIS OF DISSEMINATED PROCESSES IN LUNGS

Introduction. Disseminated processes in the lungs include more than two hundred diseases and syndromes, similar in clinical, radiological and laboratory manifestations, which is the main reason for the difficulty of differential diagnosis. In most cases, histopathological examination plays a key role in making the correct diagnosis. Aim is to analyze the current state of the problem of diagnosing disseminated processes in lungs exemplified by the experience of an anti-tuberculosis hospital and assess the algorithm for the differential diagnosis of pulmonary dissemination using histological methods. Materials and Methods. Histopathological findings (156 clinical cases) were obtained at Novosibirsk Tuberculosis Research Institute for the period of 2022-2023. The diagnostic material was biopsy tis- sue samples. Sections were stained with hematoxylin-eosin by the methods of Van Gieson or Weigert-Van Gieson, Ziehl-Neelsen, Grocott, and Perls. Results and Discussion. The study presents an analysis of cases of differential diagnosis of disseminated lung diseases of unknown etiology and provides the clinical examples of histopathological examination of biopsy material from hospital inpatients. Most often, in the presence of granulomatous processes, the preliminary diagnosis of pulmonary tuberculosis was confirmed. The second place in frequency was taken by chronic nonspecific pulmonary diseases (about ¼ of the total number of patients, which can be explained by their significant prevalence among the population). Chronic infections of fungal etiology were found in the samples, especially in immu- nosuppressed individuals. Conclusions. Diagnosis of disseminated processes in the lungs using analysis of histologi- cal material obtained through transbronchial lung biopsy, diagnostic thoracotomy, mediastinoscopy, or video-assisted thoracoscopy is the most accurate and allows the medical professional to quickly identify the nature of dissemination. The main morphological assessing algorithm includes the identification of inflammation and the subsequent clarification of the type of pathogen, using additional stains.