General information

Pulmonary Diseases and the Specialty of Pulmonology

Pulmonary diseases rank first in terms of morbidity and are one of the leading causes of death in humans. They encompass a large portion of internal medicine. The WHO (World Health Organization) forecasts a rise in the incidence of pulmonary diseases over time, with these conditions expected to become an increasingly serious medical, social, and economic problem.

Pulmonary diseases are diverse with regard to localization, etiology, development of disease, clinical characteristics, diagnostics and diagnostic criteria, course, and treatment. They are localized in the trachea, bronchi, pulmonary lung tissue, pleura, pulmonary vessels, and mediastinum (which contains the thymus, trachea, esophagus, heart, pericardium, aorta, aortic and arterial branches, veins, lymph nodes and vessels, loose connective tissue, and more).

Of particularly high prevalence and growing social significance are chronic obstructive pulmonary disease, asthma, tuberculosis, respiratory infections of various etiologies, and malignant diseases of the lungs. With advances in medicine and diagnostic capabilities in the investigation of pulmonary diseases, the incidence of congenital pulmonary diseases, pulmonary manifestations of systemic diseases, genetic, rare, and other pulmonary conditions is also increasing.

From an etiological standpoint, pulmonary diseases are divided into:

• Pulmonary diseases caused by infectious agents (viruses, bacteria, parasites, molds, etc.)
• Pulmonary diseases caused by external factors (in the occupational and ambient environment — inorganic and organic dusts, vapors and gases of various chemical compositions, powdered chemical substances, allergens of various origins, etc.) — occupational pulmonary diseases and environmental pulmonary diseases
• Malignant pulmonary diseases localized in the trachea, bronchi, lungs, pleura, and mediastinal structures, lymph nodes, pleural layers, etc.
• Secondary metastases from malignant tumors with bronchopulmonary localization or tumors of other organs and systems
• Pulmonary involvement in systemic autoimmune diseases (rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, etc.)
• Pulmonary involvement and lymph node involvement in sarcoidosis, Hodgkin's disease, non-Hodgkin's lymphomas, etc.
• Congenital pulmonary diseases
• Pulmonary diseases of unknown etiology
• Rare pulmonary diseases

Pulmonary diseases, classified by localization, causes and development, structural changes in tissues, and clinical characteristics, are divided into:

• Diseases of the airways
• Diffuse interstitial pulmonary diseases
• Diseases of the pleura
• Non-tuberculous respiratory infections
• Tuberculosis
• Thoracic tumors
• Pulmonary vascular diseases
• Respiratory failure
• Diseases of the chest wall, respiratory muscles, and diaphragm
• Mediastinal diseases (excluding tumors)
• Pulmonary manifestations of systemic/extrapulmonary diseases
• Hereditary diseases and developmental disorders
• Treatment-related diseases
• Allergic diseases (IgE-mediated)
• Eosinophilic diseases
• Sleep-related disorders
• Immunodeficiency conditions
• Occupational and environmentally caused pulmonary diseases
• Rare pulmonary diseases

Due to their specific nature, pulmonary diseases and tuberculosis — as a branch of internal medicine — have a defined and specialized scope of practice and are managed by specialist pulmonologists holding the qualification of Pneumology and Tuberculosis Treatment.