Clinical and radiological classification of chronic pneumonia

In recent years, the Minsk (1964) and Tbilisi (1972) classifications of chronic pneumonia have been increasingly criticized. The classification of diseases of the bronchopulmonary system, proposed by IV Putov and GB Fedoseev (1978), is distinguished by its harmony, but a number of its provisions require discussion and addition. First of all, this concerns the classification of chronic pneumonia (N. V. Putov, V. N. Saperov, G. B. Fedoseev). There is no doubt about the need for a clear distinction between chronic bronchitis and chronic pneumonia, but the isolation of bronchiectasis in an independent form is objectionable, since the concept of chronic pneumonia is sharply narrowed, as a result of which its number among COPD decreases to 8.8-9.5% [ 4]. To differentiate such pneumonia from bronchiectasis, bronchography becomes mandatory, which is not available to many practical institutions and is contraindicated in some patients. Moreover, it often does not provide reliable criteria for diagnosis. If bronchiectasis is isolated in an independent form, then the diagnosis will be absorbed by most of the other inflammatory diseases of the bronchopulmonary system, just as, according to the authors, they were “absorbed by the comprehensive diagnosis of chronic pneumonia”. The diagnosis of bronchiectasis will be made in case of any lung disease accompanied by the discharge of purulent sputum, especially if cellular shadows are visible on the plain radiograph, which are a reflection of sclerosis, but are often mistaken for bronchiectasis, although the diagnosis of the latter without bronchography is inappropriate.