[Diffuse lung disease--advances in patient management]

Diffuse lung diseases (DLD), known as interstitial lung diseases or diffuse parenchymal lung diseases, are a large group of disorders of diverse etiology and causes, however, sharing similar clinical, radiological and pathophysiological characteristics. In the last fifteen years, DLD have attracted considerable interest of medical society. During that period, a consensus of the British Thoracic Society on the Diffuse Parenchymal Lung Disease and Statement of the American Thoracic Society (ATS) and European Respiratory Society (ERS) on idiopathic pulmonary fibrosis, idiopathic interstitial pneumonias and sarcoidosis have helped precisely define certain phenotypes. The newly developed technique of high resolution computed tomography, which can show finest details of lung parenchyma, has also helped precisely define diverse entities, which have aroused interest among molecular biologists and genetic researchers with a goal to define the etiology, pathogenesis and progression of these diseases. The renaissance of interest in this scientific field has also stimulated pharmaceutical industry to enhance its activity, which has resulted in intensified research of potentially new drugs, especially for fibrotic lung processes such as idiopathic pulmonary fibrosis. The disease outcome is very difficult to estimate in these, most often chronic diseases; however, it is very important to achieve the best possible if not the same quality of life as before the disease onset. Different questionnaires have been used and the results were not always as expected; for instance, worsened lung function tests were not most important in defining the quality of life. These vivacious activities have stimulated us to present to the patient and diligent reader recent advances in the management of DLD patient; the article is mostly dedicated to recent advances made in diagnostic procedures, hoping for a comparable success to be achieved in therapeutic approach.