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Diagnostics
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Precise Diagnosis, Classification, and Monitoring of Pulmonary Diseases
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Precise Diagnosis, Classification, and Monitoring of Pulmonary Diseases

A Special Issue of Diagnostics (ISSN 2075-4418) belonging to the section "Clinical Diagnosis and Prognosis".

Deadline for manuscript submissions: 28 February 2027 | Viewed by 4669

Editors

Dr. Barbara Ruaro

E-Mail Website
Guest Editor
Pulmonology Unit, Department of Medical Surgical and Health Sciences, Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
Interests: autoimmune disorders; interstitial lung disease; nailfoldd capillaroscopy; sarcoidosis
Special Issues, Collections and Topics in MDPI journals
Dr. Paola Confalonieri

E-Mail Website
Guest Editor
Pulmonology Unit, Department of Medical Surgical and Health Sciences, Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
Interests: pulmonary medicine; connective tissue diseases; rheumatic diseases; interstitial lung disease; nonspecific interstitial pneumonia; cell culture
Special Issues, Collections and Topics in MDPI journals
Dr. Francesco Salton

E-Mail Website
Guest Editor
Pulmonology Unit, Department of Medical Surgical and Health Sciences, Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
Interests: non-invasive ventilation (NIV); COVID-19 disease; lung cancer; acute respiratory distress syndrome (ARDS); idiopathic pulmonary fibrosis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In this Special Issue (SI), we invite contributions that explore the evolving landscape and emerging perspectives within the field of lung diseases. Our focus is on the dynamic processes of change and innovation, highlighting the latest advancements, as well as the evolving methodologies and research responses shaping this discipline. This SI aims to inform, inspire, and guide researchers by showcasing groundbreaking developments and fostering new directions in lung disease research.

We welcome manuscripts addressing, but not limited to, the following themes:

  • Innovative imaging techniques that enhance diagnosis and inform treatment strategies;
  • Recent approaches to uncovering causal biological pathways and identifying clinically relevant biomarkers in respiratory diseases.

Recent progress in lung disease research has been remarkable, particularly over the past year, driven by significant achievements from researchers and scientists worldwide. The heightened interest in pulmonary health, amplified by the COVID-19 pandemic, underscores our limited understanding of the triggers and natural history of various lung conditions and emphasizes the need for continued inquiry.

To further explore this rapidly expanding field, this journal is proud to launch this Special Issue dedicated to the evolution of methods, processes, techniques, and conceptual frameworks that are leading to new discoveries and innovative research approaches in lung disease studies.

Dr. Barbara Ruaro
Dr. Paola Confalonieri
Dr. Francesco Salton
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • lung diseases
  • pulmonary diseases
  • imaging techniques
  • causal biological pathways
  • clinical biomarkers

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (4 papers)

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Research

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13 pages, 660 KB  
Article
Nailfold Capillaroscopy Patterns Are Associated with Impairment of DLCO in Very Early Diagnosis of Systemic Sclerosis: Insights of a Pulmonary-Vascular Interplay
by Eugenio Capparelli, Barbara Ruaro, Eleonora Zaccara, Marco Vicenzi, Greta Pellegrino, Daniela Bompane, Laura Castelnovo, Antonio Tamburello, Elisabetta Ricchiuti, Paolo Carlucci, Daniele Colombo, Giorgio Bonardi, Maria Sole Chimenti, Antonino Mazzone and Paola Maria Luigia Faggioli
Diagnostics 2026, 16(17), 2780; https://doi.org/10.3390/diagnostics16172780 - 29 Aug 2026
Viewed by 270
Abstract
Background/Objectives: Data regarding the association between diffusing lung capacity for carbon monoxide (DLCO) and nail-fold Videocapillaroscopy (NVC) patterns are sparse in Very Early Diagnosis of Systemic Sclerosis (SSc; VEDOSS). The aim of this study was to detect differences in VEDOSS patients exhibiting [...] Read more.
Background/Objectives: Data regarding the association between diffusing lung capacity for carbon monoxide (DLCO) and nail-fold Videocapillaroscopy (NVC) patterns are sparse in Very Early Diagnosis of Systemic Sclerosis (SSc; VEDOSS). The aim of this study was to detect differences in VEDOSS patients exhibiting reduced versus normal values of DLCO/single-breath (SB)% predicted (with a cut-off of 80%). Methods: A cross-sectional study was conducted in 65 VEDOSS patients, enrolled due to their fulfillment of the 2021 criteria, while not meeting the 2013 ACR/EULAR Criteria. Pulmonary function tests and NVC evaluations were conducted from January to March 2026. Univariate tests were used for intergroup analysis. Logistic and linear regression models were employed to identify predictors of DLCO/SB < 80% and DLCO/SB% values, respectively. p-values < 0.05 were considered statistically significant. Results: Forty-two (64.6%) patients reported preserved DLCO/SB% and twenty-three (35.4%) exhibited reduced DLCO/SB%. Patients with only ANA positivity were more prevalent in the DLCO-preserved group (p = 0.026), while SSc-specific autoantibodies were more frequently present in the DLCO < 80% group (p = 0.028), as well as gastrointestinal symptoms (p = 0.039). The late pattern was identified exclusively in the DLCO < 80% group (p = 0.013), while patients with advanced NVC abnormalities (namely, the active/late pattern) reported lower values of DLCO/SB%. A logistic regression model confirmed a trend toward significance in predicting reduced DLCO for the active/late pattern, while the latter was negatively associated with the unitary increase in DLCO/SB% values (standardized β= −0.38, p = 0.008) in linear regression analysis. Conclusions: Reduced DLCO/SB (<80%) is associated with an active/late pattern on NVC in VEDOSS. Full article
(This article belongs to the Special Issue Precise Diagnosis, Classification, and Monitoring of Pulmonary Diseases)
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11 pages, 546 KB  
Article
Diagnostic Yield and Safety of Radial Probe Endobronchial Ultrasound-Guided Transbronchial Lung Cryobiopsy with a Guide Sheath in Pulmonary Lesions < 3 cm
by Taehun Kim, Yujin Lee, Jung Hee Hong, Seong Hwan Youn, Hyun Jung Kim, Jae Seok Park and Sun Hyo Park
Diagnostics 2026, 16(12), 1912; https://doi.org/10.3390/diagnostics16121912 - 19 Jun 2026
Cited by 1 | Viewed by 534
Abstract
Background/Objectives: Accurate tissue diagnosis of small pulmonary nodules remains technically challenging with conventional bronchoscopic techniques. Radial probe endobronchial ultrasound-guided transbronchial lung cryobiopsy (RP-EBUS–guided TBLC) with a guide sheath (GS) may improve diagnostic yield; however, target instability during cryobiopsy remains a limitation. We [...] Read more.
Background/Objectives: Accurate tissue diagnosis of small pulmonary nodules remains technically challenging with conventional bronchoscopic techniques. Radial probe endobronchial ultrasound-guided transbronchial lung cryobiopsy (RP-EBUS–guided TBLC) with a guide sheath (GS) may improve diagnostic yield; however, target instability during cryobiopsy remains a limitation. We aimed to evaluate the diagnostic yield of RP-EBUS-guided TBLC with a GS for pulmonary nodules < 3 cm that were suspected of malignancy. Methods: This retrospective observational study included patients who underwent RP-EBUS-guided TBLC with a GS for lung lesions suspected of malignancy on computed tomography between 1 February 2024 and 31 December 2025 in South Korea. After the target lesion was identified, the bronchoscope was inserted and fixed within the segment; its position was maintained while RP-EBUS was withdrawn, and lesion stability during respiration was confirmed. Results: A total of 99 patients were included in the final analysis. After patients with an indeterminate diagnosis were excluded, the final diagnostic yield was 83.2%. The sensitivity and specificity were 78.9% and 100.0%, respectively. Pneumothorax occurred in 6.0% (6/99) of patients. Bleeding of grade 3 or higher was observed in two patients, and a Fogarty balloon catheter was preemptively used in five patients at the operator’s discretion. In multivariable logistic regression analysis, the computed tomography bronchus sign was identified as the only significant factor associated with pathological confirmation (odds ratio, 6.090; p = 0.005). Conclusions: RP-EBUS-guided TBLC with a GS provided an acceptable diagnostic yield and safety profile, even in small pulmonary nodules < 3 cm. Full article
(This article belongs to the Special Issue Precise Diagnosis, Classification, and Monitoring of Pulmonary Diseases)
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Review

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21 pages, 869 KB  
Review
Tracing Microplastics in the Human Body: From Detection to Disease Mechanisms
by Stefana Anastasia Talau, Mihaela Chialda, Cristian Ichim, Horatiu Dura and Ciprian Tanasescu
Diagnostics 2025, 15(23), 2971; https://doi.org/10.3390/diagnostics15232971 - 23 Nov 2025
Cited by 2 | Viewed by 2924
Abstract
Microplastics (MPs), defined as plastic particles < 5 mm diameter, have become a growing public health concern. First identified in the aquatic environment in 2004 and later in air samples in 2015, airborne MPs display wide variations in shape and size, with fibres [...] Read more.
Microplastics (MPs), defined as plastic particles < 5 mm diameter, have become a growing public health concern. First identified in the aquatic environment in 2004 and later in air samples in 2015, airborne MPs display wide variations in shape and size, with fibres being the most common. These physical characteristics, together with others such as median aerodynamic diameter, influence how deeply they penetrate and where they deposit within the respiratory tract. Recent studies have confirmed the presence of MPs in nasal lavage fluid, bronchoalveolar lavage fluid, sputum, pleural fluid and lung tissue samples, with higher concentrations observed in older individuals, smokers and those with occupational exposure. Multiple polymer types have been identified, most frequently polypropylene, polyethylene and polyester. Experimental models demonstrate that MPs can induce inflammation, oxidative stress, mitochondrial dysfunction, microbiota alterations, fibrosis and carcinogenic changes, with toxicity generally increasing as particle size decreases. Despite the growing evidence of plastic toxicity, only a limited number of studies have examined MPs’ influence on the respiratory system, focusing mostly on polyester spheres, rather than fibres, which dominate real-world exposure. Current findings suggest MPs contribute to several pathophysiological processes and may play a role in respiratory disease. However, further research is needed to clarify the underlying mechanisms, long-term consequences and clinical relevance of these emerging pollutants. Full article
(This article belongs to the Special Issue Precise Diagnosis, Classification, and Monitoring of Pulmonary Diseases)
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Other

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20 pages, 26469 KB  
Case Report
Not So Crystal Clear: Pulmonary Crystal-Storing Histiocytosis Without Haematological Disease: A Unique Radiological Manifestation and Review of the Literature
by Dzufar Halim, Erinn McGrath, Dimitrios Ampazis, Janusz Krawczyk, Ramadan Shatwan and Anthony O’Regan
Diagnostics 2026, 16(15), 2410; https://doi.org/10.3390/diagnostics16152410 - 31 Jul 2026
Viewed by 378
Abstract
Background and Clinical Significance: Pulmonary crystal-storing histiocytosis (CSH) without an associated haematological malignancy, lymphoproliferative disorder, plasma cell disorder, or other identifiable underlying condition is exceptionally rare. Long-term radiological data from published cases remain limited, and this case, contextualised by a narrative review of [...] Read more.
Background and Clinical Significance: Pulmonary crystal-storing histiocytosis (CSH) without an associated haematological malignancy, lymphoproliferative disorder, plasma cell disorder, or other identifiable underlying condition is exceptionally rare. Long-term radiological data from published cases remain limited, and this case, contextualised by a narrative review of the literature, may expand the recognised imaging spectrum of localised pulmonary CSH. Case Presentation: We report the case of a 59-year-old man with incidental multiple pulmonary lesions identified on CT thorax imaging. The lesions demonstrated an unusual combination of cystic change, cavitation, and surrounding ground-glass opacities. His medical history was significant for bipolar disorder treated with lithium and a 50-pack-year smoking history. Interval imaging showed progression, prompting further investigation and ultimately right upper lobectomy. Histopathological analysis confirmed pulmonary CSH; lesional cells contained crystalloid material and showed CD68 and PAS positivity, with dual kappa and lambda expression on immunohistochemistry. Markers for other differential diagnoses, including Congo red, birefringence, Langerin, and CD1a were negative. Following diagnosis and resection, serial imaging demonstrated fluctuating yet slowly progressive pulmonary abnormalities. No lymphoproliferative or plasma cell disorder has emerged after more than seven years of post-diagnostic surveillance and more than ten years since the initial imaging abnormality. Conclusions: This case demonstrates that the radiological spectrum of localised pulmonary CSH may include cystic, cavitary and ground-glass abnormalities, with subsequent fluctuating yet slowly progressive post-resection evolution. Pulmonary CSH should be considered in the differential diagnosis of unexplained or atypical pulmonary nodules, particularly when histiocyte-rich pathology with intracytoplasmic crystalloid material is identified. Long-term multidisciplinary surveillance is warranted. Full article
(This article belongs to the Special Issue Precise Diagnosis, Classification, and Monitoring of Pulmonary Diseases)
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