Diseases that manifest as Х-ray syndrome of pulmonary dissemination are one of the most complex differential diagnostic problems in pulmonology and Phthisiology. Literature data on the effectiveness of using a new intradermal test with tuberculosis recombinant allergen (ATR, Diaskintest®) for disseminated processes in the lungs are single and contradictory.The aim. Тo study the diagnostic capabilities of intradermal test with tuberculosis recombinant allergen in disseminated lung processes of various etiologies.Methods. The analysis of archival materials of 204 patients with disseminated lung processes of various etiologies who were admitted to diagnostic departments of the N.S.Pokhvisneva Voronezh regional anti-tuberculosis dispensary in 2011 – 2019 was carried out. There were 85 (41.67%) women and 119 (58.33%) men aged 19 to 87 years. The data of im mu no - logical examination of patients using intradermal Mantoux samples with 2 TE PPD-L and with ATR were studied, and their comparative analysis was performed.Results. In disseminated pulmonary processes in tuberculosis, the proportion of individuals who respond positively to the Mantoux test was greater only in comparison with the group of people with sarcoidosis (p < 0.01) and did not significantly differ from the results in other groups of patients (p > 0.05). At the same time, the proportion of people who respond positively to a test with ATR in tuberculosis was greater than in patients with pneumonia, sarcoidosis (p < 0.01) and, to some extent, with a tumor. In healthy individuals, a lower proportion of positive reactions to ATR was established compared to the Mantoux test (p < 0.01). With active disseminated pulmonary tuberculosis, a hyperergic reaction (11.9%) was observed in the sample with ATR, which was not observed with the Mantoux test. In non-specific processes in the lungs, less often than negative reactions (p < 0.05) were detected on the sample with ATR less often than on the Mantoux test with 2 TE.Conclusion. The ATR sample compared to the Mantoux test indicates that it is appropriate to use it in the differential diagnosis of tuberculosis and non-specific lung diseases in adult patients with radiological dissemination syndrome.