PT  - JOURNAL ARTICLE
AU  - Viviana Pisano
AU  - Salvatore Fuschillo
AU  - Giovanni Balzano
TI  - Histopathology and exercise: a winning combination in pulmonary fibrosis. Report of a case
AID  - 10.4187/respcare.02520
DP  - 2013 Aug 06
TA  - Respiratory Care
PG  - respcare.02520
4099  - http://rc.rcjournal.com/content/early/2013/08/06/respcare.02520.short
4100  - http://rc.rcjournal.com/content/early/2013/08/06/respcare.02520.full
AB  - Diffuse parenchymal lung diseases (DPLDs) are a heterogeneous group of disorders characterized by varying degrees of inflammation and fibrosis involving the space between epithelial and endothelial basement membranes. Among DPLDs of unknown aetiology one of the most commonly encountered is usual interstitial pneumonia/idiopathic pulmonary fibrosis (UIP/IPF), which carries the worst prognosis. In contrast, nonspecific interstitial pneumonia (NSIP), which belongs to the same DPLD group, has a more favourable prognosis. Based on the relative amount of inflammation and fibrosis observed on lung biopsies, at least two NSIP patterns have been suggested, namely cellular and fibrosing patterns. The long-term prognosis is excellent for patients with NSIP with a cellular pattern, as compared to patients with a fibrosing pattern. We describe here a case of NSIP with a fibrosing pattern in a highly practiced runner showing an unexpectedly long-term favourable course, and consider the possible role of exercise in the diagnosis and clinical course of the disease. The case that we describe reinforces the evidence that exercise training, that is a principal component of a pulmonary rehabilitation program, may have clinically significant effects on functional exercise capacity, especially if it is delivered early in the course of the disease.