TY - JOUR T1 - Histopathology and exercise: a winning combination in pulmonary fibrosis. Report of a case JF - Respiratory Care DO - 10.4187/respcare.02520 SP - respcare.02520 AU - Viviana Pisano AU - Salvatore Fuschillo AU - Giovanni Balzano Y1 - 2013/08/06 UR - http://rc.rcjournal.com/content/early/2013/08/06/respcare.02520.abstract N2 - 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. ER -