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Challenges in pulmonary fibrosis · 5: The NSIP/UIP debate
  1. Roland du Bois1,
  2. Talmadge E King Jr2
  1. 1
    Interstitial Lung Disease Unit, Department of Occupational and Environmental Medicine, National Heart and Lung Institute, Imperial College of Science, Technology and Medicine, London, UK
  2. 2
    Department of Medicine, University of California, San Francisco, California, USA
  1. Professor Talmadge E King Jr, Department of Medicine, UCSF, 1001 Potrero Avenue, Room 5H22, San Francisco, California 94110, USA; tking{at}medsfgh.ucsf.edu

Abstract

Among the idiopathic interstitial pneumonias, the two entities—idiopathic pulmonary fibrosis (IPF) characterised by the presence of the usual interstitial pneumonia pattern of histopathology (IPF/UIP) and non-specific interstitial pneumonia (NSIP; same nomenclature for the histopathological pattern and idiopathic disease)—have provoked considerable debate. IPF/UIP and NSIP closely mimic each other clinically but NSIP has a far better outcome. However, it remains unclear if NSIP is a truly separate and distinct entity. The histopathological pattern of NSIP can be found in a wide variety of clinical and radiological contexts. This review addresses these and other uncertainties regarding NSIP and UIP.

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Footnotes

  • Competing interests: None.

  • Abbreviations:
    IIP
    idiopathic interstitial pneumonia
    IPF
    idiopathic pulmonary fibrosis
    NSIP
    non-specific interstitial pneumonia
    UIP
    usual interstitial pneumonia