The article presents a clinical case of a patient with pneumoconiosis complicated by the formation of a "cellular lung" on the background of long-term (2023–2026) therapy with nintedanibin combination with bronchodilators. The patient, was born in 1960, had 20 years of experience working under the influence of quartz-containing dust. The diagnosis of pneumoconiosis was established in 2002.

During an examination in 2023, against the background of radiological signs of progressive fibrosis with the formation of a "cellular" lung, there was shortness of breath when walking up to 50 m, a decrease in saturation at rest to 93% with desaturation under load to 70%, a test distance of 270 m after a 6-minute walk, a decrease in FEV1 to 66%, VVC to 82%, lung diffusivity up to 26%, pulmonary hypertension (CDLA 38 mmHg), signs of respiratory failure of the 3rd degree. Against the background of regular therapy with syntedanib, the authors noted positive dynamics: stabilization of saturation at rest (95–97%), decrease in desaturation during physical exertion (up to 90%), increase in the test distance of a 6-minute walk to 365–384 m, increase in FEV1 to 89-99%, VVC to 111%, total vital lung capacity from 76% up to 97%, diffusion capacity up to 34%, reduction of the average pressure in the pulmonary artery to 7–8 mmHg, normalization of ESR and C-reactive protein. According to computed tomography data, the fibrotic process has stabilized with the preservation of the "cellular lung" pattern without a significant increase in changes over 4 years. The side effects of therapy (weight loss, loosening of stools, moderate increase in transaminases) were controlled.

The observation demonstrates the possibility of achieving clinical and functional stabilization in a patient with progressive pneumoconiosis on the background of prolonged antifibrotic therapy, which justifies the expediency of early treatment and regular monitoring.