PMC9841051_01
Clinical photographs of the case.. (A) Multiple whitish plaques on the tongue. (B, C) Mild clubbing and nail dystrophy including longitudinal ridging, loss of nail (closed arrow), and koilonychias.
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PMC9841051_01_gr1.jpg
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He had mild whitish plaque on the tongue, and mild dystrophy was observed on his finger and toe nails which had not been recognized by himself (Fig. 1).
Radiologic findings of the case.. (A, B, C) Chest X-ray and CT showed diffuse reticular opacity in subpleural area of both lungs without honeycombing.
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Pathologic findings of the case.. (A, B) Low power field image (magnification x 10) shows peripheral dominant fibrosis and high power field image (magnification x 100) shows focal centrilobular fibrosis. (haematoxylin and eosin stain (HE) stain, (C) In the periphery of lung, old mature fibrosis (closed arrow) and fibroblastic foci (open arrow) coexist suggesting temporal heterogeneity of fibrosis (HE stain, magnification x 100) (D) At the respiratory bronchiole level, cellular infiltration (closed arrow) and fibroblastic proliferation (open arrow) show centrilobular subacute lung injury. (HE stain, magnification x 100).
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Pathologic findings showed patchy, subpleural fibrosis and centrilobular cellular infiltration with fibroblastic foci, suggesting fibrotic HP (Fig. 3).