• Ryota Otoshi, Tomohisa Baba, Ryota Shintani, Hideya Kitamura, Yukie Yamaguchi, Haruka Hamanoue, Takeshi Mizuguchi, Naomichi Matsumoto, Koji Okudela, Tamiko Takemura, and Takashi Ogura.
• Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Japan.
• Intern. Med. 2021 Apr 15; 60 (8): 1257-1263.

AbstractA 42-year-old man with a history of surgery for tongue cancer was referred to our hospital due to an abnormal chest shadow. High-resolution computed tomography showed lower lobe reticulation. A physical examination revealed nail dystrophy, oral leukoplakia, and reticulated hypopigmentation. Lung biopsy revealed subpleural and perilobular fibrosis, suggestive of usual interstitial pneumonia. However, multiple pathological findings, including homogenous fibrosis and cell infiltration in the centrilobular region, which were compatible with nonspecific interstitial pneumonia, and bronchiolitis were also seen. Genetic testing showed a hemizygous missense mutation in the DKC1 gene, and the patient was diagnosed with dyskeratosis congenita. Although anti-fibrotic therapy was initiated, the patient's respiratory function has continued to decrease.

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