Unusual presentation of pulmonary edema in a hemodialysis patient

Despite the technical advances made during the last several years, chronic dialysis still is plagued by continuing problems. Intermittent volume overload is one of the most common. The radiologic evidence of pulmonary edema can be confusing in the end-stage renal disease population. The following case illustrates a hemodialysis patient with pulmonary edema whose initial chest x-ray appeared more consistent with metastatic malignancy.