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Hodgkin's Lymphoma Diagnosed from Peritoneal Effluent
Paul Viray1, Stella Setyapranata1, Stephen G Holt2
1The Royal Melbourne Hospital, Parkville, Victoria, Australia.
Summary
Cloudy peritoneal dialysis (PD) effluent typically indicates infection. However, this case highlights recurrent lymphoma as a rare, non-infective cause, diagnosed via cytological analysis of PD fluid.
Area of Science:
- Nephrology
- Oncology
- Pathology
Background:
- Peritoneal dialysis (PD) peritonitis commonly presents with neutrophil predominance in effluent fluid, often with identifiable bacterial pathogens.
- Culture-negative peritonitis is typically diagnosed when no organisms are found, but non-infective etiologies are infrequent.
Observation:
- A patient undergoing peritoneal dialysis presented with cloudy effluent fluid, a common sign of peritonitis.
Findings:
- Cytological examination of the peritoneal effluent revealed recurrent lymphoma as the cause of the cloudy fluid.
- This finding is unusual, as cloudy effluent in PD patients is overwhelmingly attributed to infectious peritonitis.
Implications:
- Highlights the importance of considering non-infective causes, such as malignancy, in patients with cloudy PD effluent, even when infection is suspected.
- Suggests that cytological analysis of peritoneal effluent can be a valuable diagnostic tool for identifying underlying conditions beyond infection.
- Underscores the need for a broad differential diagnosis in PD-related complications.
