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AJKD QUIZ PAGEDECEMBER 2004

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53-year-old woman with end-stage renal failure of unknown cause, who had been treated with long-term peritonealialysis for 2 years, presented to her nephrologist because of a dry cough of 5 weeks’ duration. Other medical problemsncluded arterial hypertension, hyperlipidemia, and hyperparathyroidism, secondary to her chronic kidney disease. Sheas not taking angiotensin-converting enzyme inhibitors. On auscultation, her breathing sounds were normal. A chest

-ray was performed, followed by a computed tomographic (CT) scan of the chest.

What is your final diagnosis?

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Figure 34A. What does the chest x-ray show? Figure 34B. What does the CT scan show?

Figures 34C and D. After the CT scan, a surgical procedure was done. What do you see on light microscopy ofhe tissue taken during the procedure?

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Case presented by Daniel Agmon, MD, Meirohar, MD, and Geoffrey Boner, MD, Depart-ent of Nephrology, Sanz Medical Center,etanya, Israel.

merican Journal of Kidney Diseases, Vol 44, No 6 (December), 2

If you have an interesting case you wouldike to submit for consideration, please go tottp://ajkd.edmgr.com to do so.

© 2004 by the National Kidney Foundation, Inc.doi:10.1053/j.ajkd.2004.06.032

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