Pulmonary oedema – renal failure

This 40-year-old patient has a form of non-cardiogenic pulmonary oedema – note the normal heart size and the interstitial (Kerley B) lines at the lung bases, better seen on the magnified image (arrows). Causes of non-cardiogenic pulmonary oedema include fluid overload, chronic renal failure with uraemia (as was the case in this example – note the dual-lumen dialysis catheter), aspiration, inhalation injury, head injury and ARDS. Remember also that another diagnosis to consider when you see pulmonary oedema with a normal size heart is an acute MI, causing acute heart failure.