A diabetic haemodialysis patient with dysphagia and weight loss.

Introduction Tissue diagnosis is essential for differentiating between conditionsthat present with identical symptoms, e.g. malignancy and chronicinfections. Failure to obtain a tissue diagnosis has significanttherapeutic implications. We present a case of a patient withchronic renal failure on haemodialysis who presented with dysphagiaand weight loss and caused diagnostic difficulties that mayhave led to inappropriate treatment. Case A 61-year-old Asian male with type 2 diabetes mellitus, chronicrenal failure, and on haemodialysis presented in July 2001 witha 12-month history of weight loss and a 1-month history of dysphagia,mainly to solids and occasionally to liquids. He had commencedcontinuous ambulatory peritoneal dialysis in April 1998, buthad been transferred to haemodialysis in June 2000 because ofultrafiltration