scholarly journals DIFFUSE XANTHOGRANULOMATOUS PYELONEPHRITIS OCCURRING IN A NON-FUNCTIONAL KIDNEY - A REPORT OF TWO CASES

2012 ◽  
Vol 02 (02) ◽  
pp. 54-56
Author(s):  
Harish S. Permi ◽  
Rajeev T. P. ◽  
Prajwal Ravinder ◽  
Sajitha N. ◽  
Panna Hegde
Keyword(s):  
Urinary Tract Obstruction ◽  
Renal Calculus ◽  
Xanthogranulomatous Pyelonephritis ◽  
Renal Neoplasm ◽  
Radiographic Appearance ◽  
Formidable Challenge ◽  
Adjacent Structures ◽  
Immunocompromised State ◽  
Foamy Macrophages ◽  
Functioning Kidney

AbstractXanthogranulomatous pyelonephritis is a rare debilitating illness resulting in focal or diffuse renal destruction. It is characterized pathologically by lipid-laden foamy macrophages which share many characteristics with true renal neoplasm in terms of its radiographic appearance and ability to involve adjacent structures or organs. It affects non-functioning kidney and is often associated with urinary tract obstruction, infection, nephrolithiasis, diabetes, and immunocompromised state. The treatment is almost universally extirpative and can pose a formidable challenge to the surgeon. We report two cases of diffuse Xanthogranulomatous pyelonephritis occurring in a non-functioning kidney of 38 year old diabetic male and 51 year old male with renal calculus.

scholarly journals A rare case of squamous cell carcinoma with xanthogranulomatous pyelonephritis in a patient with chronic obstructive renal calculi

2017 ◽  
Vol 4 (4) ◽  
pp. 1501 ◽  
Author(s):  
Varun Gautam P. ◽  
Manjusha M. Litake
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Xanthogranulomatous Pyelonephritis ◽  
Chronic Obstructive ◽  
Inflammatory Disorder ◽  
Predisposing Factor ◽  
Radiographic Appearance ◽  
Adjacent Structures ◽  
The Right

Squamous cell carcinoma (SCC) of the kidney is a rare entity. Often it is confused with Xanthogranulomatous Pyelonephritis (XGP), which is a chronic inflammatory disorder of the kidney, associated with the destruction of the renal parenchyma usually in the setting of an infectious process.  A 76 year old male presented with right flank pain and vomiting. On examination, was found to have tenderness with localized guarding in the right flank. Investigations revealed a mass arising from the lower pole of the right kidney which was hydronephrotic and had features suggestive of stage III xanthogranulomatous pyelonephritis (XGP) with pyonephrosis and the presence of multiple calculi. Patient initially underwent a drainage of the pyonephrosis and subsequent nephrectomy.  Histopathology revealed the presence of both XGP and SCC in the resected kidney specimen. Chronic nephrolithiasis is a predisposing factor for both XGP and SCC. XGP shares many characteristics with SCC in terms of both its radiographic appearance and its ability to involve the adjacent structures. Chronic nephrolithiasis is a predisposing factor for both XGP and SCC. XGP shares many characteristics with SCC in terms of both its radiographic appearance and its ability to involve the adjacent structures.

scholarly journals Focal Xanthogranulomatous Pyelonephritis in Brachydactyly Mental Retardation Syndrome (2q37 Deletion Syndrome)

2019 ◽  
Vol 09 (02) ◽  
pp. 114-116
Author(s):  
Esra Nagehan Akyol Onder ◽  
Mine Ozkol ◽  
Nalan Nese ◽  
Can Taneli ◽  
Osman Orkun Cankorur ◽  
...  
Keyword(s):  
Mental Retardation ◽  
Renal Fibrosis ◽  
Granulomatous Inflammation ◽  
Rare Condition ◽  
Renal Parenchyma ◽  
Xanthogranulomatous Pyelonephritis ◽  
Deletion Syndrome ◽  
Inflammatory Infiltration ◽  
Small Deletion ◽  
Foamy Macrophages

AbstractXanthogranulomatous pyelonephritis (XGP) is characterized by destruction of the renal parenchyma and granulomatous inflammation with lipid-laden foamy macrophages as well as inflammatory infiltration and intensive renal fibrosis. It generally occurs in adults, especially those in the fifth and sixth decades of life, but is occasionally seen in children as well. Brachydactyly mental retardation (BDMR) syndrome (OMIM 600430) is caused by a small deletion of chromosome 2q37 and is a rare condition, with roughly 100 cases reported worldwide. Here, we describe the case of a patient with deletion of chromosome 2q37, which is known as the BDMR syndrome, and XGP.

scholarly journals Xanthogranulomatous Pyelonephritis Associated with Hepatic Dysfunction in Pregnancy

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
L. Ferreira ◽  
C. Oliveira ◽  
C. Cruz ◽  
A. Pacheco
Keyword(s):  
Pregnant Woman ◽  
Rare Disease ◽  
Hepatic Dysfunction ◽  
Rare Event ◽  
Renal Parenchyma ◽  
Xanthogranulomatous Pyelonephritis ◽  
Normal Renal Parenchyma ◽  
Foamy Macrophages ◽  
In Pregnancy ◽  
Total Nephrectomy

Xanthogranulomatous pyelonephritis is a rare disease characterised by the replacement of normal renal parenchyma by foamy macrophages. The only treatment for this type of pyelonephritis is of a surgical nature with partial or total nephrectomy. The occurrence of xanthogranulomatous pyelonephritis during pregnancy is a rare event (with only 6 cases described in the literature). We report a case of xanthogranulomatous pyelonephritis in a 32-week pregnant woman associated with hepatic dysfunction.

Xanthogranulomatous Pyelonephritis

2011 ◽  
Vol 135 (5) ◽  
pp. 671-674 ◽  
Author(s):  
Li Li ◽  
Anil V. Parwani
Keyword(s):  
Renal Cell Carcinoma ◽  
Urinary Tract ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Urinary Tract Obstruction ◽  
Xanthogranulomatous Pyelonephritis ◽  
Cell Renal Cell Carcinoma ◽  
Laboratory Findings ◽  
Palpable Mass ◽  
Wide Range

Abstract Xanthogranulomatous pyelonephritis is an uncommon chronic destructive granulomatous process of renal parenchyma in association with long-term urinary tract obstruction and infection. It affects females more often than males, with a wide range of age, from newborn to elderly. Almost all patients are symptomatic and the most common symptoms are flank or abdominal pain, lower urinary tract symptoms, fever, palpable mass, gross hematuria, and weight loss. The common laboratory findings are leukocytosis and anemia. Urine cultures most often reveal Escherichia coli and Proteus mirabilis. Computed tomography is the mainstay of diagnostic imaging for xanthogranulomatous pyelonephritis. Imaging studies may demonstrate diffuse or focal form. Histologically, xanthogranulomatous pyelonephritis presents a granulomatous inflammatory infiltrate composed of neutrophils, lymphocytes, plasma cells, xanthomatous histiocytes, and multinucleated giant cells. The differential diagnosis includes clear cell renal cell carcinoma, papillary renal cell carcinoma, sarcomatoid renal cell carcinoma, leiomyosarcoma, malakoplakia, and megalocytic interstitial nephritis. Both antibiotics and surgery can be treatment options depending on the patient's disease status.

Giant Renal Calculus in a Solitary Functioning Kidney

2007 ◽  
Vol 78 (1) ◽  
pp. 91-92 ◽  
Author(s):  
Cengiz Girgin ◽  
Akif Sezer ◽  
Oğuz Şahin ◽  
Mehmet Öder ◽  
Çetin Dinçel
Keyword(s):  
Renal Calculus ◽  
Solitary Functioning Kidney ◽  
Functioning Kidney

A Retrospective Review of Xanthogranulomatous Pyelonephritis - Our Experience at a Tertiary Care Center Located in Dharwad District, Karnataka

2021 ◽  
Vol 8 (33) ◽  
pp. 3139-3144
Author(s):  
Pramod Jagadeesh Makannavar ◽  
Srinivas Kalabavi ◽  
Revanasiddappa Kanagali ◽  
Bhuvanesh Aradhya ◽  
Sangamnath Sangamnath
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Care Center ◽  
Tertiary Care ◽  
Chronic Pyelonephritis ◽  
Xanthogranulomatous Pyelonephritis ◽  
Diagnosis And Treatment ◽  
Tertiary Care Center ◽  
Functioning Kidney

BACKGROUND Xanthogranulomatous pyelonephritis (XGP) is an uncommon form of chronic pyelonephritis that is characterized by extensive enlargement and destruction of the involved kidney which ultimately results in non-functioning kidney. It often mimics other inflammatory or neoplastic renal disorders. Unlike chronic pyelonephritis, it spreads to the perinephric space with formation of multiple abscesses and fistulas. It is now being recognized as an important cause of renal morbidity and mortality worldwide. METHODS This is a case series undertaken in a tertiary care center. Clinical data was collected from last 6 years. Clinical features, radiological findings, treatment, and its outcome were analysed and presented. RESULTS A total of 23 cases diagnosed clinically were included in our study. The disease is more prevalent in females than in males with ratio of 1.8 : 1, with mean age of 47.04 years. Most of the patients presented with flank pain and fever. 2 patients had unusual presentations that are nephrocutaneous fistula and necrotising fasciitis of flank region. In our study, disease was associated with urolithiasis in 43.47 % and diabetes mellitus (DM) in 60.8 %. E. coli was the most commonly grown organism in urine culture. Most of the patients underwent initial percutaneous nephrostomy (PCN) or double-J (DJ) stenting followed by definitive treatment that is nephrectomy (21 patients, 2 patients lost to follow up). Extraperitoneal flank approach was most commonly chosen compared to subcostal transperitoneal approach. Excess blood loss was the most common complication encountered during surgery; 8 patients required post-operative blood transfusion. 5 patients required intensive care unit (ICU) care with inotropic support postoperatively. 6 patients had post-operative superficial surgical site infection. CONCLUSIONS XGP is a rare form of chronic pyelonephritis resulting in enlarged non-functioning kidney. UTI (urinary tract infection) and urolithiasis are the most important factors involved in pathogenesis. Prompt diagnosis and treatment is essential. Initial antibiotic treatment with drainage procedure (PCN or DJ stenting) followed by nephrectomy is treatment of choice. Early diagnosis and treatment may limit the disease process and associated morbidity, thus leading to good outcome. KEYWORDS Xanthogranulomatous Pyelonephritis, UTI (Urinary Tract Infection), Urolithiasis, Nephrectomy

scholarly journals Xanthogranulomatous pyelonephritis presenting as a pseudotumour

2016 ◽  
Vol 10 (1-2) ◽  
pp. 36 ◽  
Author(s):  
Mohamed Chlif ◽  
Marouene Chakroun ◽  
Sami Ben Rhouma ◽  
Mohamed Ali Ben Chehida ◽  
Ahmed Sellami ◽  
...  
Keyword(s):  
Percutaneous Biopsy ◽  
Renal Calculi ◽  
Renal Calculus ◽  
Xanthogranulomatous Pyelonephritis ◽  
High Rate ◽  
Atypical Form ◽  
Clinicopathological Profile ◽  
Loin Pain ◽  
The Mean ◽  
Average Size

Introduction: Xanthogranulomatous pyelonephritis (XGPN) is an atypical form of chronic pyelonephritis referred to as the ‘‘great imitator’’ because the clinical and radiological findings closely resemble other pathological entities, especially for the focal forms. Distinguishing focal XGPN from renal cancer is preoperatively difficult.Methods: We report a total number of 12 pseudotumoural XGPN cases diagnosed and treated in our department. The aim of this study is to try to better understand the clinicopathological profile of XGPN and improve its management.Results: The mean age of patients was 51.52 years. Gender ratio was 0.71. An obstructive renal calculus was noticed in nine patients (75%). Only one patient (8.3 %) presented with loin pain associated with fever, weight loss, asthenia, and increased biological inflammation markers. A bifocal mass was noticed in one case (8.3 %). The average size of the tumour was 6.58 cm. The mass was cystic in three cases (25 %). Perinephral fat strand, thickening of Gerota’s fascia, hydronephrosis, and presence of renal calculi was noticed in all solid tumour cases. XGPN was suspected in only one case (8.3%), a percutaneous biopsy showed XGPN lesions treated by antibiotics and a double J drainage. Radical nephrectomy was performed in eight patients (66.7 %) and three patients underwent partial nephrectomy (25 %). No recurrence of XGPN has been noted.Conclusion: Pseudotumoural XGPN is a rare benign disease of the kidney. Its treatment should be conservative. Lack of knowledge of this disease may explain the high rate of abusive nephrectomies. These data should be considered in the future.

Renai carcinoma: Obligatory conservative surgery

1998 ◽  
Vol 65 (1) ◽  
pp. 48-51
Author(s):  
A. Scopelliti ◽  
A. Verbena ◽  
C. Pontorieri ◽  
F. Capocasale ◽  
R. Sergi
Keyword(s):  
Renal Carcinoma ◽  
Complete Removal ◽  
Conservative Surgery ◽  
Renal Parenchyma ◽  
Renal Neoplasm ◽  
Renal Neoplasms ◽  
Renal Lithiasis ◽  
Aggressive Approach ◽  
Extracorporeal Dialysis ◽  
Functioning Kidney

Radical nephrectomy is still widely held as being the most effective treatment for renal carcinoma. Such an aggressive approach is, however, inadvisable in patients with sole kidney, especially as no advantage has been shown in terms of survival compared to surgical procedures which spare the renal parenchyma and do not condemn the patient to extracorporeal dialysis or a transplant. Conservative surgery is therefore the treatment of choice in the case of bilateral carcinoma or sole functioning kidney. It allows complete removal of the tumour, helped by the actual characteristics of the same, while enough renal parenchyma si preserved to avoid uremia. Four clinical cases observed in the last 24 months are described and their surgical solutions are paradigmatic of the most frequently used therapeutic approach in obligatory conservative surgery of renal neoplasms. The cases consisted of 1 bilateral renal neoplasm, 2 neoplasms in sole kidney and 1 neoplasm in a patient with pluri-recurrent renal lithiasis. Post-operative course was regular in all cases and as of today there are no recurrences or metastases.

scholarly journals Xanthogranulomatous pyelonephritis: Rare presentation of a rare disease

2013 ◽  
Vol 02 (01) ◽  
pp. 4-4 ◽  
Author(s):  
Saifullah Khalid ◽  
Sufian Zaheer ◽  
Samreen Zaheer ◽  
Ibne Ahmad ◽  
Mohd Khalid
Keyword(s):  
Rare Disease ◽  
Radical Nephrectomy ◽  
Renal Mass ◽  
Favourable Outcome ◽  
Renal Parenchyma ◽  
Xanthogranulomatous Pyelonephritis ◽  
Stage Iii ◽  
Rare Presentation ◽  
Renal Infection ◽  
Functioning Kidney

AbstractXanthogranulomatous pyelonephritis is a rare chronic renal infection of unknown pathogenesis characterized by replacement of renal parenchyma by lipid filled macrophages frequently associated with an enlarged, non-functioning kidney and an obstructing calculus. We report a case of a 45 year old non diabetic female who presented with gradually enlarging renal mass with extensive retroperitoneal involvement and a non-functioning kidney with no evidence of obstructing stone or fat density and simulating malignancy. She was diagnosed as stage III Xanthogranulomatous pyelonephritis and managed with radical nephrectomy with favourable outcome.

scholarly journals Idiopathic Spontaneous Rupture of Renal Pelvis in a Single Functioning Kidney

2021 ◽  
pp. 221-226
Author(s):  
Maciej Tylski ◽  
Katarzyna Muras-Szwedziak ◽  
Michał Nowicki
Keyword(s):  
Abdominal Pain ◽  
Renal Pelvis ◽  
Spontaneous Rupture ◽  
Urinary Tract Obstruction ◽  
Rare Condition ◽  
Inflammatory Infiltration ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Functioning Kidney

Spontaneous rupture of renal pelvis (SRRP) is a rare condition resulting in an extravasation of urine into retroperitoneal space. Due to the uncharacteristic symptoms, often mimicking renal colic, its diagnosis may be complicated. Herein, we report a case of a 73-year-old male with a solitary functioning kidney who presented with malaise and right-sided abdominal pain, rapidly followed by anuria. Laboratory tests showed the signs of AKI. Contrast-enhanced CT performed soon after the admission showed nonspecific abnormalities in the right middle abdomen suspected to be either inflammatory infiltration or surgical scarring. Symptomatic treatment was started, and an acute hemodialysis treatment was commenced. After a temporal improvement, the patient’s general condition worsened significantly, with exacerbated pain and massive increase in plasma creatinine. A second contrast-enhanced CT was performed with an addition of urography phase, revealing the extravasation of the contrast media in the location suggesting the rupture of the renal pelvis. The patient was treated successfully by the placement of a double-J ureteral stent into the ureter. Usually, a clear etiology of SRRP can be determined, that is, urinary tract obstruction, but in this case, we could not find a definite cause. It is important to remember that in the presence of a nonspecific abdominal pain and laboratory signs of AKI, a rare cause like SRRP should be taken into consideration. Performing a contrast CT scan with urography phase can save time in establishing a diagnosis and enable immediate urological intervention.

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