Xanthogranulomatous Pyelonephritis

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.

Download Full-text

Xanthogranulomatous Pyelonephritis: A Rare Presentation

Journal of Renal and Hepatic Disorders ◽

10.15586/jrenhep.2017.19 ◽

2017 ◽

Vol 1 (2) ◽

pp. 52-56 ◽

Cited By ~ 1

Author(s):

Kafil Akhtar ◽

Mahboob Hasan ◽

Kiran Alam ◽

Mohd Talha ◽

Atia Z Rab

Keyword(s):

Renal Cell Carcinoma ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Cell Carcinoma ◽

Renal Cell ◽

Recurrent Urinary Tract Infection ◽

Disease Process ◽

Xanthogranulomatous Pyelonephritis ◽

Palpable Mass

Xanthogranulomatous pyelonephritis is an uncommon chronic destructive disease process of renal parenchyma, associated with recurrent urinary tract infection. It is seen predominantly in females with no age specificity. The most common symptoms are flank or abdominal pain, fever, palpable mass, and gross hematuria. 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. Histologically, xanthogranulomatous pyelonephritis presents a granulomatous inflammatory infiltrate mainly composed of lymphocytes, plasma cells, foamy histiocytes, and multinucleated giant cells. The differential diagnosis includes clear cell renal cell carcinoma, sarcomatoid renal cell carcinoma, leiomyosarcoma, malakoplakia, tuberculosis, and interstitial nephritis. Treatment includes antibiotics and surgery. In this article, we report a case of xanthogranulomatous pyelonephritis in a 38-year-old male patient with recurrent urinary tract infection.

Download Full-text

Clinical features of sarcomatoid renal cell carcinoma causing bilateral urinary tract obstruction

The International Journal of Artificial Organs ◽

10.1177/039139880803101008 ◽

2008 ◽

Vol 31 (12) ◽

pp. 910-912

Author(s):

N. Stabellini ◽

V. Orlandi ◽

S. Sartori ◽

P. Tombesi ◽

F. Fabbian ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Urinary Tract ◽

Cell Carcinoma ◽

Clinical Features ◽

Renal Cell ◽

Urinary Tract Obstruction ◽

Sarcomatoid Renal Cell Carcinoma

Download Full-text

Surgically Discovered Xanthogranulomatous Pyelonephritis Invading Inferior Vena Cava with Coexisting Renal Cell Carcinoma

The Scientific World JOURNAL ◽

10.1100/tsw.2009.6 ◽

2009 ◽

Vol 9 ◽

pp. 5-9 ◽

Cited By ~ 3

Author(s):

Henry M. Rosevear ◽

Melissa M. Meier ◽

Brian L. Gallagher ◽

Fadi N. Joudi

Keyword(s):

Renal Cell Carcinoma ◽

Inferior Vena Cava ◽

Cell Carcinoma ◽

Renal Cell ◽

Inflammatory Process ◽

Inferior Vena ◽

Vena Cava ◽

Posterior Wall ◽

Xanthogranulomatous Pyelonephritis ◽

Cell Renal Cell Carcinoma

Xanthogranulomatous pyelonephritis (XGP) is a chronic inflammatory process that results in replacement of renal and/or perirenal tissue with a diffuse infiltrate of inflammatory cells referred to as xanthoma cells. We present a case of a 49-year-old man with an incidentally discovered renal mass with inferior vena cava (IVC) thrombus, who was found intraoperatively to have a significant inflammatory process involving the posterior wall of his IVC and right renal vein consistent with XGP surrounding a focus of clear cell renal cell carcinoma in the midportion of his right kidney.

Download Full-text

Analysis of the p53 pathway in clear cell renal cell carcinoma to identify novel drug combinations.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.5_suppl.460 ◽

2012 ◽

Vol 30 (5_suppl) ◽

pp. 460-460

Author(s):

Mark T. Boyd ◽

Amro Ahmed-Ebbiary ◽

Radoslaw Polanski ◽

Aidan Noon ◽

Keith Parsons ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Clinical Trials ◽

Cell Carcinoma ◽

Renal Cell ◽

Clear Cell ◽

Drug Combinations ◽

Wild Type ◽

Cell Renal Cell Carcinoma ◽

Mdm2 Antagonist ◽

Wide Range

460 Background: p53 is rarely mutated in clear cell renal cell carcinoma (ccRCC) with typical mutation frequencies between 0 and 5%. Recent studies have shown that combined p53/MDM2 expression is significantly linked with reduced survival (P<0.0001, HR=3.2) and is an independent prognostic indicator (Cox multiple regression analysis, P=0.027). Studies have also found that p53 is negatively regulated by MDM2 in RCC cells but that rescue of p53 stability is not effective at inducing apoptosis. Studies of normal kidney have shown that signalling to p53 by genotoxic agents is intact, but fail to elicit an apoptotic response. We have therefore investigated a rational combinatorial approach to drug targeting in RCC cells in which both MDM2 is inhibited and apoptosis is stimulated. Methods: Senescence was quantitated by assaying SA-β-galactosidase. Drug sensitivity was determined by measuring MTT conversion at multiple time points. Data from these were used to generate isobolograms and combination indices. Further details of the drugs used will be presented. Results: Using a p53-MDM2 antagonist (currently in clinical trials), our results indicate that in RCC cells rescue of p53 induces some growth arrest and senescence but not apoptosis (IC70 range 7-30 μM). Similarly, using a pro-apoptotic drug (also in clinical trials) which has been demonstrated to promote apoptosis in a wide range of cells, we find little growth inhibitory effect (IC70 range 2.5-30 μM). However, combining a p53-MDM2 antagonist with the pro-apoptotic drug leads to dramatic synergy (combination indices as low as 0.26 [<1 indicates synergy]) and rapid p53-dependent apoptosis in a range of p53 wild-type RCC cell lines. Crucially, the drug combinations have no impact on non-tumour renal cells (neither IC70 nor IC50 could be determined, but both exceed 30 μM) suggesting these may have a high therapeutic index. Conclusions: Rationally designed combinatorial approaches for the treatment of RCC can lead to dramatic enhancement of RCC cell sensitivity and clearly warrant further investigation in both pre-clinical studies (under development) and in clinical trials for RCC due to the retention of wild-type p53 in this disease.

Download Full-text

638: Macroscopic Tumor Necrosis is a Prognostic Indicator for Non-Metastatic Clear Cell Renal Cell Carcinoma

The Journal of Urology ◽

10.1016/s0022-5347(18)30878-4 ◽

2007 ◽

Vol 177 (4S) ◽

pp. 214-214

Author(s):

Sung Kyu Hong ◽

Byung Kyu Han ◽

In Ho Chang ◽

June Hyun Han ◽

Ji Hyung Yu ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Tumor Necrosis ◽

Clear Cell ◽

Prognostic Indicator ◽

Cell Renal Cell Carcinoma ◽

Macroscopic Tumor

Download Full-text

Abstract #1001: Extremely Aggressive Papillary Thyroid Cancer (PTC) with Widespread Metastases Including Spleen and Clear Cell Renal Cell Carcinoma (RCC) in one Patient: An Unknown Syndromic Entity or Manifestation of Familial PTC?

Endocrine Practice ◽

10.1016/s1530-891x(20)44123-0 ◽

2017 ◽

Vol 23 ◽

pp. 210

Author(s):

Shilpi Singh ◽

Anh-Thu Nguyen ◽

Robert Anderson

Keyword(s):

Renal Cell Carcinoma ◽

Thyroid Cancer ◽

Cell Carcinoma ◽

Papillary Thyroid Cancer ◽

Renal Cell ◽

Clear Cell ◽

Papillary Thyroid ◽

Cell Renal Cell Carcinoma

Download Full-text

Rare localization of renal cell carcinoma metastases in the paranasal sinuses and breast: a case report

Medical Visualization ◽

10.24835/1607-0763-2018-6-13-22 ◽

2019 ◽

Vol 22 (6) ◽

pp. 13-22

Author(s):

E. V. Kryaneva ◽

N. A. Rubtsova ◽

A. V. Levshakova ◽

A. I. Khalimon ◽

A. V. Leontyev ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Paranasal Sinuses ◽

Renal Cell ◽

Clinical Case ◽

Clear Cell ◽

Malignant Tumors ◽

Metastatic Potential ◽

Cell Renal Cell Carcinoma ◽

Metastatic Lesions

This article presents a clinical case demonsratinga high metastatic potential of clear cell renal cell carcinoma combined with atypical metastases to breast and paranasal sinuses. The prevalence of metastatic lesions to the breast and paranasal sinuses in various malignant tumors depending on their morphological forms is analyzed. The authors present an analysis of data published for the last 30 years. The optimal diagnostic algorithms to detect the progression of renal cell carcinoma and to evaluate the effectiveness of the treatment are considered.

Download Full-text