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PubMed1995

Xanthogranulomatous pyelonephritis, the gatekeeper's dilemma: a contemporary look at an old problem.

OBJECTIVES: To review 12 patients with a clinicopathogenic diagnosis of xanthogranulomatous pyelonephritis (XGP) and to determine if a computed tomography (CT) scan is the imaging procedure of choice for diagnosis. METHODS: A retrospective review, over the last 12 years, of patients with XGP at our institution. RESULTS: Nine of 10 patients (90%) who were evaluated by CT scan had the correct diagnosis made prior to nephrectomy. The most common presenting symptoms and signs were flank pain (64%), leukocytosis (73%), and anemia (82%). Seventy-five percent of the patients had a ureteropelvic junction stone or a staghorn stone in the affected kidney at the time of clinical presentation. Proteus was the most common organism cultured. CONCLUSIONS: After reviewing the clinical features of these 12 patients, we recommended CT scan to evaluate the patient in whom clinical suspicion of XGP is entertained. CT has proven to be the most accurate imaging study to evaluate this disease.

Adult↗
PubMed2001

Intra-abdominal actinomycosis with hepatic pseudotumor and xanthogranulomatous pyelonephritis in a 6-y-old boy.

We report the case of a 6-y-old boy with actinomycosis, presenting as xanthogranulomatous pyelonephritis (XGP), hepatic pseudotumor and abdominal abscess. Symptoms included intermittent fever, abdominal pain and significant weight loss. Hepatic and renal tumor masses were suspected on sonography and computerized tomography. XGP and actinomycosis were proven by pathology. The patient recovered well with antibiotic alone.

Abdominal Abscess↗
PubMed2003

Analysis of 39 cases of xanthogranulomatous pyelonephritis with emphasis on CT findings.

OBJECTIVE: In this retrospective study a review of the clinical, laboratory and radiologic features of 39 cases of xanthogranulomatous pyelonephritis (XGP) is presented. CT characteristics of XGP are analyzed in detail and the relevant literature is reviewed in order to determine the most typical among them. MATERIAL AND METHODS: Pathologic material from 39 patients suffering from XGP was reviewed in order to confirm the initial diagnosis. Data compiled from the previous history of the patients, clinical, laboratory, urographic and CT findings, preoperative diagnosis, operative findings and postoperative period were analyzed. RESULTS: Diffuse and focal forms of XGP were recognized in 38 and 1 cases, respectively. Fever, pain in the flank or abdomen, chills and malaise were the commonest symptoms. A non-functioning kidney and/or staghorn calculus were the commonest urographic findings. When available (15 cases), CT revealed multiple fluid-filled cavities in the affected kidney and demonstrated the extension of the disease to the perinephric spaces in all cases. All patients had undergone nephrectomies, which were characterized as difficult in 60% of cases, whereas two patients developed postoperative complications requiring re-exploration. CONCLUSIONS: Nephrectomy for XGP may be followed by severe complications and appropriate patient preparation and operation planning is of great importance. CT is considered the imaging technique of choice for diagnosing the disease preoperatively and a plethora of CT characteristics have been described to date. Low-density fluid-filled areas within the renal parenchyma and findings indicating perinephric extension should be considered the most typical CT features of XGP.

Adult↗
PubMed2003

Superior vena cava syndrome due to fibrosing mediastinitis histologically identical to xanthogranulomatous pyelonephritis.

We present herein a case of superior vena cava (SVC) syndrome caused by localized fibrosing mediastinitis (FM), which had histological features similar to xanthogranulomatous pyelonephritis (XGP). A 63-year-old woman presented with facial swelling 5 months after undergoing right nephrectomy for XGP. Radiologic investigations of the chest confirmed the presence of SVC obstruction due to an intraluminal tumor. The histological features of the tumor were consistent with those of FM and were very similar to those of XGP. Although the pathogenesis of neither FM nor XGP is known, some pathogenic process of FM and XGP may be the same.

Diagnosis, Differential↗
PubMed1995

Renocolic fistula caused by xanthogranulomatous pyelonephritis.

A 68-year-old female was diagnosed with a renocolic fistula, associated with left chronic pyelonephritis due to a ureter stone. Nephrectomy and repair of the fistula were performed. Histopathological examination revealed xanthogranulomatous pyelonephritis.

Aged↗
PubMed1995

[Xanthogranulomatous pyelonephritis with phlegmonous abdominal wall infiltration. Diagnosis and assessment of extent via computerized tomography].

A 34-year-old woman who 14 years previously had undergone a left nephrotomy for nephrolithiasis complained of pain in the left renal fossa which was reddened and painful on percussion. She had a fever of 38.2 degrees C. C-reactive protein was raised to 80 mg/l, the white cell count to 14,620/microliters (83% neutrophils). Protein and white cells were found in the urine together with a significant number of E. coli on urine culture. Plain film of the abdomen showed a staghorn calculus and ultrasonography demonstrated renal enlargement with a possible paranephritic abscess. The computed tomography diagnosis was xanthogranulomatous pyelonephritis, on the basis of renal enlargement, staghorn calculus, hypodense areas with typical density values (10-15 Hounsfield units), contrast enrichment and extrarenal extension of partly phlegmonous partly fused-together inflammatory changes. The abscessing parts were drained under computed tomography control. Starting 7 days pre-operatively the patient had been receiving ciprofloxacin (0.4 g daily) intravenously. A nephrectomy had to be performed subsequently. Antibiotic treatment was discontinued 2 weeks later and she was discharged symptom-free. The diagnosis of diffuse xanthogranulomatous Pyelonephritis was confirmed by histological examination of the surgical specimen.

Abdominal Abscess↗
PubMed1989

[Xanthogranulomatous pyelonephritis with fatty proliferation of the renal space. Aspects in x-ray computed tomography and MRI].

The authors report one case of one case of xanthogranulomatous pyelonephritis associated with very extensive fatty proliferation in the renal space. This mass surrounded a small, pyelonephritic kidney with a considerable xanthomatous component containing a coral calculus. It was associated with a streaming abscess in the lumbar fossa. The computed tomography (CT) and magnetic resonance imaging (MRI) features are described in this article.

Adipose Tissue↗
PubMedDate not supplied

[Xanthogranulomatous pyelonephritis].

A four years-old boy with Xanthogranulomatous pyelonephritis was surgically treated at the Pediatric Surgery Unit of the Santa Casa de Misericórdia of Maceió. Comments are made upon pathology, pre-operative diagnostic difficulties, differential diagnosis, and the rare occurrence in children.

English Abstract↗
PubMed1995

Intrapelvic Wilms' tumor simulating xanthogranulomatous pyelonephritis.

A 2-year-old boy presented with an atypical renal mass with extension into the pyelocalyceal system and distal ureter which was diagnosed initially as xanthogranulomatous pyelonephritis (XGP). The final diagnosis was intrapelvic Wilms tumor extending into the ureter. In the literature, only three patients have been described with Wilms tumor extending into the ureter, none of whom had a continuous extension into the distal ureter.

Child, Preschool↗
PubMedDate not supplied

Focal xanthogranulomatous pyelonephritis simulating malignancy in children.

Xantogranulomatous pyelonephritis is a severe chronic form of renal parenquimal infection that usually results in diffuse renal destruction. An unusual case of xanthogranulomatous pyelonephritis in a child is reported which presented as a focal mass without calculus in a functioning kidney and was diagnosed as a renal tumor.

Child↗
PubMed1979

[Xanthogranulomatous pyelonephritis in the infant. A report on 4 cases (author's transl)].

Four cases of xanthogranulomatous pyelonephritis in children are reported. In three cases, the disease took a diffuse form and in the fourth it was of a localised form. Around these cases, the authors review 39 case histories published between 1963 and 1978 and which involve only children. An over-all assessment of the 43 cases thus gathered together allows the general picture of xanthogranulomatous pyelonepn 9 cases, it was of the localised type; and in 4 cases, the pyelonephritis only involved one or another pyelon in patients with re-duplication. The diffuse type is more common in boys and the localised type in girls. Twenty-nine cases were found in children of less than five years. In 23 cases, there was a proteus infection. The etio-pathogenesis of xanthogranulomatous pyelonephritis remains obscure. The main clinical and therapeutic problems are dealt with.

Child↗
PubMed1992

Bilateral xanthogranulomatous pyelonephritis involving native kidneys in a renal transplant recipient: association with renal cell carcinoma and amyloidosis.

An unusual case of a 44-year-old male renal transplant recipient who developed bilateral xanthogranulomatous pyelonephritis (XPN) of his native kidneys is presented. Bilateral nephrectomy specimens showed classic features of XPN. In addition, there was amyloidosis involving both kidneys and a small renal cell carcinoma in the left kidney. To the best of our knowledge, such a combination of pathologic conditions in one patient has not been previously reported.

Adult↗
PubMed1972

Xanthogranulomatous pyelonephritis. A comparison of the disease in the cat and man with special reference to the origin of the fat.

The origin of the intracellular fat in human xanthogranulomatous pyelonephritis has been the centre of some discussion in the past. A report of a case in a domestic cat is of interest as normal feline renal epithelium is rich in stainable fat. A comparison of the human and feline varieties of xanthogranulomatous pyelonephritis reveals certain fundamental differences between the two and reinforces the view that the fat concerned in the human disease does not originate in the renal epithelium.

Animals↗
PubMed1996

Xanthogranulomatous pyelonephritis in a pregnant woman: a case report and review of the literature.

We report a rare case of a 24-year-old woman who presented during her second trimester of pregnancy with a presumptive diagnosis of right-sided xanthogranulomatous pyelonephritis (XGP). Despite attempted conservative management, the patient ultimately required a right nephrectomy without complications to either the patient or fetus. Pathology confirmed the diagnosis of XGP of the right kidney. Herein, we present a case report and a review of the literature concerning XGP and pregnancy.

Adult↗
PubMed1991

[Pseudo-tumoral xanthogranulomatous pyelonephritis. Apropos of a case].

The authors report the case of a 20 year old patient in whom the clinical findings combined with the radiological signs, suggested the diagnosis of renal cancer. The histological findings after nephrectomy established the diagnosis of xanthogranulomatous pyelonephritis. This disease may rarely give the appearance of a renal tumor. This points out the importance of identifying this lesion in preoperative staging to avoid carcinologic surgery and all of its difficulties.

Adult↗
PubMed1975

Xanthogranulomatous pyelonephritis: a report of 2 cases.

Two cases of xanthogranulomatous pyelonephritis are reported in Negroes. The clinical findings are similar to those in previously reported cases. In 1 case nephrolithotomy was followed by the development of a perinephric abcess 8 months later. Late diagnosis has limited experience with more conservative management, which should be reserved for demonstrably focal disease.

Aged↗