PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Pyelonephritis, Xanthogranulomatous”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 559 records · Page 31Linked to original sources
PubMed1993

Lipid-laden foamy macrophages in renal cell carcinoma. Potential frozen section diagnostic pitfall.

Lipid-laden foamy macrophages are characteristic of xanthogranulomatous pyelonephritis (XGP). We have encountered a case of renal cell carcinoma (RCC), with extensive necrosis, in which confluent sheets of foamy macrophages were a dominant feature. We describe the case and discuss the potential frozen section diagnostic problem in attempting to distinguish between confluent sheets of xanthoma cells a "reactive" change in RCC and xanthoma cells as a fundamental component of XGP. We propose that awareness of that problem should prompt the pathologist to request additional samples.

Aged↗
PubMed1996

A middle-aged woman with back and flank pain.

Xanthogranulomatous pyelonephritis is an uncommon variant of chronic pyelonephritis that predominantly affects middle-aged women. Patients usually present with fever, back or flank pain, flank mass, and the constitutional symptoms of fatigue, malaise, weight loss, and anorexia. Rarely, they may present with a draining sinus. There is usually a history of urinary tract infection, obstruction, or instrumentation. Other abnormalities include anemia, leukocytosis, abnormal liver enzymes, pyuria, and hematuria. Mild azotemia may be present, but frank renal failure is rare. Urine and renal tissue cultures are frequently positive. The most commonly isolated bacterial pathogens are P. mirabilis and E. coli, but other organisms have also been implicated. A CT scan is the best radiologic imaging technique to discover the extent of inflammation as well as any involvement of adjacent structures. Lipid-laden macrophages called xanthoma cells characterize the disease at the microscopic level. Nephrectomy is curative. Careful preoperative evaluation will guide surgical planning in choosing an approach that provides adequate exposure of the affected tissue and facilitates subsequent care of the patient.

Back Pain↗
PubMed2004

Hand-assisted laparoscopic nephrectomy for inflammatory renal conditions.

PURPOSE: Laparoscopic surgery for large renal lesion or kidneys with chronic inflammation has proved to be technically challenging. Hand-assisted laparoscopic surgery might be useful in these complex cases, as it provides surgeons the benefits of tactile feedback, digital retraction, and facilitated dissection of the renal hilar vessels. PATIENTS AND METHODS: Twenty-two patients undergoing hand-assisted laparoscopic (HAL) nephrectomy for benign conditions were compared with patients who underwent HAL radical nephrectomy during the same period. The demographic data, laterality, operative time, estimated blood loss, conversion rate, length of stay, histopathology findings, morbidity, and mortality were reviewed. RESULTS: The main indications for surgery were chronic inflammation and xanthogranulomatous pyelonephritis. Twenty patients had unilateral nephrectomy (10 each on the right and left), and two patients had bilateral nephrectomy. The mean operative times for unilateral and bilateral nephrectomy were 163 minutes (range 55-261 minutes) and 265 minutes (range, 238-291 minutes), respectively. Nine patients (45%) with inflammation had complications (15% major and 30% minor). The mean length of hospitalization for patients undergoing HAL nephrectomy was 7.2 days (range 2-35 days). The patients with inflammatory pathology had longer mean operative times, higher estimated blood loss, longer hospital stay, and higher morbidity than patients undergoing radical nephrectomy. CONCLUSION: Compared with standard laparoscopy, the hand-assisted approach has been reported to reduce operative times and increase safety. The advantages of minimally invasive surgery, such as reduced analgesia, shorter hospital stay, and faster return to normal activity, appear to be similar to those in patients undergoing a pure laparoscopic nephrectomy. Compared with radical nephrectomy for renal tumor, HAL simple nephrectomy can often be more challenging and associated with greater morbidity. For both the community urologist as well as an experienced laparoscopist, this approach is useful in handling these challenging cases.

Adult↗
PubMed1982

Computed tomography of renal inflammatory disease.

The value of computed tomography (CT) in patients with severe renal inflammatory disease has not been previously emphasized. This paper presents the authors' experience using this modality in 17 patients with acute intrarenal inflammatory conditions. A spectrum of various renal abnormalities and their CT appearance ranging from lobar nephronia (focal pyelonephritis) to xanthogranulomatous pyelonephritis is presented. These cases demonstrate that CT provides more precise anatomic information than does urography and is helpful in distinguishing uncomplicated patterns of renal infection from other types of renal inflammatory disease. In this way, patients who may be managed medically can be differentiated from those who require surgical intervention.

Abscess↗
PubMed2006

Granulomatous interstitial nephritis: a clinicopathologic study of 46 cases from a single institution.

Acute interstitial nephritis is commonly seen in kidney biopsies of patients with acute renal failure; however, granulomatous interstitial nephritis (GIN) is rare. We identified 46 cases of GIN in a 17-year period in this institution and we investigated their most probable etiologies. Complete clinical information was available in 38 patients. Seventeen of 38 patients (44.7%) were classified as drug-induced. Renal sarcoidosis was responsible for 28.9% of cases, and the remaining 15.9% of cases included Wegeners granulomatosis, foreign body giant cell reaction, GIN secondary to intravesical bacillus Calmette-Guérin therapy for bladder cancer, and xanthogranulomatous pyelonephritis. Clinical investigation failed to reveal possible etiology in 4 patients (10.5%), classified as idiopathic. We concluded that three quarters of our cases were either drug-induced or due to sarcoidosis; only a small proportion of our cases occurred secondary to any other cause or to unknown factors.

Acute Disease↗
PubMed1986

Granulomatous nephritis.

Granulomatous nephritis (renal tuberculosis, malacoplakia, xanthogranulomatous pyelonephritis, and echinococcus disease) represents an infectious process that is characterized by (renal) parenchymal destruction and consists of a chronic cellular reaction and mature, mononuclear infiltrate. These infections may mimic one another as well as other renal infections and cystic and neoplastic disorders. This article addresses some of the unique aspects and similarities of these varied disease entities and their management.

Echinococcosis↗
PubMed2003

[Xanthrogranulomatous pyelonephritis with nephrocutaneous fistula].

The authors report a case of xanthogranulomatous pyelonephritis presenting with nephrocutaneous fistula. This case illustrates all of the typical features of this disease: late diagnosis, non-functioning affected kidney, staghorn calculi, urinary tract anomaly, perinephritis with fistulization. The authors review the diagnostic and therapeutic modalities of xanthogranulomatous pyelonephritis and discuss the other aetiologies of nephrocutaneous fistula. In view of the severity of this disease and its preoperative resemblance to renal cancer, nephrectomy is often the only available treatment option.

Female↗
PubMed1996

[Replacement lipomatosis of renal tissue: a peculiar reaction to inflammation].

Replacement lipomatosis is an abnormal fatty proliferation of the renal sinus, hilus, perirenal and, sometimes, periureteral spaces. Our experience with 18 cases of replacement lipomatosis is reported: 6 patients had the massive form, one of them bilateral, 5 patients had associated xanthogranulomatous pyelonephritis and 7 had an initial focal form. After a thorough review of the literature of the last 30 years, we analyzed the etiopathogenetic bases of this abnormal chronic reaction. The cause of this abnormal fatty proliferation is thought to be related to peculiar individual reactivity; the association of predisposing factors (chronic obstruction and stones) with multiple infections (especially by Coli) does not seem to cause the abnormality. This hypothesis is confirmed by the frequent association of replacement lipomatosis and xanthogranulomatous pyelonephritis, where abnormal individual reactivity has been postulated. Replacement lipomatosis may develop even when the classic predisposing factors are not present or, in contrast may not develop even when they are present. The peculiarity of this pseudotumoral form, where the expansile trend of fatty tissue is apparent, is to mimic neoplastic mesenchymal disease. So far, few cases have been reported in the literature-i.e., less than 20 massive cases in the last 30 years. In this study, the clinical presentation and pathologic findings are correlated with imaging data, especially of CT; the diagnostic yield of this method is stressed, in one with the differential diagnosis with the other, neoplastic or not, forms with negative densitometry. The similarities and differences between replacement lipomatosis and xanthogranulomatous pyelonephritis, which are distinct conditions, are emphasized, so that a careful study of imaging findings may help make the correct diagnosis.

Humans↗
PubMed1975

Xanthogranulomatous ureteritis.

A case of xanthogranulomatous ureteritis is described and the numerous similarities with xanthogranulomatous pyelonephritis in their clinicopathological presentation are discussed. Of the xanthogranulomatous pyelonephritis symptoms our patient manifested a long history of urinary tract infection, weight loss, urinary obstruction, pyuria and gram-negative bacteriuria. The ureteral lesion was a yellowish nodule, granulomatous and was highlighted histologically by foamy histiocytes with periodic acid, Schiff positive cytoplasmic granules. The lesion mimicked an obstructing neoplasm and a specific granuloma.

Aged↗
PubMed1979

Xanthogranulomatous lymphadenitis.

A case of an unusual type of granulomatous lymphadenitis, initially suspected of being a malignant lymphoma, is reported. Histologically, this lesion shows a striking xanthomatous appearance, due to collections of foamy histiocytes interspersed with chronic inflammatory cells, and resulting in a storage-like aspect. Evidence indicates that this process merely represents the reabsorption and healing phases of an acute suppurative lymphadenitis, with histopathologic features comparable to those of xanthogranulomatous pyelonephritis. The term xanthogranulomatous lymphadenitis is suggested for this previously inadequately described lesion, and the likely non-specific degenerative character of the xanthomatous response is stressed.

Adolescent↗
PubMed1998

An unusual cause of hemoptysis.

Xanthogranulomatous pyelonephritis is a renal inflammatory process associated with chronic obstruction and renal calculi. A patient with xanthogranulomatous pyelonephritis presented with the acute onset of hemoptysis and a lung mass. At thoracotomy the mass was resected and found to be a renal calculus embedded within inflammatory tissue.

Aged↗
PubMed1977

A qualitative and quantitative comparison of the fat in human, feline and canine kidneys.

While xanthogranulomatous pyelonephritis in humans tends to be rich in birefringent fat, this variety cannot be demonstrated microscopically in the feline morphological counterpart of the condition, which is, however, rich in readily stainable fat. Since normal feline kidney is rich in such lipid, a qualitative and quantitative comparison of the lipid in human, feline and canine kidney was carried out in an attempt to throw further light on the possible origin of the birefringent fat in the human disease. No significant difference could be found in the amount of cholesterol in the 3 species. Despite its visual prominence in feline kidneys, human kidney was richer in neutral fat and the percentage of total lipid formed by cholesterol was greater in humans than in the other species. The results suggested that cases of xanthogranulomatous pyelonephritis may occur in those kidneys unusually rich in cholesterol.

Aged↗
PubMed2004

Xanthogranulamatous pyelonephritis with psoas abscess: 2 cases and review of the literature.

Xanthogranulomatous pyelonephritis (XGP) is a rare form of chronic pyelonephritis. With the review of the literature, we reported two cases of XPN with psoas muscle abscesses caused by Staphylococci aereus in one of the patient and Serratia mascerentes in the other. Both of the patients had renal calculus. We performed nephrectomy with psoas abscess drainage and started appropriate antibiotics, but one of the patients died of septic shock. Other patient is free of symptoms at the end of 5 years follow-up.

Adolescent↗