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PubMed1990

[Renocolic fistula caused by xanthogranulomatous pyelonephritis: a case report].

Renocolic fistulas caused by typical xanthogranulomatous pyelonephritis are rare. We present a case of renocolic fistula caused by xanthogranulomatous pyelonephritis. A 58-year-old woman was admitted to the Department of Urology, Sakata City Hospital, with the chief complaint of pain in the left flank region. The plain film showed no calculi. An intravenous pyelogram showed left non-functioning kidney. A left retrograde pyelogram demonstrated a communication between the left renal calyx and the descending colon. A computed tomography done after the retrograde pyelography revealed contrast medium in the descending colon and a heterogenous left renal mass and thickness of Gerota's fascia. On the basis of the radiologic studies a diagnosis of renocolic fistula was made. The patient underwent a nephrectomy with closure of the fistula of the colon. The pelvicaliceal system of the resected kidney was distended and contained yellow fatty like tissue. Histologically xanthogranulomatous pyelonephritis was confirmed. The patient made an uneventful recovery.

Colonic Diseases↗
PubMed1989

Ureteral involvement in stage I xanthogranulomatous pyelonephritis--(a case report).

A case of xanthogranulomatous pyelonephritis (Stage-I: Nephric) with ureteral involvement is described. The patient had undergone right nephrectomy with the working diagnosis of calculus pyonephrosis and non-functioning kidney. Histopathological examination of the nephrectomy specimen revealed xanthogranulomatous pyelonephritis confined to the kidney and non-contiguous involvement of ureter. Post-operative recovery was uneventful and there had been no evidence of disease recurrence till one year's follow-up.

Humans↗
PubMed2001

[Pseudotumoral xanthogranulomatous pyelonephritis: diagnosis with percutaneous biopsy and success of conservative treatment].

Focal xanthogranulomatous pyelonephritis is an unusual form of chronic renal infection that is difficult to diagnose prior to surgery. We report on a 19-year-old woman who presented with a renal mass that mimicked malignancy. The diagnosis of focal xanthogranulomatous pyelonephritis was first suspected by radiological findings and further confirmed by histopathologic examination of percutaneous biopsy specimens of the lesion. Successful treatment of the patient was achieved with antibiotic therapy alone. Maximal efforts, including percutaneous renal biopsy, should be made to establish the diagnosis of focal xanthogranulomatous pyelonephritis before a therapeutic decision is reached. We recommend the use of antibiotics as a first-line treatment for patients with focal xanthogranulomatous pyelonephritis.

Adult↗
PubMed1998

[Pseudotumorous focal xanthogranulomatous pyelonephritis in children. Apropos of a case].

Xanthogranulomatous pyelonephritis is a particular form of chronic pyelonephritis. It is observed less frequently in children and can sometimes present with a focal pseudoneoplastic appearance. An 11-year-old child was admitted with abdominal pain, alteration of the general state and weight loss without fever or palpable mass. Medical imaging was unable to distinguish between malignant renal tumour or tuberculosis. The diagnosis was confirmed by the inflammatory and purulent appearance of the mass and histopathological examination of the biopsy fragment. Percutaneous drainage of the abscess, combined with antibiotics provided marked improvement. Despite its rarity and its nonspecific clinical features, focal xanthogranulomatous pyelonephritis must be considered in order to propose conservative treatment.

Amoxicillin-Potassium Clavulanate Combination↗
PubMed2004

Diffuse xanthogranulomatous pyelonephritis in a child with severe complications.

Xanthogranulomatous pyelonephritis is a rare disease in childhood. Because the symptoms and signs are chronic and non-specific, preoperative diagnosis is usually difficult. We report an 8-year-old boy who had an abdominal mass and anemia for more than 6 months. Fever and dyspnea occurred 4 days prior to admission. Ultrasonography revealed an enlarged right kidney with multiple parenchymal hypoechogenic areas, absence of normal parenchymal structures, and perinephric thickening with multiple calcifications. An abdominal computed tomogram demonstrated an irregular, enlarged right kidney with multiple low-density round areas consistent with hydronephrosis and calculi. Diminished excretion of contrast media and a severe perinephric inflammatory reaction were present. Poor right kidney function was demonstrated by Tc99m-diethylenetriamine penta-acetic acid split renal function examination. We diagnosed xanthogranulomatous pyelonephritis preoperatively based on the clinical and radiological features. The child first had drainage of an extrarenal abscess and antibiotic therapy, followed by definitive nephrectomy. The hospital course was complicated with pleural effusion, peritonitis, pelvic abscess, and sepsis. A two-stage nephrectomy requiring less radical resection and decreasing the surgical complications would have been preferable.

Child↗
PubMed2006

[Amyloidosis secondary to xanthogranulomatous pyelonephritis: a case report and review of the literature].

Xanthogranulomatous pyelonephritis (XGP) is a rare entity characterized by the formation of inflammatory renal masses rich in macrophages loaded with lipids. It is usually secondary to repeated urinary infections and urinary obstruction due to stones, which produce slow destruction of the renal parenchyma, requiring nephrectomy. It may sometimes be associated to secondary amyloidosis that leads to the appearance of a nephrotic syndrome. We have conducted a search in the Medline database between the years 1967 and 2003 and we only found 6 cases in adults and 3 cases in pediatric patients with amyloidosis secondary to xanthogranulomatous pyelonephritis. During this same period, there are more than 570 citations that include more than 1,000 patients with isolated XGP, so that we estimate that amyloidosis that complicates a XGP should be less than 1% of all the XGP cases. We present a case of XGP in a 51 year old female patient associated to amyloidosis that initiated with nephrotic syndrome, analyzing the clinical characteristics of the 9 previous cases. We compared their clinical characteristics with those of 51 patients with xanthogranulomatous pyelonephritis without amyloidosis of a large classical series in order to characterize this clinical picture better.

Amyloidosis↗
PubMedDate not supplied

[Stage II focal xanthogranulomatous pyelonephritis].

OBJECTIVE: To report a case of focalized stage II xanthogranulomatous pyelonephritis and the diagnostic difficulties encountered. METHODS: A 63-year-old female consulted at the emergency services for fever during the last two months and right lumbar pain. Urinary cultures were negative. A CT scan showed a poorly-defined heterogeneous mass in the lower pole of the right kidney. Fine needle punction-aspiration biopsy was compatible with renal cell carcinoma. The patient underwent radical nephrectomy. RESULTS: The histopathological study showed focalized stage II xanthogranulomatous pyelonephritis but no evidence of neoplasia. CONCLUSIONS: Xanthogranulomatous pyelonephritis can mimic the clinical, cytological and imaging features of renal neoplasia.

Biopsy, Needle↗
PubMed1987

Serendipitous diagnosis of childhood xanthogranulomatous pyelonephritis in a child with osteomyelitis.

Xanthogranulomatous pyelonephritis (XGP), a rare chronic renal infection in children, usually presents as high fever, pyuria and an abdominal mass. This child with clinical and radiologic evidence of osteomyelitis was not suspected of renal disease until a non-functioning kidney was discovered during a bone scan. The pathologic proven diagnosis of XGP could have been made by correlative imaging using renal ultrasound, a renal scan and a gallium scan. Computed tomography and voiding cystourethrography provided additional information as to the nature and extent of the disease process.

Bone and Bones↗
PubMed1989

[Xanthogranulomatous pyelonephritis. Value of magnetic resonance imaging].

Xanthogranulomatous pyelonephritis is a rare disease which frequently has a pseudotumoral appearance. Preoperative diagnosis is hazardous in spite of ultrasonography and CT scan correlation. Recently developed magnetic resonance imaging (MRI) identifies fatty tissue which is specific for XGP. The frequency of invasive investigations has decreased because of this new data and partial nephrectomy has become possible in localized forms of XGP. Magnetic resonance imaging provides an accurate reproduction of the lesions in three dimensions which allows detection of complications (abscess and fistulae) and a study of resection difficulties.

Aged↗
PubMed1988

[Xanthogranulomatous pyelonephritis: clinical experience of 8 cases].

Xanthogranulomatous pyelonephritis (XGP) is an uncommon form of granulomatous inflammation characterized by destruction of the renal parenchyma and replacement by solid sheets of lipid-laden macrophages. The first report was made by Schlagenhaufer in 1916. Due to diagnostic difficulties, relatively few cases have been reported. However, within the past 20 years, XGP has been recognized with increasing frequency. At present, over 400 cases have been reported. Recently, the computed tomographic (CT) findings of XGP have been described in a few sporadic case reports (1-4). Our clinical experience consists of 8 cases of XGP. The sonographic and computed tomographic findings in our cases are presented along with the correlation with the pathological specimens. We stress the importance of sonography and CT in preoperative planning. Moreover, in our cases we could obtain typical findings on sonography and CT, which enabled us to make a correct preoperative diagnosis. In this report we describe some specific features.

Adult↗
PubMed2006

[Xanthogranulomatous pyelonephritis in children].

OBJECTIVE: The authors report their experience of xanthogranulomatous pyelonephritis in children and emphasize the diagnostic and therapeutic difficulties supported by several published series. MATERIALS AND METHODS: This was a retrospective based on ten patients treated for xanthogranulomatous pyelonephritis. RESULTS: Treatment was surgical in 90% of patients. Total nephrectomy was performed in all diffuse forms (80%) and one of the 2 localized forms (10%). Treatment was exclusively medical in only one patient (10%). Five subcapsular nephrectomies, three total nephrectomies and one radical total nephrectomy were performed. The course after treatment was excellent in 100% of cases. CONCLUSION: The treatment of xanthogranulomatous pyelonephritis is surgical, although cure can sometimes be achieved by conservative treatment.

Adolescent↗
PubMed1976

Preoperative diagnosis of xanthogranulomatous pyelonephritis.

Preoperative diagnosis of xanthogranulomatous pyelonephritis may be correctly made in a significant proportion of affected patients thus preventing unnecessary radical surgery especially in the poor-risk patient. The diagnosis should be suggested in the patient with a history of chronic urinary tract infection and certain radiologic features. These include unilateral renal enlargement (either localized or diffuse), nonfunction on excretory urography, presence of renal and/or ureteral calculi, angiographic demonstration of avascular mass or masses with stretched, attenuated intrarenal vessels, prominent capsular and periureteric vessels, and an irregular impaired nephrogram with prominent avascular areas.

Angiography↗
PubMed1989

Xanthogranulomatous pyelonephritis.

Four patients with xanthogranulomatous pyelonephritis are presented; all patients were male and their symptoms were not urinary but nonspecific. Three of the patients are from a low socioeconomic class and did not have adequate medical services; therefore, we suggest that the disease is underreported.

Child, Preschool↗
PubMed1980

[Xanthogranulomatous pyelonephritis (author's transl)].

Xanthogranulomatous pyelonephritis, a special form of pyonephrosis, is hard to differentiate from other inflammatory or tumourous changes of the kidney. This is due to manifold clinical symptoms and uncharacteristic X-ray findings. The diagnosis is made histologically. The disease was observed in four female patients ages 11 to 53 years. Nephrectomy leads to cure in diffuse forms of the disease. In localised forms organ preserving operations with partial renal resections are sufficient.

Adult↗