Arterial encasement in xanthogranulomatous pyelonephritis.
A case of xanthogranulomatous pyelonephritis is reported in which arterial encasement was demonstrated. Pathologic correlation is shown.
Aged↗
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Computed tomography in xanthogranulomatous pyelonephritis.
Two cases of xanthogranulomatous pyelonephritis (XGP) examined preoperatively by computed tomography are reported. In one, preoperative diagnosis of an inflammatory abscess-forming disease was possible. Several features of computed tomography in XGP permit differentiation from renal carcinoma. Global renal enlargement, the presence of calculi, the spread of infiltration into the fatty capsule with thickening of Gerota's fascia, and the characteristic density differences between cortex and medulla as a result of reduced contrast medium concentrations in the pyramids are suspicious of this special form of interstitial nephritis.
Diagnosis, Differential↗
Angiographic features of xanthogranulomatous pyelonephritis.
Preoperative diagnosis of xanthogranulomatous pyelonephritis (XGP) is possible in numerous cases by renal angiography, thus permitting the differentiation of this disease from renal adenocarcinoma. Angiographic features are reviewed in patients with proved XGP. The most useful findings are: (1) presence of hypervascularised areas; (2) dilated renal capsular and perforating arteries, and (3) heterogenous aspect of the kidney during the nephrographic period.
Adult↗
Xanthogranulomatous pyelonephritis associated with renal cell carcinoma. Report on two cases and review of the literature.
Xanthogranulomatous pyelonephritis is a rare and particularly aggressive variant of chronic destructive pyelonephritis. Even when all modern diagnostic possibilities are exhausted, it is often not possible to distinguish xanthogranulomatous pyelonephritis from a renal cell carcinoma preoperatively. In clinical practice false diagnoses are therefore frequent. The coexistence of xanthogranulomatous pyelonephritis and renal cell carcinoma is extremely rare. We report 2 such cases. In 1 case surgery was performed on the kidney affected by xanthogranulomatous pyelonephritis using a renal sparing technique.
Aged↗
[Xanthogranulomatous pyelonephritis combined with retroperitoneal xanthogranuloma, simulating kidney tumor].
Xanthogranulomatous pyelonephritis is a special variant of interstitial nephritis, when an inflammatory infiltration contains xanthomatous cells. Its diagnosis is difficult and possible only on the basis of a histologic analysis of a surgically removed kidney. A case of xanthogranulomatous pyelonephritis combined with retroperitoneal xanthogranuloma is presented. Kidney carcinoma was suspected and in the course of operation the biopsy of kidney was taken. In the authors' opinion a histologic express diagnosis is recommended during the operation.
Adult↗
Hand-assisted laparoscopic nephrectomy for xanthogranulomatous pyelonephritis with nephrocutaneous fistula after failed flank exploration.
Xanthogranulomatous pyelonephritis presenting with nephrocutaneous fistula is a rare condition, and its treatment of choice is nephrectomy. Laparoscopic management has been proved to be challenging in these inflammatory renal conditions. However, there was no previous report in the literature regarding laparoscopic treatment of nephrocutaneous fistula especially after previous operation. In this communication, we report the first case of hand-assisted laparoscopic nephrectomy for xanthogranulomatous pyelonephritis with nephrocutaneous fistula after previous failed flank exploration.
Cutaneous Fistula↗
Xanthogranulomatous pyelonephritis in childhood: case report and review of English and Japanese literature.
Xanthogranulomatous pyelonephritis is an uncommon disease that is usually seen in middle-aged women and is much rarer in children. We report a case of diffuse xanthogranulomatous pyelonephritis in a 3-year-old boy who had a nonfunctioning hydronephrotic right kidney on an excretory urogram. A review of the English and Japanese literature on xanthogranulomatous pyelonephritis in childhood revealed 2 remarkable differences regarding the incidence of sex and radiological findings. The majority of patients were girls in the English literature, whereas the opposite sex was seen in the majority of cases in Japan. The involved kidney was functioning on an excretory urogram in the majority of cases reported in the English literature, however, in all cases from Japan the involved kidney was non functioning. These findings further support the newer concept that xanthogranulomatous pyelonephritis in childhood exists in focal as well as diffuse forms.
Child, Preschool↗
[Xanthogranulomatous pyelonephritis in childhood: considerations on 2 new cases].
The Authors report their experience about two cases of xanthogranulomatous pyelonephritis in childhood. The clinical history, diagnostic procedures and surgical treatment are described. The xanthogranulomatous pyelonephritis is a rare form of chronic inflammatory disease of the kidney, in which pre-operative differential diagnosis with renal cancer or with extra renal neoplastic and inflammatory diseases is very difficult. The signs and symptoms are not characteristic, such as renal tumour, recurrent UTI, abdominal pain, fever. Also non characteristic are the findings, performed with diagnostic ultra sound and computed tomography. The surgical treatment is always effective in the xanthogranulomatous pyelonephritis. About 500 cases are described in adults and about 80 cases in children, from the first description in 1963. The first of our cases, occurring in a boy 6 years old, was treated with nephrectomy, because of the pre-operatory aspect was like tumour. In the second of the cases described, occurring in a girl 11 years old, the nephrectomy was performed because the chronic purulent inflammatory process had involved all the kidney. In the post-operative, in the first case was performed a relaparotomy for intestinal occlusion in 12th day, in the second case the post-operative was uneventful. The Authors emphasize the importance of the xanthogranulomatous pyelonephritis in the differential diagnosis in children with recurrent UTI, renal masses, fever, in the clinical history.
Child↗
Xanthogranulomatous pyelonephritis in bilharzial patients: a report of 25 cases.
The preoperative diagnosis of xanthogranulomatous pyelonephritis is difficult due to its similarities to other renal diseases. Also, its relationship to bilharziasis to the best of our knowledge has never been studied. We attempted to explore these 2 problems by reviewing the files and pathological slides of 25 patients whose diagnosis was proved histopathologically to be xanthogranulomatous pyelonephritis. We concluded that the diagnosis of xanthogranulomatous pyelonephritis preoperatively still is difficult. We believe that bilharziasis is an etiologic factor for the disease by increasing the incidence of urinary tract obstruction, infection and stone formation. We plan to study this relationship further by examining the freshly removed kidneys immunohistologically.
Adult↗
[A case of xanthogranulomatous pyelonephritis--an experience of echo-guided aspiration biopsy for the diagnosis].
Xanthogranulomatous pyelonephritis is a rare disease of the kidney. The pre-operative diagnosis of this disease is usually very difficult. Recently, echo-guided aspiration biopsy has been suggested for the differential diagnosis of the renal mass. We experienced a case of xanthogranulomatous pyelonephritis and performed echo-guided aspiration biopsy. A 57-year-old female was admitted to our hospital with complaints of upper abdominal pain and right lumbago. Judging from the findings obtained by intravenous pyelography, computed tomographic scan, ultrasonography and angiography, the lesion was a right renal inflammatory mass but renal tumor could not be denied. Because clear cell carcinoma was suspected from the results of echo-guided aspiration biopsy, right radical nephrectomy was performed. However, the resected kidney was diagnosed to be xanthogranulomatous pyelonephritis. Post-operative course was uneventful.
Adenocarcinoma↗
Xanthogranulomatous pyelonephritis in children: analysis by diagnostic modalities.
Xanthogranulomatous pyelonephritis (XGP), an uncommon chronic inflammatory renal disorder of middle-aged women, is rarely seen in childhood. We report the sonographic findings in a 2-year-old girl with the diffuse form of XGP and discuss the role of newer imaging modalities in the diagnosis and management of this disorder.
Child, Preschool↗
Simultaneous occurrence of transitional cell carcinoma and urothelial adenocarcinoma associated with xanthogranulomatous pyelonephritis.
We report on a patient with xanthogranulomatous pyelonephritis, in situ transitional cell carcinoma, and focal prosoplasia revealing abrupt conversion of transitional epithelium to moderately well-differentiated adenocarcinoma. The etiology and pathogenesis of mucinous adenocarcinoma in the renal pelvis very likely involves the prosoplastic transition of pre-existing transitional carcinoma to adenocarcinoma. The urologist should be aware of the increased possibility of this tumor developing in a patient with longstanding infection, and frozen section should be performed more often because the gross structure of the tumor frequently appears normal. This permits the urologist to change his surgical strategy if frozen section is positive for tumor.
Adenocarcinoma↗
Xanthogranulomatous pyelonephritis: clinical findings and surgical considerations.
OBJECTIVE: Xanthogranulomatous pyelonephritis (XGP) is an uncommon but well-characterized inflammatory process of the kidney. Few reports, however, have correlated preoperative radiographic features with findings at surgical exploration. We report our experience in the surgical management of XGP with emphasis on the use of computed tomography (CT) in the preoperative evaluation. METHODS: We retrospectively reviewed all medical records including radiographic materials of 27 patients with a pathologic diagnosis of XGP. In particular, preoperative CT features were analyzed to see if they correlated with surgical findings. RESULTS: A CT scan was performed in 23 of the 27 patients. Of these 23 patients 20 (87%) were diagnosed with XGP based on the CT findings. CT accurately defined the extent of the perinephric inflammatory reaction, identifying 8 patients with muscular extension, 3 with splenic involvement, 1 with extension into the colon, and 5 with encasement of the great vessels. In no case did CT underestimate the involvement of adjacent tissues. CONCLUSIONS: Although XGP is a rare disease, a careful preoperative evaluation can suggest its diagnosis. CT is particularly valuable in that it not only demonstrates characteristic renal findings, but also shows the extent of inflammation and extent into adjacent tissues. This will aid in surgical planning in choosing an approach that will provide adequate exposure and facilitate patient care.
Adult↗
Xanthogranulomatous pyelonephritis in childhood.
A case of multifocal xanthogranulomatous pyelonephritis (XPN) in childhood diagnosed by ultrasound, computed tomography and needle biopsy is described. Following antibiotic therapy, ultrasound and a DMSA renal scintiscan showed no discernible scarring and restoration of function. This has not been previously described.
Child, Preschool↗
Pediatric focal xanthogranulomatous pyelonephritis: dynamic contrast-enhanced MRI findings.
Xanthogranulomatous pyelonephritis (XPN) is the result of chronic renal infection. It is very rare in childhood and the focal form, which is said to be more common in children, is often misdiagnosed as a renal tumor. We report a case of a focal XPN in a 14-year-old girl. The true preoperative diagnosis may be very hard in children especially in the focal form but it seems to be possible by the help of dynamic contrast-enhanced MRI.
Adolescent↗
Focal xanthogranulomatous pyelonephritis simulating a renal tumor: CT characteristics.
Xanthogranulomatous pyelonephritis is the replacement of renal parenchyma by large lipid-filled macrophages clinically associated with an enlarged, nonfunctioning kidney containing a calculus in the diffuse form or tissue destruction in one pole of a duplicated kidney associated with a calculus in the focal form. We report a case where a focal mass in a functioning kidney with no evidence of calculus, duplication, or fat density simulated a primary renal tumor.
Adult↗
Xanthogranulomatous pyelonephritis. A review with 2 case reports.
Xanthogranulomatous pyelonephritis is a rather peculiar and rare form of chronic pyelonephritis and is usually caused by calculous urinary tract obstruction. The characteristic pathological finding is the presence of foam cells. We present 2 cases and give special attention to the clinical diagnosis and the phenomenon of nephrogenic hepatic dysfunction. A new series of 200 cases has been analyzed, and the most typical features of this inflammatory condition are compared with the findings in earlier series from the world literature.
Adult↗
Xanthogranulomatous pyelonephritis in a 1-year old boy.
Xanthogranulomatous pyelonephritis (XGP) is a rare, chronic inflammatory lesion of the kidney associated with both chronic infection and obstruction. Most common in middle-aged females, it is important to recognize in children because it may be confused with childhood renal malignancies particularly Wilms' tumor. We report a case of a 1-year old male with antenatally detected and postnatally confirmed hydronephrosis. Further investigation revealed a left incomplete duplex collecting system with obstructing lower pole stones, pelvicaliectasis and widespread foci of calcification. He underwent a left nephroureterectomy with the pathological report noting XGP.
Humans↗