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PubMedDate not supplied

[Systemic amyloidosis secondary to xanthogranulomatous pyelonephritis].

Secondary amyloidosis is a relatively common pathology in which chronic infectious diseases are common causes, especially infected bronchiectasis, osteomyelitis or chronic ulcers. The association of xanthogranulomatous pyelonephritis and systemic amyloidosis is extremely rare. To our knowledge, despite innumerable cases of xanthogranulomatous pyelonephritis reported in the literature, this association has been reported in only 8 previous cases. Patients usually complain of fever, back or flank pain and urinary tract symptoms. A long lasting evolution of the process is frequent. We report a 70 year old patient who developed amyloidosis secondary to xanthogranulomatous pyelonephritis. As well as the rarity of this association, this case is exceptional in its clinical presentation, without any urinary tract symptoms that could suggest the diagnosis.

Aged↗
PubMed1980

Xanthogranulomatous pyelonephritis associated with renal carcinoma.

The first case of xanthogranulomatous pyelonephritis associated with renal carcinoma is reported. Differentiation of the 2 entities clinically may be difficult and, since treatment regimens recommended in the past have included partial nephrectomy in cases of limited xanthogranulomatous pyelonephritis, one must hereafter be aware of such a combination when considering such a therapeutic modality.

Granuloma↗
PubMed2005

Xanthogranulomatous pyelonephritis due to calculi: report of 63 cases and review of literature.

OBJECTIVE: To examine the relationship between clinical history and results of renal investigations in patients with xanthogranulomatous pyelonephritis. METHODS: A retrospective review was conducted on 63 cases presenting with histopathological diagnosis of xanthogranulomatous pyelonephritis between 1995 to 2002, at the department of Urology, Bolan Medical College and Sandeman Provincial Teaching Hospital Quetta. RESULTS: There were 26 males and 37 females having an average follow up of two years. Positive findings on examination and investigations at presentation were fever and flank pain in 59 (93.6%) patients and pyuria in 34 (53.9%) patients. All the patients had renal and ureteric calculi with no or severe reduction in the function of the affected kidney on DTPA scan. Hypertrophy of the contra lateral kidney was seen in 56 (88.8%) patients. CONCLUSION: Xanthogranulomatous pyelonephritis is a common entity in this part of the world. Late referral leads to loss of the kidney. Pre-operative diagnosis of the condition is desirable and if surgery is mandatory then all infected tissues have to be removed.

Adolescent↗
PubMed2003

Xanthogranulomatous pyelonephritis with acquired cystic disease of the kidney in a haemodialysis patient.

A 54-year-old-female patient who had received regular haemodialysis therapy for 12 years was referred to our hospital for evaluation of a left renal mass. Imaging examinations revealed acquired cystic disease of the kidney (ACDK) and a tumour-like lesion in the left kidney. Because of the preoperative diagnosis of the left renal cell carcinoma, the patient underwent a left nephrectomy. Pathological examination revealed xanthogranulomatous pyelonephritis. It was difficult to distinguish xanthogranulomatous pyelonephritis from renal cell carcinoma in our case, because it is very rare for xanthogranulomatous pyelonephritis to occur in ACDK.

Female↗
PubMed1997

Xanthogranulomatous pyelonephritis mimicking malignant disease: is preservation of the kidney possible?

Xanthogranulomatous pyelonephritis (XGP) is an uncommon form of pyelonephritis rarely seen in children. It is characterized by destruction of the renal parenchyma and invasion of adjacent tissues, mimicking renal tumors. Preoperative diagnosis is very difficult. Two children with XGP are presented. One underwent nephrectomy and the other drainage of a renal abscess with kidney preservation. Although surgery is considered the only effective treatment, a high index of suspicion and renal biopsy may prevent radical nephrectomy.

Child↗
PubMed1998

Xanthogranulomatous pyelonephritis: report of four cases.

We report 4 patients with xanthogranulomatous pyelonephritis (diagnosed and treated between 1992 and 1996), aged 16 to 55 years (mean age 37 years). All had urolithiasis, pyonephrosis and nonfunctioning kidneys prior to surgical intervention, and underwent total nephrectomy. Clinical, laboratory and radiologic findings are discussed in the light of the cases reported in the literature.

Adolescent↗
PubMed1992

Focal xanthogranulomatous pyelonephritis associated with renal cell carcinoma.

A case of focal xanthogranulomatous pyelonephritis (XGP) with an associated renal cell carcinoma is presented. The tumor was discovered incidentally during a general surgical procedure. Subsequent evaluation showed a 3 cm mass in the lower pole of an otherwise normal kidney with no evidence of calculus or infection. Radical nephrectomy revealed classic findings of focal XGP with coexistent clear cell carcinoma. The literature describing the rare association between these conditions is reviewed.

Carcinoma, Renal Cell↗
PubMed2000

Xanthogranulomatous pyelonephritis in childhood: a rare but important clinical entity.

PURPOSE: Xanthogranulomatous pyelonephritis (XGPN) is extremely rare in children. The authors review their experience of this condition. METHODS: Medical records were investigated to conduct a retrospective study of 4 patients with XGPN (3 boys, 1 girl; age range, 2 months to 7 years) at the authors' institute over the past 14 years. RESULTS: Three of the 4 patients presented with fever of unknown origin and 1 with general fatigue. An abdominal mass was palpable in two cases at initial presentation. Although all patients had pyuria or hematuria, preoperative urine culture was positive in only 2 cases. Preoperative radiologic studies showed that 1 kidney was affected completely in 2 cases and affected partially in 2 cases. Preoperatively, the provisional diagnosis was XGPN in 3 cases, and Wilms' tumor in 1 case. Total nephrectomy was performed in 3 cases and enucleation in 1 case. XGPN was confirmed in all cases by histopathologic studies, but the underlying disease could be identified only in 1 case (cystinuria). All patients did well postoperatively and have had no further health problems over a mean follow-up period of 4.8 years. CONCLUSIONS: XGPN should be considered when there is a history of recurrent or therapy-resistant pyelonephritis. Preoperative radiologic investigation is paramount for diagnosis, and nephrectomy is the treatment of choice, although partial resection or enucleation are adequate for partially affected kidneys.

Child↗
PubMedDate not supplied

MR imaging of xanthogranulomatous pyelonephritis.

The magnetic resonance (MR) appearance of a case of xanthogranulomatous pyelonephritis is described and compared with CT and surgical findings. Both CT and MR were comparable in displaying the morphology of this uncommon renal abnormality.

Female↗
PubMed2005

Diffuse xanthogranulomatous pyelonephritis in a patient with myotonic dystrophy and cerebral palsy.

Xanthogranulomatous pyelonephritis (XGP), a morphological and clinical variant of chronic pyelonephritis, is an uncommon disease in children. It is characterized by the destruction of the renal parenchyma and replacement by granulomatous tissue containing foamy lipid-laden macrophages and is classified into diffuse and focal XGP. We present a case of diffuse XGP in a child with myotonic dystrophy complicated by cerebral palsy and discuss the importance of correct diagnosis and preoperative management to reduce inflammation and improve malnutrition associated with the disease.

Adolescent↗
PubMed1996

Xanthogranulomatous pyelonephritis associated with transitional cell carcinoma of the renal pelvis.

Xanthogranulomatous pyelonephritis (XPN) is an uncommon, but not rare, type of bacterial infection of the kidneys. Malignancies originating within the renal pelvis are uncommon. We report a case of XPN associated with a transitional cell carcinoma (TCC) of the renal pelvis in a 70-year-old woman. The pathogenesis of carcinoma of the renal pelvis in the presence of XPN is related to obstruction, chronic inflammation, and mechanical irritation caused by calculi. In the case reported here, obstruction was due to a concomitant TCC of the ureter without the presence of calculi. A review of the twelve published case reports of XPN with TCC of the renal pelvis, including the present case, showed that the frequency of this association is 3.3%, the average age at presentation is 65.3 (range 49-78) years, and that the male:female ratio is 2:1. Moreover, 25% of the patients had TCC of the ureter and 8.3% TCC of the bladder. The combination of XPN, TCC of the renal pelvis, and lithiasis occurred in 33.3% of the cases. XPN must be treated by nephrectomy not only because it is a destructive inflammatory process leading to complete loss of renal function, but also because the kidney may be harboring a malignant tumor.

Adult↗
PubMed1996

Xanthogranulomatous pyelonephritis in children: conservative management.

OBJECTIVES: Three new cases of xanthogranulomatous pyelonephritis are described in children. METHODS: Laboratory examinations including white and red blood cell counts, erythrocyte sedimentation rate, renal function, urinalysis and cystography were performed. RESULTS: All of the patients had a palpable abdominal mass. Urine culture was positive (Proteus mirabilis) in only 1 patient. Associated urological abnormalities were found in 2 cases. Urographically a functionless kidney was encountered in 2 children and a renal mass in the other. None could be diagnosed preoperatively. CONCLUSIONS: Although nephrectomy has been said to be the treatment of choice, conservative treatment can be successful as shown by 1 of our patients.

Biopsy↗
PubMed2003

[Xanthogranulomatous pyelonephritis. Diagnostic and therapeutic problems. Report of three paediatric cases].

Xanthogranulomatous pyelonephritis (XGP) is an unusual and rare form of chronic renal suppuration in children, which appear to have a multifactorial pathogenesis. It is usually diffuse, but can remain localized to one part of the kidney, resulting in a misleading pseudoneoplastic appearance raising a problem of differential diagnosis with the other renal masses, particularly Wilms tumour. The authors present a retrospective analysis of three cases of XGP observed in the Monastir department of paediatric surgery. The preoperative diagnosis was pyonephrosis with perirenal abscess in two cases and Wilms tumour in the third case. The diagnosis of XGP was established on histological examination of the operative specimens. The aim of this study is to emphasize the diagnostic difficulties of this disease that, in localized forms, often lead to inappropriate treatment and to establish a treatment regimen for this rare disease.

Child, Preschool↗
PubMed1992

[A clinical study of xanthogranulomatous pyelonephritis (XGP) with special emphasis on the magnetic resonance imaging].

Xanthogranulomatous pyelonephritis (XGP) is an uncommon form of granulomatous inflammation characterized by destruction and replacement of the renal parenchyma by masses of lipid-laden macrophages. We report the first case of the pyonephrotic type of XGP in which Magnetic resonance imaging (MRI) was used in Japan, and summarize the clinical characteristics of 163 cases with XGP in the Japanese literature for age, sex, laboratory data, preoperative diagnosis and operation. A 56-year-old female was admitted with left flank pain. Left nephrectomy was performed following diagnosis of XGP by computed tomography (CT) and MRI. Histopathological findings confirmed the diagnosis of XGP. Furthermore, we evaluated the MR images in XGP. MR images correlated well with the CT images showing an enlarged multiloculated kidney. The internal portion of the loculated areas were of intermediate intensity on T1-weighted images, and became very intense on the T2-weighted sequences, indicating a long T2. MRI appears to be of value in the investigation of renal mass lesions.

Female↗
PubMedDate not supplied

[Xanthogranulomatous pyelonephritis].

Based on the evidence obtained on 28 cases of xanthogranulomatous pyelonephritis (XP), the authors suggest to distinguish two XP clinical forms: obstructive and nonobstructive. The former may occur in noticeable destruction of renal tissue and urine retention secondary, most frequently, to long-standing nephrolithiasis. The latter simulates by symptoms and examination results renal carcinoma. In suspicion of nonobstructive XP, the surgeon should consider fast-made intraoperative biopsy to decide on feasibility of sparing intervention.

Adolescent↗
PubMed1998

Is diffuse xanthogranulomatous pyelonephritis a contraindication to retroperitoneoscopic nephroureterectomy? A case report.

Diffuse xanthogranulomatous pyelonephritis (XGP) is a rare form of chronic infection of the child's kidney. The clinical presentation is nonspecific, and investigation often reveals a nonfunctional kidney. Preoperative diagnosis is very difficult even with ultrasonography and computed tomography. Total nephrectomy is the treatment of choice, but it is considered very difficult and is usually contraindicated for laparoscopic or retroperitoneoscopic techniques. Reported here is a case of retroperitoneal laparoscopic nephroureterectomy for XGP.

Adolescent↗