Xanthogranulomatous pyelonephritis

Xanthogranulomatous Orchitis: Rare Case with Brief Literature Review

Xanthogranulomatous reaction is uncommon non neoplastic reaction involving multiple organs, commonly kidney and gallbladder. Its rarely involve testicle. We report 69-year old man present to clinic with right testicular swelling for six month duration. Testicular markers within normal range. Us scrotum revealed right large avascular heterogeneous mass inside testicle. Right inguinal orchiectomy done and revealed Xanthogranulomatous orchitis.

[A CASE OF XANTHOGRANULOMATOUS PYELONEPHRITIS ASSOCIATED WITH CHROMOPHOBE RENAL CELL CARCINOMA]

Xanthogranulomatous pyelonephritis (XGP) is a type of chronic suppurative renal inflammation. We present an extremely rare case of XGP concomitant with chromophobe renal cell carcinoma (RCC). A-39-year-old woman presented with transient fever and left lower abdominal pain during steroid pulse therapy for thyroid eye disease. Imaging studies including contrast-enhanced computed tomography, magnetic resonance imaging, and doppler ultrasonography, showed a 40 mm unusual mass lesion in the upper pole of the left kidney, and we could not rule out the possibility of malignancy.A left open partial nephrectomy for the renal mass was performed. Pathological examination revealed a 5 mm chromophobe RCC located beside a 30 mm XGP. The patient presented a favorable course without inflammatory episodes or tumor recurrence during the 9-month follow-up. This is the first case report of the coexistent XGP and chromophobe RCC.

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.

Xanthogranulomatous pyelonephritis: King Faisal Specialist Hospital experience

Clinicopathologic features in a series of 11 cases of xanthogranulomatous pyelonephritis are reviewed. There were seven males and four females ranging in age from 6-56 years with an average age of 34 years. The disease was unilateral in ten cases and bilateral in one. There was associated urinary tract obstruction in eight cases due to renal or ureteric stones (5), ureteric stricture (2), and carcinoma of the urinary bladder (1). Two of the patients were renal transplant recipients in which native kidneys were involved by xanthogranulomatous pyelonephritis. In one of these cases, a small renal cell carcinoma was found in one kidney along with amyloidosis involving both kidneys. Radiologic findings were mostly non-specific. These findings are briefly discussed in light of the salient features of this disease as published in the literature.

Xanthogranulomatous pyelonephritis with emphasis on computerized tomography scan. Retrospective study of 20 cases and literature review

The authors reviewed 20 cases of xanthogranulomatous pyelonephritis. An accurate preoperative diagnosis of this disease is difficult because of its clinical and radiologic similarities to various other renal lesions. A resistant urinary tract infection in a patient with a nonfunctioning kidney and a perinephric abscess should lead to the condition being suspected. Although xanthogranulomatous pyelonephritis is mainly a histologic diagnosis, computerized tomography opens new perspectives in the preoperative determination. This could allow less radical surgery in selected cases.

Xanthogranulomatous pyelonephritis

Thirty-eight nephrectomy specimens and two biopsies of perinephric abscesses from patients with xanthogranulomatous pyelonephritis have been examined. Twenty showed evidence of venous damage. This included organised thrombi in 12, intimal thickening in five and phlebitis in three. All specimens showed evidence of previous haemorrhage in the form of haemosiderin deposition. These findings differed significantly from a control series of chronic pyelonephritis. It is suggested that venous occlusion and haemorrhage are factors in the pathogenesis of the lipid accumulation in the kidney which is characteristic of this condition. The association of a papillary transitional cell carcinoma of the pelvis in a patient with xanthogranulomatous pyelonephritis is reported for the first time.

Bilateral renal malakoplakia

A case of malakoplakia is presented which was confined to the renal parenchyma of both kidneys in a thirty-five-year-old woman in whom fatal renal failure developed in three weeks. Bilateral renal malakoplakia is rare, and unlike malakoplakia of the bladder, it behaves as a progressive, destructive, and fatal disease.

Xanthogranulomatous pyelonephritis masquerading as occult malignancy

Xanthogranulomatous pyelonephritis (XGP) can present with weight loss, anemia, leukemoid reaction, and generalized debility; there may be no signs or symptoms referable to the urinary tract. Confusion between XGP and renal adenocarcinoma is well recognized, but other malignancies can also be simulated. Case histories of patients with proved XGP whose clinical presentations suggested occult malignancies are recorded. Proteus urinary tract infection, calculi, and a nonvisualizing kidney on intravenous pyelogram should suggest the correct diagnosis. The pathology, bacteriology, diagnosis, and treatment are reviewed.

Xanthogranulomatous endometritis: case report

A case of chronic endometritis with unusual histological features due to the presence of abundant foam cells and lipid material is described. The presence of foam cells, abundant intra- and extracellular lipid together with other inflammatory cells in the absence of endometrial hyperplasia or carcinoma warrants the diagnosis of xanthogranulomatous endometritis.

Xanthogranulomatous pyelonephritis

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