Xanthogranulomatous pyelonephritis (XGPN) is a rare clinicopathological syndrome that is unique among the various inflammatory conditions of the kidney, and it closely mimics renal cell carcinoma, both clinically and radiologically. Approximately one third of XGPN cases have associated complications, such as abscess and fistulas, although the latter is much less common. Spontaneous renocolic fistulas of non-tubercular origin are also rare, especially in Asia. Fistula or deep sinus formation as a complication of XGPN is a rare clinical condition. Currently, only approximately 10 such cases (including our case) have been reported in the literature. We present one such case of spontaneous nephrocolic fistula complicating XGPN. Ultrasonography, an intravenous urogram, retrograde pyelogram, and computerized tomography aided in diagnosing the presence of a renocolic fistula. The treatment regimen of total nephrectomy with primary closure of the rent in the colon was adequate.

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Background: Beta-catenin is normally expressed in the membrane and cytoplasm of endometrial glandular cells. Aberrations in beta-catenin expression can predict progression of endometrial hyperplasia to endometrial carcinoma. Nuclear expression of beta-catenin correlates with the increasing histological grade of endometrial cancer. Methods: 51 cases were included in our study. The patients presented with clinical and/or radiological evidence of probable endometrial disease. Formalin fixed paraffin embedded tissues were stained with hematoxylin and eosin followed by histological diagnosis and exact categorisation. Immunostaining with anti-beta-catenin monoclonal antibody carried out on these endometrial biopsies. Result: Statistically significant association was seen between nuclear positivity of beta-catenin in the endometrial glandular cells with increasing severity of endometrial pathology (P < 0.001). Atypical hyperplasia and endometrial carcinoma cases showed nuclear beta-catenin positivity. Nuclear expression of beta-catenin also correlated with advanced FIGO stage of endometrial carcinomas. 67% of endometrial carcinoma of FIGO stage III demonstrated nuclear localization of beta-catenin. A statistically significant association was noted between the intensity of beta-catenin expression and the histological diagnosis (P < 0.001). There was also a statistically significant association between percentage of endometrial glandular cells showing membranous and cytoplasmic positivity and the endometrial pathology (P=0.038). Conclusion: Variations in beta-catenin expression play an important role in endometrial pathology and it is a relatively early event during the endometrial hyperplasia-carcinoma sequence. Alterations in beta-catenin expression in atypical endometrial hyperplasia and in increasing grades of endometrial cancers can be used as a predictive as well as a prognostic indicator.