Pyélonéphrite xanthogranulomateuse bilatérale focale : à propos d’un cas

Yacoubi, S.; Ziouziou, Imad; Zizi, M.; Jahid, Ahmed; Karmouni, Tarik; Khader, Khalid El; Koutani, Abdellatif; Andaloussi, Ahmed Iben Attya

doi:10.5489/cuaj.700

Cited by 4 publications

(4 citation statements)

References 17 publications

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“…Bilateral XPN is extremely rare. Only ten cases of bilateral diffuse and six cases of bilateral focal XPN have been reported in the literature [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Xantogranulomatous pyeloneprhritis in children

et al. 2018

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Xanthogranulomatous pyelonephritis (XPN) is an unusual and severe form of chronic inflammatory lesion of the kidney, characterised by the destruction of the renal parenchyma and the presence of multinucleated giant cells and lipid-laden macrophages, inflammatory infiltration and intensive renal fibrosis. There are a few cases in the literature which describe the disease in children. The pathomechanism of XPN is poorly understood. Renal obstruction with concomitant urinary tract infection is the most commonly associated pathological finding. The process is typically unilateral and may be focal or diffuse. In both cases, the perirenal infiltration is possible and can be mistaken for common renal neoplasm or inflammatory process. The symptoms are non-specific. Diagnostic imaging techniques with clinical suspicion have enabled XPN to be diagnosed and differentiated from malignancy with a high degree of confidence. Computed tomography (CT) is the mainstay of diagnostic imaging. The definitive diagnosis of XPN is based on pathological assessment after nephrectomy. We review and illustrate the clinical, radiological, surgical and pathological characteristics of XPN in children. All cases shown are surgically and histopathologically proven.Teaching Points • XPN can present different clinical manifestations. • CT is the mainstay of diagnostic imaging in XPN. • Focal type of XPN should be included in the differential diagnosis of children with a renal mass. • There are no clear guidelines on the management of XPN. • Conservative and surgical treatments should be considered for each individual case. • Histopathological examination confirms the diagnosis and excludes other benign and malign diseases.

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“…Bilateral XPN is extremely rare. Only ten cases of bilateral diffuse and six cases of bilateral focal XPN have been reported in the literature [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Xantogranulomatous pyeloneprhritis in children

et al. 2018

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“…Xanthogranulomatous pyelonephritis (XGP) is a form of chronic renal suppuration [3,4] occurring at any age, after 40 years, it affects more frequently three women for one man [5] but paradoxically men were concerned. Its etio-pathogenesis is not well known but the obstruction of the excretory tract (lithiasis, stenosis, tumor), recurrent urinary tract infection and immune deficiencies are the etiological factors [6,7].…”

Section: Discussionmentioning

confidence: 99%

Pseudotumor Xanthogranulomatous Pyelonephritis: Dignaostic and Therapeutic Difficulties (Two Cases)

Alafifi¹,

Larrache²,

Gallouo³

et al. 2022

SAR J Med Case Rep

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Introduction: Xanthogranulomatous pyelonephritis is a rare and unusual form of chronic pyelonephritis, characterized by the destruction of the renal parenchyma and its replacement by granulomas, abscesses and lipid-laden macrophage collections. Despite clinical and radiological knowledge, it remains a surprise for the surgeon. We are reporting through these two observations the diagnostic difficulties of this condition would lead to an inappropriate treatment as well as to a more severe disease. Observations: Two patients (52 and 57 years old), one of whom is followed fortype 2 diabetes mellitus , were hospitalized for pyonephrosis due to obstructive pyelic and ureteral lithiasis. The pyonephrosis was revealed by a chronic loin pain in a febrile context and confirmed by urogramme showing a destruction of the renal parenchyma, dilated pyelocaliceal cavities with rounded formations of pseudo-tumoral appearance on the lithiasis obstacles. Our initialtreatment consisted of percutaneous nephrostomy under antibiotic covering and secondarily of nephro-ureterectomy without bladder flange performed six weeks later. Histopathology studies showed diffuse xanthogranulomatous pyelonephritis. The postoperative follow up was simple in both cases. Conclusion: Xantogranulomatous pyelonephritis is a rare, severe and chronic form of pyelonephritis whose diagnosis is always histological. Its clinical picture is no specific, hence the problem is that it poses achalleng of differential diagnosis with renal tumors and urogenital tuberculosis. Its treatment is based on nephrectomy.

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“…21,22 The final diagnosis should be determined by the histopathological examination findings, showing chronic pyelonephritis consisting of interstitial fibrosis and cellular infiltrates. It is thought that XGPN is a morphologic variant of chronic pyelonephritis, but differs from it with the abundant infiltrate of foam cells, which are thought to be macrophages containing lipids.…”

Section: Discussionmentioning

confidence: 99%

Xanthogranulomatous pyelonephritis presenting as a pseudotumour

Chlif

Chakroun

Rhouma

et al. 2016

CUAJ

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Original research E36case series AbstractIntroduction: Xanthogranulomatous pyelonephritis (XGPN) is an atypical form of chronic pyelonephritis referred to as the ''great imitator'' because the clinical and radiological findings closely resemble other pathological entities, especially for the focal forms. Distinguishing focal XGPN from renal cancer is preoperatively difficult. Methods:We report a total number of 12 pseudotumoural XGPN cases diagnosed and treated in our department. The aim of this study is to try to better understand the clinicopathological profile of XGPN and improve its management. Results: The mean age of patients was 51.52 years. Gender ratio was 0.71. An obstructive renal calculus was noticed in nine patients (75%). Only one patient (8.3 %) presented with loin pain associated with fever, weight loss, asthenia, and increased biological inflammation markers. A bifocal mass was noticed in one case (8.3 %). The average size of the tumour was 6.58 cm. The mass was cystic in three cases (25 %). Perinephral fat strand, thickening of Gerota's fascia, hydronephrosis, and presence of renal calculi was noticed in all solid tumour cases. XGPN was suspected in only one case (8.3%), a percutaneous biopsy showed XGPN lesions treated by antibiotics and a double J drainage. Radical nephrectomy was performed in eight patients (66.7 %) and three patients underwent partial nephrectomy (25 %). No recurrence of XGPN has been noted. Conclusion: Pseudotumoural XGPN is a rare benign disease of the kidney. Its treatment should be conservative. Lack of knowledge of this disease may explain the high rate of abusive nephrectomies. These data should be considered in the future.

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Pyélonéphrite xanthogranulomateuse bilatérale focale : à propos d’un cas

Cited by 4 publications

References 17 publications

Xantogranulomatous pyeloneprhritis in children

Xantogranulomatous pyeloneprhritis in children

Pseudotumor Xanthogranulomatous Pyelonephritis: Dignaostic and Therapeutic Difficulties (Two Cases)

Xanthogranulomatous pyelonephritis presenting as a pseudotumour

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