Xanthogranulomatous pyelonephritis presenting as a pseudotumour

Chlif, Mohamed; Chakroun, Marouene; Rhouma, Sami Ben; Chehida, Mohamed Ali Ben; Sellami, Ahmed; Gargouri, M.; Nouira, Yassine

doi:10.5489/cuaj.3225

Cited by 24 publications

(26 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Two forms of morphological involvement are reported; more common diffuse form which spread with pelvic communication and relatively rarer focal form within the renal cortex [5]. Since, focal form strictly mimics renal carcinoma; distinguishing focal XGP from renal cancer is preoperatively difficult [6].…”

Section: Discussionmentioning

confidence: 99%

Xanthogranulomatous pyelonephritis: a case with rare adhesion to pancreas

2017

View full text Add to dashboard Cite

Xanthogranulomatous pyelonephritis (XGP) is a rare benign condition with unknown aetiology and chronic infection of kidney. Commonly, most cases are related with urinary tract obstruction, nephrolithiasis, infection, diabetes, and/or immune compromise. XGP is associated with destruction of the renal parenchyma and granulomatous inflammation with foamy lipid-laden macrophages resulting from obstructive uropathy. It closely mimics a malignancy, exhibiting local tissue invasion and destruction. Adjacent organs especially duodenum as well as very rarely pancreas or spleen may be involved. Additionally, XGP is known as notorious for fistulisations, such as pyelocutaneous and ureterocutaneous fistulae, which have been reported as well described. XGP may be indistinguishable from renal cell carcinoma by radiographic and clinic consultation so it must be diagnosed based on the histopathologic examinations. Furthermore, macroscopic appearance of XGP is a mass of yellow tissue with focal haemorrhage besides necrosis and in this regard, it grossly resembles renal cell carcinoma. Here, we report the case of a 32-year-old female, preoperatively diagnosed as malignancy by clinical examination. Our further pathological evaluations revealed very rarely adhesion of XGP to pancreas tissue.

show abstract

Section: Discussionmentioning

confidence: 99%

Xanthogranulomatous pyelonephritis: a case with rare adhesion to pancreas

2017

View full text Add to dashboard Cite

show abstract

“…A recently published case series of 12 XGPN [1] cases showed that only one patient presented with fever. Common presentations include a flank mass or flank pain.…”

Section: Discussionmentioning

confidence: 99%

Xanthogranulomatous pyelonephritis presenting asProteuspreperitoneal abscess

Yeow

Chong

2016

J. surg. case rep.

View full text Add to dashboard Cite

Xanthogranulomatous pyelonephritis (XGPN) is a rare form of chronic pyelonephritis with progressive loss of renal function. Commonly, obstructing urinary calculi are seen. It is difficult to differentiate between XGPN and malignancy in many cases, and the diagnosis is usually only confirmed post-operatively upon histopathological examination of the specimen. Surgical treatment is often the main treatment modality due to suspicion for malignancy. Here, we present a case of XGPN that presented with abdominal distension, which was eventually discovered to be due to a preperitoneal abscess.

show abstract

“…The organism isolated was Escherichia coli, a gram negative organism, from the urine and blood, though in one-fourth of cases urine culture may be sterile [6]. The initial findings of left ureterohydronephrosis on a renal ultrasound and the totally distorted architecture with multiple non-enhancing sectors on computed tomography raised the possibilities of isolated xanthogranulomatous pyelonephritis, renal cell carcinoma or their coexistence [7] [8] [9] [10]. The treatment plan was to cover the patient with a course of antibiotics and to manage conservatively the renal failure, including a preoperative sessions of hemodialysis.…”

Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury and Hepatic Dysfunction

Karkar¹

2017

OALib

View full text Add to dashboard Cite

This clinical report presents a 45-year-old female patient with acute kidney injury, hepatic dysfunction and urosepsis without past history of any illness related to urinary system. Laboratory investigations showed Hb 15.6 gm/dl, neutrophilic leukocytosis, thrombocytes 9000/mm 3 , ESR 90 mm/h, plasma thromboplastin time (PTT) 48 seconds (control 32 seconds), INR 2, and fibrinogen degradation product 7500 ng/ml (normal <250 ng/ml). Serum creatinine was 450 µmol/L (5.1 mg/dl), direct bilirubin 68.40 µmol/L, alanine aminotransferase 1.6 mmol/L and albumin 25 gm/L. Urinalysis revealed leucocyturia, hematuria without casts and proteinuria. Abdominal plain x-ray revealed left-sided radio-opaque shadow at the ureteric line, left uretero-hydronephrosis with thickened cortex and left ureteric stone, but normal right kidney. Computerized tomography of abdomen showed a large left kidney (13.5 cm) with totally distorted architecture, multiple enhancing and nonenhancing sectors, thickening of renal capsule, moderate dilatation of renal pelvis, dilated ureter and no passage of contrast in the ureter. The patient was treated with a 2-week course of Ceftriaxone and Aztreonam and pre-operative session of hemodialysis before the performance of a left-sided nephrectomy. Gross examination revealed adherent capsule, granular cortex covered with purulent exudates, no demarcation between cortico-medullary junction, and the cut surface showed minute abscess and necrosis with markedly dilated pelvis. Light microscopic examination showed fibrosis and inflammation of parenchyma with vacuolized histiocytes foam cells surrounding necrotic areas confirming the diagnosis of xanthogranulomatous pyelonephritis. The patient was discharged after 35 days of hospital stay with normal renal and hepatic function.

show abstract

Xanthogranulomatous pyelonephritis presenting as a pseudotumour

Cited by 24 publications

References 22 publications

Xanthogranulomatous pyelonephritis: a case with rare adhesion to pancreas

Xanthogranulomatous pyelonephritis: a case with rare adhesion to pancreas

Xanthogranulomatous pyelonephritis presenting asProteuspreperitoneal abscess

Acute Kidney Injury and Hepatic Dysfunction

Contact Info

Product

Resources

About