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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinical, pathological and radiographic findings of 135 cases of xanthogranulomatous pyelonephritis have been reviewed. It is a form of renal suppuration and obstruction most commonly seen in middle aged women although all ages and both sexes may be affected. There is no race predilection. Gram-negative organisms are usually present and bilateral involvement has not been reported. The most common offending organism is Proteus mirabilis. Hepatic dysfunction is seen and appears to normalize with removal of the XGP process. Preoperative angiography may increase the accuracy of differentiating this disorder from hypernephroma and may aid the surgeon in planning his approach to kidney resection depending upon the staging of XGP. Chronic renal failure is not usually a feature of XGP and nephrectomy is curative without any incidence of recurrence.
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PMID:Xanthogranulomatous pyelonephritis (XGP): a local disease with systemic manifestations. Report of 23 patients and review of the literature. 43 2

Preoperative diagnosis of xanthogranulomatous pyelonephritis (XGP) is possible in numerous cases by renal angiography, thus permitting the differentiation of this disease from renal adenocarcinoma. Angiographic features are reviewed in patients with proved XGP. The most useful findings are: (1) presence of hypervascularised areas; (2) dilated renal capsular and perforating arteries, and (3) heterogenous aspect of the kidney during the nephrographic period.
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PMID:Angiographic features of xanthogranulomatous pyelonephritis. 44 5

Manifestations of xanthogranulomatous pyelonephritis in 26 patients closely mimicked those of neoplastic and other inflammatory renal parenchymal diseases. Middle-aged or older women were affected most often. Most patients presented with anemia, chronic febrile illness, a painful tender flank mass and recurrent urosepsis. Some features of nephrogenic hepatic dysfunction were present in 13 patients. Bacterial cultures of renal tissue were almost always positive but the spectrum differed considerably from that of the bladder urine. Urographically, a renal mass lesion was encountered in 62% of the patients, nephrolithiasis in 38% and a functionless kidney in 27%. Angiographically, none of the 4 mass lesions studied was distinguished from hypernephroma. Indeed, a correct preoperative diagnosis was made in only 1 instance. There were 3 stages of xanthogranulomatous pyelonephritis recognized. Treatment consisted of nephrectomy for diffuse or advanced stage disease or both (21 patients), excision of the diseased renal segment for localized and low stage disease (2 patients) and renal biopsy (3 patients). Xanthogranulomatous pyelonephritis did not recur but in some patients bacteriuria continued or hypertension developed.
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PMID:Xanthogranulomatous pyelonephritis: a critical analysis of 26 cases and of the literature. 66 Jul 25

67Ga scanning was performed in 26 patients with hypernephroma (17 with only a primary lesion of hypernephroma, 4 with both primary and metastatic lesions, 2 with hypernephroma and pyelonephritis, and 3 with only a metastatic lesion after nephrectomy). In patients with primary lesions alone, the positive finding rate by 67Ga scanning was low (26%), and in metastatic lesions that by scanning was high (86%). The practical conclusions are as follows: 67Ga scanning is of littel use as a diagnostic aid in primary lesion of hypernephroma, but may be useful in case with metastases with inflammatory disease.
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PMID:67Ga-citrate scanning in hypernephroma. 67 76

Computed tomography (CT) using the EMI CT5000/5005 scanner was performed on 14 patients with a solitary functioning kidney demonstrated by other radiological investigations. Examinations before and after intravenous injection of contrast material have been undertaken. In the majority of cases, the patients were referred as a "nonfunctioning kidney" following excretion urography. Other referrals included previous nephrectomy or solitary kidneys. In all cases, the CT scan made possible the definitive diagnosis. The diagnosis included unsuspected hydronephrosis, vestigial kidney, contracted kidney secondary to chronic pyelonephritis and calculus, recurrence of a hypernephroma, and lymphomatous infiltration. Valuable information was obtained about the vascular pedicle, the renal collecting systems, the perinephric space, and the retroperitoneal space including the paraaortic lymph nodes. Furthermore, the increased sensitivity of the technique in detecting lower concentrations of iodine provided information regarding renal function. It is concluded that the noninvasive nature of CT makes it a valuable adjunct in the further investigation of such patients.
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PMID:Computed tomography in the evaluation of the solitary or unilateral nonfunctioning kidney. 70 16

Xanthogranulomatous pyelonephritis (XGP) is a rare form of chronic pyelonephritis. The present author has found about 150 cases on going through the literature. The lipid filled "foam cell" is typical of the condition. The preoperative diagnosis is often renal carcinoma. The treatment is nephrectomy. It is important to make the diagnosis in order to avoid unnecessary radical surgery. A unilateral non-functioning kidney with urinary tract infection (with or without calculi) should lead to the condition being suspected. The prognosis is good. Two new cases that both illustrate the condition well are presented.
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PMID:Xanthogranulomatous pyelonephritis. A report of 2 cases. 73 70

In a woman aged 67, comprehensive angiographic examination revealed an extensive renal process which had led to thrombosis of the inferior vena cava. At exploratory surgery the process seemed inoperable. The angiographic study was repeated after an asymptomatic period of 6 years and disclosed shrinking of the kidney involved. Revision of the microscopic findings altered the initial diagnosis of renal carcinoma in favour of xanthogranulomatous pyelonephritis. The observation is of interest by virtue of the characteristic angiographic findings, extension of the process to the venous system, and angiographic evidence that spontaneous regression is possible.
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PMID:Xanthogranulomatous pyelonephritis. Angiographic observations made in one case at an interval of six years. 94 71

One hundred B-mode nephrosonograms were reviewed, and 41 percent of these had a diagnosis proved by either arteriography, cyst puncture or tissue examination. There were 8 proved normal sonograms with one error, an upper pole renal cell carcinoma in a kidney badly distorted by chronic pyelonephritis and ureteral obstruction. Overlying ribs and anatomic distortion contributed to the misinterpretation. Sonic diagnosis of solid tumor was correct in all proved cases. Cysts were diagnosed in 23 patients; six were in error. Four were called cysts less than 3 cm. in diameter. If the lower limit of sonographic resolution is considered 3 cm., the accuracy for diagnosed simple cysts becomes 90 per cent.
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PMID:B-mode nephrosonography in renal masses. Its use and some limitations. 114 16

A clinical and roentgenographic analysis of 13 patients with pathologically proved xanthogranulomatous pyelonephritis (X-P) has demonstrated that many previously accepted truisms associated with this disease may not be valid. As a result of this study it is suggested that X-P: 1. Does have a prominant female distribution. 2. May arise relatively acutely. 3. Can be associated with a well-functioning kidney. 4. May destroy the kidney and collecting system. 5. Does not demonstrate neovascularity. 6. Can be distinguished angiographically from hypernephroma. 7. May be associated with diabetes. Other important facts were again observed: 1. X-P is still often associated with staghorn calculi and urinary tract obstruction. 2. Proteus mirabilis is the main offending organism.
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PMID:New thoughts concerning xanthogranulomatous pyelonephritis (X-P). 120 Feb 8

1. The evaluation of renal masses has become an increasingly important topic because of the increasing incidence of kidney cancer, the improved cure rate of renal carcinoma with the proper preoperative diagnosis, and the proliferation in renal mass diagnostic methodology. 2. A variety of benign entities can produce an abnormal renal mass with attendant difficulties in being distinguished from malignant neoplasms. Among these benign lesions are: simple renal cysts, polycystic kidneys, congenital variations in renal size and shape, segmental renal hypertrophy, renal infarcts, intrarenal hematomas, renal hamartomas, renal leiomyomas, renal adenomas, renal angiomas, renal fibrolipomatosis, hydronephrosis of a duplicated collecting system, renal abscesses, and xanthogranulomatous pyelonephritis. 3. Nephrotomography, nephrosonography (ultrasound), adrenalin renal arteriography, selective magnification renal arteriography, renal venography and cavography, lymphangiography, renal scintillation scanning, abnormal levels of enzymes in blood and urine, immunologic studies (circulating antibodies and tumor-associated antigens), percutaneous needle aspirations, and retrograde renal brushing have all increased the diagnostic accuracy of determining the etiology of renal masses. None of these diagnostic procedures is infallible. A judicious combination of procedures gives the most reliable diagnostic results. 4. A search continues for (a) chemical agent(s) or a chemical profile in the blood or urine which is (are) specific for renal carcinoma, but as yet this is an investigational area and not a practical clinical reality.
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PMID:Evaluation of renal masses including retrograde renal brushing. 125 Dec 98


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