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

A case of xanthogranulomatous pyelonephritis associated with 'small' renal carcinoma is presented. The urinary sediment showed atypical cells, suspect of malignancy. The renal neoplasm measured only 1.5 cm, had the typical papillary configuration of a 'small' renal carcinoma and was composed of atypical cells with finely granular cytoplasm and hyperchromatic nuclei. The xanthogranulomatous pyelonephritis was a primary lesion, spacially separate one from the other. The clinicopathological features of reported examples of coexistence of these diseases have been reviewed.
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PMID:Association of xanthogranulomatous pyelonephritis with small renal cell carcinoma. Case report and review of the literature. 669 91

Thirty patients with focal renal masses were evaluated on a .12-Tesla resistive magnetic resonance unit using partial saturation and spin echo pulse sequences. A short repetition time (TR = 143 ms) was employed for partial saturation images and a spin echo was present in each case (TE = 10 ms). Additional pulse sequences through regions of interest were also obtained. Fifteen patients had cystic lesions, nine patients had renal cell carcinoma, two had metastatic lesions, one had an angiomyolipoma, and three had focal bacterial infection. Cystic lesions were well circumscribed and demonstrated a range of signal intensities. Small intra-parenchymal cysts were difficult to identify. Renal cell carcinomas demonstrated areas of increased signal using a partial saturation sequence (TR = 143-415 ms, TE = 10 ms). Magnetic resonance imaging accurately detected perinephric extension and vascular invasion in all patients. Metastatic disease to the kidney was uniformly low in signal, in contrast to primary renal cell carcinoma; an angiomyolipoma demonstrated very high signal intensity. Two masses resulting from acute focal bacterial nephritis were uniformly low in signal. One additional case of a more indolent pyelonephritis demonstrated high signal in regions of replacement lipomatosis and low signal in sites of active infection. Magnetic resonance imaging appears to be an accurate way of detecting, identifying, and staging focal renal masses.
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PMID:Focal renal masses: magnetic resonance imaging. 673 18

A case is reported of the simultaneous occurrence of renal carcinoma with staghorn calculus, perinephric abscess, and xanthogranulomatous pyelonephritis in the same kidney, with subcutaneous abscess of the thigh as the initial presentation. The coexistence of these diseases in the same kidney would seem to be important since they are frequently confused with each other.
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PMID:Renal carcinoma with staghorn calculus, perinephric abscess, and xanthogranulomatous pyelonephritis in same kidney. Subcutaneous abscess of thigh as initial presentation. 686 40

The ability to evaluate the composition and to precisely locate calcifications within renal masses resulted in more accurate evaluation of 21 calcified renal masses by computed tomography than by standard radiographic techniques. Of 11 solid tumors, computed tomography demonstrated a soft-tissue mass extending beyond the calcification in nine cases of renal cell carcinoma. Of 10 benign cystic lesions, all six lesions characterized by a uniform water-density center, calcification confined to the wall, and no detectable soft-tissue mass were benign cysts. Three additional cystic lesions (xanthogranulomatous pyelonephritis, multilocular cystic nephroma, and a cyst containing calcified debris) were believed to represent benign lesions prospectively due to the absence of a soft-tissue mass. Only peripherally calcified lesions with a central attenuation higher than accepted for benign cysts were indeterminate by computed tomography. The significance of the computed tomographic findings in terms of malignant potential and patient management is discussed.
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PMID:CT of calcified renal masses. 697 10

Evaluation of clinical, radiological and pathological data from 10 adult patients with xanthogranulomatous pyelonephritis has been carried out. There are no pathognomonic diagnostic features, but the majority of patients present with a previous history of recurrent urinary tract disorders. Obstruction and infection are essential pathogenetic factors, but it is suggested that immunologic factors are also play a part. The treatment is nephrectomy, as correct diagnosis cannot be established preoperatively, and as the condition is often misinterpreted as renal carcinoma. A definite diagnosis can only be obtained from pathologic examination with demonstration of the characteristic inflammatory xanthogranulomatous reaction.
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PMID:Xanthogranulomatous pyelonephritis. 720 25

In adults with xanthogranulomatous pyelonephritis (XGP) focal involvement occurs in 17% Of patients and the remainder have diffuse involvement of the kidney. Most patients are in the fourth and fifth decades. There appears to be a predilection for the left kidney, and 60% of patients will have a positive urine culture. Radiographically, a poorly-functioning, hypovascular renal mass is seen. The clinical and pathological presentations of focal XGP can closely resemble clear-cell renal cell carcinoma, but partial nephrectomy is the preferred treatment for this inflammatory disorder. We discuss three adults with focal XGP who have been treated at The Johns Hopkins Hospital in the past 2 1/2 years.
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PMID:Focal xanthogranulomatous pyelonephritis in adulthood. 736 60

The first case of xanthogranulomatous pyelonephritis associated with renal carcinoma is reported. Differentiation of the 2 entities clinically may be difficult and, since treatment regimens recommended in the past have included partial nephrectomy in cases of limited xanthogranulomatous pyelonephritis, one must hereafter be aware of such a combination when considering such a therapeutic modality.
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PMID:Xanthogranulomatous pyelonephritis associated with renal carcinoma. 741 98

The role of nephron-sparing surgery for renal cell carcinoma is well established in patients with an anatomical or functional solitary kidney (imperative indication) in which a radical nephrectomy would render the patient anephric with subsequent need for hemodialysis. This also encompasses patients with a unilateral renal cell carcinoma and a functioning contralateral kidney when the opposite renal unit is affected by a disease that might threaten its future function, such as renal artery stenosis, chronic pyelonephritis, stone disease or systemic conditions such as diabetes. A functioning renal remant of at least 20% of normal renal parenchyma seems to be necessary to avoid end-stage renal failure in these patients [16]. There have been several reports in the literature of excellent 5-year cancer-specific survival rates of over 80% in such circumstances [12, 15]. These results were confirmed in our institution, with a 5-year cancer-specific survival rate of 83% in over 70 patients with an imperative indication for nephron-sparing surgery. Thereby the prognosis was significantly influenced by the local tumor stage and the grade of malignancy. These data support the efficacy of nephron-sparing surgery in this clinical situation.
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PMID:Current controversies in nephron-sparing surgery for renal-cell carcinoma. 755 Mar 88

From 1981 through 1990, 21 urologic cancer cases were discovered in 21 uremic patients at our hospital. This constituted 55% (11 of 20) of the total malignancies in nondialyzed uremic patients, 41% (nine of 22) of the total in chronic hemodialysis patients, and 50% (one of two) of those in patients on continuous ambulatory peritoneal dialysis. No cases of urologic cancer were found in kidney transplant recipients. When compared with the general population, the standardized incidence ratio of kidney cancer in chronic hemodialysis patients was found to be 24.1 (P < 0.01) and that of bladder cancer was found to be 16.4 (P < 0.01). Multiple underlying renal diseases contributed to the development of the urologic cancer cases, including four analgesic nephropathy-associated transitional cell carcinoma cases, two acquired cystic kidney disease-associated renal cell carcinoma cases, two chronic pyelonephritis-associated (stone and tuberculosis) squamous cell carcinoma cases, and one xanthogranulomatous pyelonephritis-associated transitional cell carcinoma case. Uremia per se may be an important promoting factor. Hematuria (17 of 21 cases) was the most common presenting feature despite the fact that most of the patients were anuric. The clinical diagnosis of renal parenchymal tumors was based on ultrasonography (five of five cases), whereas most urothelial tumors were detected by cystoscopy or retrograde pyelography (14 of 16 cases). The survival rate of the 17 aggressively treated patients was 82% at 2 years and 45% at 5 years. We conclude that uremic patients are at greater risk of developing urologic cancer.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Urologic cancers in uremic patients. 774 22

Based on the evidence obtained on 28 cases of xanthogranulomatous pyelonephritis (XP), the authors suggest to distinguish two XP clinical forms: obstructive and nonobstructive. The former may occur in noticeable destruction of renal tissue and urine retention secondary, most frequently, to long-standing nephrolithiasis. The latter simulates by symptoms and examination results renal carcinoma. In suspicion of nonobstructive XP, the surgeon should consider fast-made intraoperative biopsy to decide on feasibility of sparing intervention.
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PMID:[Xanthogranulomatous pyelonephritis]. 778 15


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