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

Five cases of spontaneous rupture of the renal parenchyma are reported. Two patients had renal cell cancer, one sustained acute purulent pyelonephritis secondary to stone related ureteral obstruction, one suffered from aposthematous pyelonephritis without obstruction, while one had chronic pyelonephritis and a cortical cyst as probable predisposing factors. Aetiology and important points concerning diagnosis and therapy are discussed.
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PMID:Spontaneous rupture of the kidney: a report on 5 cases. 803 20

In the traditional kidney position three trocars are inserted after creation of a pneumoperitoneum: 10 mm periumbilical (port I), 10/12 mm subcostal (port II) and 12/10 mm above the iliac spine (port III) in the mamillary line. After laterocolic incision the colon is dissected away from the lateral wall. Thereafter two 5-mm trocars (ports IV, V) are inserted into the lateral abdominal wall parallel to parts II and III. Following clipping and dissection of the ovarian (spermatic) vein, the ureter is isolated and incised. Then the cranial part of the ureter is used as a retractor exposing the renal hilum for dissection of the renal vessels. The main renal artery and vein are dissected separately by use of an endoscopic stapling device (Endo-GIA, white magazine). Finally, the kidney including Gerota's fascia is isolated from the adrenal and the upper peritoneum. Entrapment of the organ is performed with a specially designed bag (Lap-sac). The neck of the bag is brought out onto the surface of the abdomen (via port II/III) allowing digital morcellation with index finger inside the bag and removal of the organ in several pieces. We have applied this technique for 17 procedures in the upper retroperitoneum: 9 transperitoneal laparoscopic nephrectomies (TLN) for benign disease (5 hydronephrosis, 3 renovascular disease, 1 chronic pyelonephritis), 3 radical TLN including adrenalectomy for renal cell carcinoma (T2G2), 1 adrenalectomy for a cortical adrenaloma, 1 nephroureterectomy, 1 diagnostic ureterolysis and 2 modified retroperitoneal lymphadenectomies for stage I testicular cancer. The mean operation time was 4 h (2-5), the mean postoperative hospital stay 6 days (4-12).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The technique of transperitoneal laparoscopic nephrectomy, adrenalectomy and nephroureterectomy. 833 45

Lipid-laden foamy macrophages are characteristic of xanthogranulomatous pyelonephritis (XGP). We have encountered a case of renal cell carcinoma (RCC), with extensive necrosis, in which confluent sheets of foamy macrophages were a dominant feature. We describe the case and discuss the potential frozen section diagnostic problem in attempting to distinguish between confluent sheets of xanthoma cells a "reactive" change in RCC and xanthoma cells as a fundamental component of XGP. We propose that awareness of that problem should prompt the pathologist to request additional samples.
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PMID:Lipid-laden foamy macrophages in renal cell carcinoma. Potential frozen section diagnostic pitfall. 837 77

Lipid peroxidation (LPO) activity has been analyzed in homogenates and microsomes of cortical samples obtained intraoperatively from the kidneys of 33 patients. Of them, 21 patients had mild, moderate or severe pyelonephritis or nephrolithiasis. Unaffected cortical tissue from renal carcinoma patients was used as control. LPO activity was judged by basal level of malonic dialdehyde (MDA) and MDA growth in the homogenate and microsomes following initiation of ascorbate-dependent LPO. Activation of LPO was registered in patients with moderate disease with active inflammation. They also exhibited greater MDA basal levels and rapid MDA increase in response to in vitro initiation of ascorbate-dependent LPO simultaneously with attenuation of endogenous antioxidant defense. In severe pyelonephritis and nephrolithiasis with drastic deficiency of renal function LPO activity was low and nonresponsive to stimulation either by ascorbate or Fe+2. This is probably due to lack of the substrate after massive death of renal cells. Enhancement of LPO activity in patients with pyelonephritis or nephrolithiasis against functioning kidneys may appear responsible for destruction of renal tissue.
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PMID:[Lipid peroxidation in the kidney tissue of patients with nephrolithiasis and chronic pyelonephritis]. 857 92

Renal carcinoma and urolithiasis combine rather rarely. Postnephrectomy patients often consult the urologist when the condition is serious because of complications resultant from uroliths in the contralateral kedney. In view of solitary kidney, progressive chronic pyelonephritis, associated chronic renal failure surgical treatment of the condition becomes risky and necessitates individual approach to choice of therapeutic policy and definition of indications to urolithiasis treatment in patients after nephrectomy for renal carcinoma. This includes the decision whether to perform nephrolithiasis before or after nephrectomy and whether to attempt any surgery in the absence of urolithiasis clinical symptoms.
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PMID:[The treatment procedure in patients with a combination of kidney tumor and urolithiasis]. 868 15

A 47-year-old female was admitted with colicky pain in the left flank. Ultrasonography and abdominal CT revealed left perirenal hematoma. Abdominal CT revealed a multilocular cystic lesion in the upper pole of the left kidney. Renal angiography revealed left renal cell carcinoma. Left nephrectomy was performed under a tentative diagnosis of left renal cell carcinoma. However, pathological diagnosis was xanthogranulomatous pyelonephritis. Xanthogranulomatous pyelonephritis is an atypical form of chronic renal parenchymal infection that can be classified as diffuse type or focal type. Preoperative diagnosis of focal xanthogranulomatous pyelonephritis is difficult because of clinical and radiological similarities to renal cell carcinoma. Our case is presented with a brief review of the literature.
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PMID:[Spontaneous renal rupture due to xanthogranulomatous pyelonephritis; a case report]. 868 83

This study focuses on the diagnostic and therapeutic challenge posed by spontaneous perirenal haematomas (SPHs). The medical records of 18 patients with SPHs seen in the past 8 years were reviewed with respect to aetiology, diagnosis and therapeutic management. SPH was secondary to angiomyolipoma (n = 4), polycystic kidneys (n =4), panarteritis nodosa (n = 3), renal cell carcinomas (RCCs, n = 2), glomerulonephritis, pyelonephritis, Morbus Wegener and cortical adenoma (one each). One case remained unclear. With appropriate imaging techniques (computed tomography and angiography) the underlying disorder was detected in 72%; in 4 cases the diagnosis was revealed by exploration and biopsy. Surgery was necessary in 16 patients. The cause of bleeding can be revealed by appropriate imaging in most cases. When imaging procedures fail to reveal the cause of SPH, exploration and biopsy are mandatory to exclude RCC. If the cause of SPH remains unclear even after exploration, patient monitoring by CT is justified.
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PMID:Aetiology, diagnosis and management of spontaneous perirenal haematomas. 874 36

The MN/CA9 protein is a tumor-associated antigen that has been shown to have diagnostic utility in identifying cervical dysplasia and carcinoma. MN/CA9 expression is limited to very few normal tissues. We have now extended those observations to further investigate expression of the MN/CA9 protein in histological sections and fine-needle aspiration biopsy smears of normal kidney, benign renal cell lesions, all categories of renal cell carcinomas (clear/granular/spindle cell, chromophilic cell, chromophobic cell, and collecting duct cell RCCs), metastatic RCCs, and non-renal cell clear cell adenocarcinomas. We have found that high levels of MN/CA9 expression is seen in all primary RCCs, cystic RCCs, and metastatic RCCs, with the exception of two cases of the chromophobe cell type, which were MN/CA9 negative. Identical MN/CA9 immunostaining was also observed in the aspiration cytological smears. In contrast, all benign lesions, including pyelonephritis, renal cysts, adenomas, oncocytomas, and normal kidney, did not express the MN/CA9 protein. Thus, we conclude that MN/CA9 protein expression could serve as a valuable adjunct to the cytological and histological diagnosis of benign renal cysts versus cystic RCC, adenoma versus RCC, and oncocytoma versus granular cell RCC. Diffuse membraneous staining of all RCCs (with the exception of chromophobic cell RCC) suggests that MN/CA9 protein expression might have an important clinical utility in the early detection and treatment of RCC. Absence of MN/CA9 expression in non-renal cell clear cell adenocarcinoma also indicates that MN/CA9 protein expression may be used as a differential diagnostic biomarker of metastatic clear cell RCC.
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PMID:Identification of the MN/CA9 protein as a reliable diagnostic biomarker of clear cell carcinoma of the kidney. 923 Jan 82

Xanthogranulomatous pyelonephritis (XGP) is a rare and aggressive form of chronic pyelonephritis for which partial or complete nephrectomy is mandatory [1.2]. The diagnosis and, in particular, the differentiation from hypernephroma is mostly established by the histopathological examination only. We have reviewed the literature and present an unusual case of XGP with septic spreading into the lungs mimicking pulmonary metastasis and with an inflammatory infiltration of the descending colon.
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PMID:[Xanthogranulomatous pyelonephritis with septic lung metastases and infiltration of the colon. Difficult preoperative differential pulmonary hypernephroma metastasis diagnosis]. 946 24

Two cases of renal cell carcinoma, both of which underwent extensive spontaneous regression, are reported. The first occurred in a 56 year old man, forming a well circumscribed renal cortical nodule which contained only very occasional foci of viable renal cell carcinoma with areas of hyalinisation and calcification, and with metaplastic ossification. The second lesion was removed from an 82 year old man, comprising a cystic cavity containing necrotic debris with only occasional viable foci of classical renal cell carcinoma. Spontaneous regression of renal cell carcinoma is a rare but recognised entity. These two cases emphasise the important differential diagnoses: metastatic secondary carcinomas, xanthogranulomatous pyelonephritis, and infective granulomatous conditions of the kidney. The importance of adequate tissue sampling of all renal nodules cannot be overemphasised in the processing for examination of lesions within the kidney.
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PMID:Spontaneous regression of renal cell carcinoma: a pitfall in diagnosis of renal lesions. 965 51


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