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

Xanthogranulomatous pyelonephritis (XGP) is a rare histological subset of pyelonephritis characterized by being a chronic destructive granulomatous inflammation of the renal parenchyma. XGP is classified according to the extent of disease into two entities: within the renal cortex (focal or segmental XGP) or diffuse spread with pelvic communication (diffuse XGP). Although rare, XGP can have fatal complications including perinephric, psoas abscess, nephro-cutaneous fistula and reno-colic fistula. Only few studies have reported XGP complicated with psaos abcess and reno-colic fistula. Our aim is to add to the literature and share our experience with a case of extensive XGP eroding into the psoas muscle and ascending colon leading to severe sepsis that was successfully managed. We report a 56-year-old woman who was found to have XGP complicated by psoas abscess and reno-colic fistula managed by antibiotics, nephrostomy, and subsequent nephrectomy and partial colectomy.
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PMID:An unusual presentation of xanthogranulomatous pyelonephritis: psoas abscess with reno-colic fistula. 2747 99

Xanthogranulomatous pyelonephritis is an uncommon inflammatory condition accounting for 1% of chronic pyelonephritis cases. Clinically and radiologically it mimics other renal space occupying lesions. Hence, correct preoperative diagnosis is not possible in all cases and nephrectomy is done in most patients. Renal tubulopapillary adenomas are benign epithelial lesions of kidney found to be associated with papillary renal cell carcinoma, acquired renal cystic disease, long term hemodialysis, arteriosclerotic renal vascular disease, etc. Here, we report two cases of Xanthogranulomatous pyelonephritis associated with the rare finding of renal tubulopapillary adenomas.
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PMID:Xanthogranulomatous pyelonephritis and renal tubulopapillary adenomas: A rare coexistence. 2772 Dec 88

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.
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PMID:Xanthogranulomatous pyelonephritis presenting as Proteus preperitoneal abscess. 2791 41

Xanthogranulomatous pyelonephritis (XGP) is a rare form of pyelonephritis associated with repeated infection, chronic inflammation, and obstruction. Various fistulas, including those to the intestine, are a known association with XGP. Here, a 55-year-old woman with a history of multiple previous renal calculi presented with dysuria and back pain. Contrast-enhanced computed tomography (CT) revealed a soft tissue density in her renal pelvis and perirenal space consistent with XGP along with a tract connecting the upper pole of her right kidney to the second portion of the duodenum. This finding was subsequently confirmed during percutaneous nephrostomy placement, stent placement, a small bowel follow-through study, and upper endoscopy. She was diagnosed with XGP with associated renoduodenal fistula, eventually treated by open nephrectomy with fistula takedown. Histopathologic analysis was consistent with the diagnosis of XGP with no malignant or infectious cause of the fistula. XGP should be considered in the diagnosis of patients with dysuria and back pain, especially when a history of obstruction or chronic inflammation. Associated fistulas should also be considered prior to surgical management to prevent complications.
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PMID:A Case of Xanthogranulomatous Pyelonephritis Associated with Renoduodenal Fistula. 2842 36

Xanthogranulomatous pyelonephritis (XGPN) is an atypical long-term pyelonephritis with destruction of renal parenchyma and a long-term inflammatory infiltrate of macrophages. Reported presentations of transitional cell carcinoma (TCC) are different. A 73-year-old woman presented with loin pain, prostration, and fever. Computed tomography scan revealed poor cortical enhancement of the kidney, but some of the images bore resemblance to the characteristic "bear's paw" sign, consistent with XGPN with a 7-cm perinephric collection. She was provisionally diagnosed as severe acute pyelonephritis, possibly XGPN, with abscess. In view of the poor clinical condition, decision was made to perform nephrectomy. Histology revealed a G3pT4 high grade TCC with perineural and vascular invasion and reactive xanthogranulomatous inflammatory response. There are few reports of concomitant XGPN and TCC affecting the kidney. However, there has not been any mention of XGPN and TCC presenting as acute pyelonephritis and perinephric abscess so far.
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PMID:High-grade transitional cell carcinoma masquerading as a xanthogranulomatous pyelonephritis and perinephric abscess. 2849 Nov 70

Xanthogranulomatous pyelonephritis (XGP) is a chronic pyelonephritis observed in children and exceptionally in infants. Symptomatology is vague and may delay diagnosis and patient's management. Treatment is based on medical therapy but most often on surgery with poor renal prognosis. We report the case of a 15-month old infant with isolated mass in the left flank. He had no fever or alteration of general state and urine cultures were sterile. Radiological evaluation (renal ultrasound, uroscan and renal scintigraphy) highlighted left non-functioning kidney with "hydropyonephrosis" evoking the diagnosis of XGP. The indication for total nephrectomy by lombotomy was posed and definitive anatomo-pathological examination confirmed the diagnosis of diffuse XGP. This observation emphasizes the importance of suspect PXG in patients with renal mass or malformative uropathy with recurrent urinary tract infections whose treatment should be rigorous and codified.
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PMID:[Abdominal mass revealing xanthogranulomatous pyelonephritis in an infant]. 2874 18

We here report the case of a 55 year-old man presenting with right renal colic and with a history of intermittent lower back disorders. At the time of admission, clinical examination showed lower back pain on contact. Renal ultrasound objectified heterogeneous mass at the lower pole of the right kidney with dilation of lower calyx groups. Abdominal CT scan confirmed the presence of right inferior renal polar lesion characterized by mixed density, associated with significant hydronephrosis eroding the renal parenchyma upstream of a voluminous pyelic coralliform lithiasis. The patient underwent nephrectomy with anatomo-pathological examination revealing chronic inflammation of the renal parenchyma characterized by macrophages associated with monocytes and lymphocytes with spongy cells and fibrosis. Anatomo-pathological result was compatible with a diagnosis of xanthogranulomatous pyelonephritis. Xanthogranulomatous pyelonephritis is a relatively rare chronic pyelonephritis whose symptoms resemble those of a pseudotumor. The diagnosis is suspected on the basis of clinical arguments and on laboratory tests and may be evoked quite exclusively on the basis of preoperative CT scan. Kidney cancer was its main differential diagnosis.
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PMID:[Renal tumor or pseudotumoral xanthogranulomatous pyelonephritis]. 2987 48

Xanthogranulomatous pyelonephritis is a rare form of chronic pyelonephritis that generally afflicts middle-aged women with a history of recurrent urinary tract infections. Its pathogenesis generally involves calculus obstructive uropathy and its histopathology is characterized by replacement of the renal parenchyma with lipid filled macrophages. This often manifests as an enlarged, nonfunctioning kidney that may be complicated by abscess or fistula. This case details the first reported case of xanthogranulomatous pyelonephritis complicated by urinothorax, which resolved on follow-up chest X-ray after robot-assisted nephrectomy.
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PMID:Urinothorax Caused by Xanthogranulomatous Pyelonephritis. 3007 57

Xanthogranulomatous pyelonephritis (XGP) is an unusual form of chronic pyelonephritis in which the renal parenchyma is destroyed and replaced by lipid-laden foamy macrophages. It usually affects middle-aged women with a history of recurrent urinary tract infection, diabetes, or kidney stones. The inflammatory process is usually diffuse and can extend beyond the kidney. The rare focal forms may simulate primary renal tumours. The preoperative imaging diagnosis may be difficult. We reported five cases of XGP, The findings of ours were recorded including kidney size, shape, contour, the echogenecity of the renal parenchyma, the internal echoes of the dilate collecting system, the presence of perinephric fluid accumulation and obstruction. One of the 5 cases was a male patient, and the other four were female, with a mean age of 53 years. He affected kidneys of the 5 cases swelled in different degrees, and one of them was found with line-like anechoic fluid. Among the 5 cases, one kidney appeared as diffusely reducing of the parenchyma echogenicity, multiple hypoechoic areas, disappearance of corticomedullary differentiation and multiple hyperecho with shadow. A round cystic anechoic lesion was found in one kidney, with internal punctate echo and peripheral fluid. Ultrasonographic finding of 1 case was extremely hypoechoic lesion on the left kidney, protruding from the outline of the kidney, with the partial renal capsule discontinuous, the less clear boundary, and a little blood flow in it. Ultrasonographic demonstration of 2 cases was mild dilatation of the collecting system with irregular wall thickening and internal hypoechogenicity, and 1 case was solid lesion with less clear boundary to the pelvic wall and a small amount of blood flow signal, the another 1 case was showed floccule without internal blood flow. Three cases were caused by chronic obstruction verified by operation, of which one was staghorn calculi, one was poorly differentiated squamous cell carcinoma in the middle part of the ureter, and one was inflammatory stricture of upper ureteral. Through analysis of the above five cases and review of related literature, we explored diagnoses and management of the patients with XGP. Xanthogranulomatous pyelonephritis (XGP) is a rare chronic variant of pyelonephritis characterized by destruction of the renal parenchyma. Combining ultrasonographic features of XGP with clinical recurrent urinary infection and chronic obstruction, XGP can be included in the differentiation. The diagnosis of XGP suspected by ultrasound can be clarified by CT, MRI, contrast-enhanced ultrasound.
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PMID:[Xanthogranulonatous pyelonephritis: report of 5 cases]. 3012 83

Xanthogranulomatous pyelonephritis is a rare form of chronic pyelonephritis in which the involved areas of the kidneys are destroyed and replaced by foam cells. It usually occurs in immunocompromised middle-aged females with ureteral obstruction or chronic urinary tract infection induced by the formation of renal stones. We herein report the case of a 44-year-old woman, with a history of left kidney staghorn calculi and recurrent urinary tract infections. Abdominal computed tomography showed the 'bear paw' sign, typical appearance of XGP and patient underwent a nephrectomy with uneventful post-operative course.
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PMID:Bear Paw Sign: Xanthogranulomatous Pyelonephritis. 3064 33


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