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

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

Xanthogranulomatous pyelonephritis is an uncommon variant of chronic pyelonephritis that predominantly affects middle-aged women. Patients usually present with fever, back or flank pain, flank mass, and the constitutional symptoms of fatigue, malaise, weight loss, and anorexia. Rarely, they may present with a draining sinus. There is usually a history of urinary tract infection, obstruction, or instrumentation. Other abnormalities include anemia, leukocytosis, abnormal liver enzymes, pyuria, and hematuria. Mild azotemia may be present, but frank renal failure is rare. Urine and renal tissue cultures are frequently positive. The most commonly isolated bacterial pathogens are P. mirabilis and E. coli, but other organisms have also been implicated. A CT scan is the best radiologic imaging technique to discover the extent of inflammation as well as any involvement of adjacent structures. Lipid-laden macrophages called xanthoma cells characterize the disease at the microscopic level. Nephrectomy is curative. Careful preoperative evaluation will guide surgical planning in choosing an approach that provides adequate exposure of the affected tissue and facilitates subsequent care of the patient.
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PMID:A middle-aged woman with back and flank pain. 881 29

A 76-year-old woman presented with spiking fever and right back pain. Ultrasonography (US) revealed that her right kidney was enlarged. Computed tomography (CT) showed the parenchyma was replaced by non-enhancing masses but the overall kidney shape was maintained. These findings were compatible with those of xanthogranulomatous pyelonephritis (XP). The nonenhancing masses on CT coincided with the multiple butter yellow nodules of the resected kidney and microscopically these lesions were proved to be abscesses with xanthoma cells. In this case, the US and CT findings reflected the pathological feature of XP and thus these techniques are thought to be useful for the diagnosis of XP.
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PMID:Xanthogranulomatous pyelonephritis. 926 Jul 79

Xanthogranulomatous pyelonephritis (XGP) is a rare entity and constitutes less than 1% of chronic pyelonephritis. A 71-year-old male was introduced to our department with general malaise and abnormal findings of computed tomography (CT). Abnormal findings of complete blood count and laboratory examination included an elevated WBC count and C-reactive protein. Urinalysis showed combined hematuria and pyuria, and Escherichia coli was detected in urine culture. Abdominal CT revealed left hydronephrosis with staghorn renal calculi and thin cortex of the left kidney. Because of poor condition, the patient underwent construction of the left nephrostomy. After that, the remission of the inflammation was achieved. Several months after the construction, frequent obstructions of nephrostomy catheter because of turbid urine and intermittent fever elevation were observed. The patient and his family desired left nephrectomy despite his poor condition in general. Surgical dissection was very difficult due to fixed mass. Not long after that the patient died due to sepsis and cardiovascular failure. Microscopic findings of the left kidney revealed infiltration of lymphocytes and lipid-laden macrophages (xanthoma cells) corresponding to XGP.
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PMID:Case of the diffuse form of xanthogranulomatous pyelonephritis. 2336 80