Enlarged kidneys and acute renal failure why is a renal biopsy necessary for diagnosis and treatment?

Diwakar, Ramaswamy; Else, J; Wong, Vincent; Carne, Andrew; Banerjee, Debasish; MacPhee, Iain

doi:10.1093/ndt/gfm627

Cited by 10 publications

(15 citation statements)

References 6 publications

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“…4,6 Survival depends upon the organs affected and the extent of the lesion as there can be multiple organ involvement and subsequent organ failure (ie, hydronephrosis due to renal obstruction). [3][4][5] Plaques within the bladder appear to be the most amenable to treatment, but other cases require a multimodal therapeutic approach, including systemic antibiotics and, potentially, surgery to remove large masses or re-routing of ureters. [3][4][5]9,14 …”

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confidence: 99%

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Successful treatment of malakoplakia of the bladder in a kitten

Rutland¹,

Nimmo

Goldsworthy³

et al. 2013

Journal of Feline Medicine and Surgery

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A 4-month-old female kitten presented with chronic lower urinary tract signs and Escherichia coli cystitis, and was diagnosed with urinary bladder malakoplakia based upon histopathology. The kitten was treated with a prolonged antibiotic course and the malakoplakia resolved. Malakoplakia is a chronic granulomatous reaction characterized by the formation of Michaelis-Gutman bodies within von Hansemann macrophages. It is well described in humans, but has never been documented in a living veterinary patient. This case report describes the first successful treatment of malakoplakia in veterinary medicine.

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confidence: 99%

“…[3][4][5] Plaques within the bladder appear to be the most amenable to treatment, but other cases require a multimodal therapeutic approach, including systemic antibiotics and, potentially, surgery to remove large masses or re-routing of ureters. [3][4][5]9,14 …”

mentioning

confidence: 99%

Successful treatment of malakoplakia of the bladder in a kitten

Rutland¹,

Nimmo

Goldsworthy³

et al. 2013

Journal of Feline Medicine and Surgery

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show abstract

“…These bodies are basophilic structures that exist within clusters of macrophages, termed von Hansemann cells, which are amalgamated with lymphocytes and plasma cells 6. A Michaelis-Gutmann body can also be found extracellularly among bundles of collagen producing fibroblasts within the stroma, and its composition includes organic components as well as calcium, phosphorus and iron 3 4…”

Section: Discussionmentioning

confidence: 99%

Renal malakoplakia mimicking a malignant renal carcinoma: a patient case with literature review

Purnell¹,

Davis

Burch-Smith

et al. 2015

BMJ Case Reports

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Malakoplakia, a medical, surgical, pathological and radiological enigma, is an infrequent chronic inflammatory condition that can affect many organ systems, including the gastrointestinal tract, integument, skeletal system and genitourinary tract. Review of the literature has shown that malakoplakia presents in paediatric as well as adult populations, and that it is associated with impaired immune function. Variable clinical manifestations as well as the sometimes non-specific radiological findings of malakoplakia can be misleading, making diagnosis quite difficult. We present a clinical case of renal malakoplakia mimicking a malignant renal carcinoma in a 62-year-old woman. This report highlights the importance of awareness of malakoplakia in the differential diagnosis for renal masses and renomegaly. This case can serve as a reminder that things are not always what they seem, and it reinforces the idea that unusual disease entities should be explored to aid in achieving a correct diagnosis and, thus, potentially avoid unnecessary treatment.

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“…Renal failure is common at presentation with variable severity [4]. About 40% of patients have some form of immunosuppression, including solid organ transplants, autoimmune diseases requiring steroid use or chemotherapy, chronic systemic diseases, malignancy, alcohol abuse and poorly controlled diabetes mellitus [5].…”

Section: Introductionmentioning

confidence: 99%

“…The diagnosis of malakoplakia must be kept in mind for patients presenting with a renal mass and a history of long-term recurrent renal infections or renal failure [4]. Renal malakoplakia may mimic renal tumors and lead to unnecessary surgery.…”

Section: Introductionmentioning

confidence: 99%

Renal malakoplakia presenting as a renal mass in a 55-year-old man: a case report

et al. 2012

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IntroductionMalakoplakia is an uncommon chronic inflammatory condition that has a gross and microscopic appearance resembling that of xanthogranulomatous pyelonephritis. It is characterized by distinctive Michaelis-Gutmann bodies. Malakoplakia can affect any organ system but genitourinary tract involvement is the most common, particularly in immunocompromised individuals. Very rare cases have been reported to present as a unifocal lesion mimicking a renal tumor.Case presentationWe report a case of renal malakoplakia in a 55-year-old Iranian man with a past history of recurrent urinary tract infections who presented with left flank pain. An ultrasound study showed a large solid left renal mass, and he underwent a left radical nephrectomy with a clinical diagnosis of a renal tumor. Pathology slides revealed the diffuse infiltration of sheets of Periodic Acid Schiff-positive histiocytes in his renal parenchyma; these cells showed strong immunoreactivity for CD 68. The final diagnosis was renal malakoplakia.ConclusionRenal malakoplakia must be kept in mind for patients presenting with a renal mass and a history of long-term recurrent renal infections or renal failure. The large, rapidly growing nodules of malakoplakia may mimic renal cell carcinoma in imaging studies. In these cases, a true cut needle biopsy may help the correct diagnosis and prevent unnecessary surgery.

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Enlarged kidneys and acute renal failure why is a renal biopsy necessary for diagnosis and treatment?

Cited by 10 publications

References 6 publications

Successful treatment of malakoplakia of the bladder in a kitten

Successful treatment of malakoplakia of the bladder in a kitten

Renal malakoplakia mimicking a malignant renal carcinoma: a patient case with literature review

Renal malakoplakia presenting as a renal mass in a 55-year-old man: a case report

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