Xanthogranulomatous Pyelonephritis: Our Experience With Review of Published Reports

Abstract

Xanthogranulomatous pyelonephritis is a relatively rare entity that is associated with obstruction, stones and infection of the urinary tract. Late presentation leads to loss of renal parenchyma. It cannot be differentiated preoperatively with renal tumours (renal cell carcinoma and Wilms' tumour), pyonephrosis, infected hydronephrosis and renal lymphoma. Nephrectomy and antibiotics are the treatment of choice.

Successfully treated bilateral xanthogranulomatous pyelonephritis in a child

“…Until now about 213 cases of XPN in children have been reported in the literature [3]. XPN is predominantly unilateral and extremely rarely bilaterally [1,2,5]. Thanks to concerted intensive conservative and surgical treatment, respectively, our patient survived, showing surprisingly good excretory renal function.…”

“…This disease is characterized by progressing renal parenchymal damage, ill-defined margins with inflammatory infiltration of the perinephric fat, and focal inflammatory tissue destruction [1][2][3]. The hallmark of pathological alterations are foamy cells that are macrophages, and focal sclerosing soft-tissue calcification and microthrombosis may also be present.…”

“…The hallmark of pathological alterations are foamy cells that are macrophages, and focal sclerosing soft-tissue calcification and microthrombosis may also be present. Bilateral XPN is rather a rare exception [1,2]. The most common bacteria initiating renal destructive inflammation are gram-negative bacteria.…”

An infant presenting with a non-functional kidney on dimercaptosuccinic acid scan: answer

“…The differential diagnoses of renal mass associated with pyelo-calyceal involvement included Wilms' tumour [22,23], renal cell carcinoma [35], xanthogranulomatous pyelonephritis [1][2][3], malakoplakia [4][5][6], inflammatory pseudotumour of the renal pelvis [7][8][9], renal lymphoma [36], and fungal infection [10,11]. In our patient the lesion could not be identified preoperatively; hence, a needle biopsy was performed.…”

“…elonephritis [1][2][3], malakoplakia [4][5][6], inflammatory pseudotumour of the renal pelvis [7][8][9], and fungal infection [10,11].…”