Xantogranulomatous pyelonephritis: The missed diagnosis

Abiad, Yassine El; Dehayni, Y.; Qarro, A.; Balla, Bouzid; Ammani, A.; Alami, M.

doi:10.1016/j.ijscr.2015.11.026

Cited by 3 publications

(2 citation statements)

References 6 publications

(8 reference statements)

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“…Xanthogranulomatous pyelonephritis 12 is characterized microscopically by destruction and replacement of the renal parenchyma, and even adjacent tissues, with granulomatous tissue containing lipid-filled macrophages. Although the diffuse form of xanthogranulomatous pyelonephritis is more common, it may also be focal or segmental, in which case partial involvement of the kidney may greatly mimic RCC.…”

Section: Discussionmentioning

confidence: 99%

Clear Cell Renal Cell Carcinoma with Immunotherapy Effect Mimicking Xanthogranulomatous Pyelonephritis

et al. 2022

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Renal cell carcinoma is now increasingly treated with checkpoint inhibitor therapy, predominantly in the metastatic setting or occasionally in the adjuvant setting; however, there is little published histopathology data demonstrating the post-therapy features of renal cell carcinoma tumor tissue. We report a middle-aged man, who was undergoing treatment with pembrolizumab for locally recurrent cutaneous basal cell carcinoma and was incidentally found to have a renal mass. Radical nephrectomy demonstrated a 5.0 cm renal mass with extensive xanthogranulomatous features, mimicking xanthogranulomatous pyelonephritis. However, rare clusters of cells demonstrated gland-like lumina, clear cytoplasm, and slightly increased atypia, suggesting scant residual renal cell carcinoma cells. Immunohistochemistry demonstrated focal positivity for pan-keratin and keratin 8/18, EMA, PAX8, CD10, and carbonic anhydrase 9 (CA9), supporting a diagnosis of renal cell carcinoma with extensive treatment response, to the point that it mimicked xanthogranulomatous pyelonephritis. This report demonstrates the histologic features of post-immunotherapy renal cell carcinoma, aiding pathologists in recognition of this phenomenon, which may be misdiagnosed as an inflammatory process, if immunotherapy was performed for other reasons.

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Section: Discussionmentioning

confidence: 99%

Clear Cell Renal Cell Carcinoma with Immunotherapy Effect Mimicking Xanthogranulomatous Pyelonephritis

et al. 2022

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“…Some studies have classified XGPN as focal, segmental, and diffuse 1 while others have classified it as being either diffuse or focal with the focal form imitating greatly renal cell carcinoma (RCC) 3 .…”

Section: Introductionmentioning

confidence: 99%

Xanthogranulomatous pyelonephritis mimicking renal cell carcinoma: a case report

Daoud

Ismaiel

Bashour

et al. 2023

Annals of Medicine &Amp; Surgery

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Introduction and importance: Xanthogranulomatous pyelonephritis (XGPN) is a rare, serious, and chronic inflammatory disorder of the kidney characterized by a destructive process that invades the renal parenchyma, which is most commonly associated with urinary tract obstruction and infection. It affects women more often than men. Case presentation: Herein, the authors report a case of a 48-year-old male presented to their hospital with complaints of malaise, fever, chills, left flank pain, and a history of a staghorn calculus in the renal pelvis, which was removed by surgery 7 years ago. Ultrasonography and computed tomography scans showed an enlarged left kidney with cystic formation and pelvicalyceal system dilation with the presence of multiple large stones. The renogram showed a dysfunctioning left kidney. An open radical left nephrectomy was performed. Renal cell carcinoma (RCC) was suspected in both the gross and microscopic examinations. The immunohistochemistry was the decisive factor in confirming the diagnosis of XGPN. Clinical discussion: Preoperative and postoperative diagnosis of XGPN can sometimes be difficult due to diverse differential diagnoses. The misinterpretation of ‘foam cells’ as ‘clear cells’ consistent with RCC is the most important diagnostic challenge for pathologists. Conclusion: The unusual findings of this case report suggest a careful evaluation of patients with a renal cystic mass, that can be misdiagnosed as a RCC. A combined computed tomography scan evaluation together with histopathology and immunohistochemistry are essential for a correct diagnosis of this rare renal entity.

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Complications of Urolithiasis

Al-Mamari

2017

Urolithiasis in Clinical Practice

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Introducción: La urolitiasis es una enfermedad de alta prevalencia con una importante asociación con complicaciones y mortalidad, tanto en su presentación como en relación con el manejo activo de la misma. La epidemiología entorno a esta patología, las complicaciones y mortalidad de los diferentes abordajes de intervención es generalmente basada en datos de series internacionales, desconociendo los datos nacionales. Objetivo: El objetivo de este trabajo es determinar la mortalidad (30 y 90 días) y las complicaciones postoperatorias (30 días) de los pacientes del régimen contributivo en Colombia llevados a tratamiento activo para la litiasis urinaria durante los años 2016 y 2017. Metodología: Es un estudio de cohorte retrospectivo basado en una base de datos oficial del SISPRO y una base de datos de defunciones provista por el DANE (Departamento Administrativo Nacional de Estadística). Resultados: Se incluyeron 40.612 pacientes distribuidos en los diferentes abordajes: endoscópico 29.685 pacientes (73%), abierto 4.732 (11.6%), LEC 4.340 (10.7%), percutáneo 1.728 (4.2%) y laparoscópico 127 (0.3%). La mortalidad en el manejo activo de la litiasis urinaria en nuestra cohorte fue del 0.52% y 1.1% para 30 y 90 días respectivamente. El tener cáncer, un Índice de Charlson ≥3, el requerimiento de UCI postoperatoria, la transfusión de hemoderivados, la interacción de obstrucción urinaria alta e IVU extrahospitalaria, el abordaje endoscópico (más representado) y percutáneo fueron las variables con mayor relación con mortalidad. La derivación urinaria y el dolor urológico tienen un efecto protector para mortalidad. Conclusión: Es el primer estudio en Colombia de mortalidad asociada a manejo activo de urolitiasis. A pesar de que nuestra cohorte difiere de otras series y no es estrictamente comparable, contamos con una mortalidad asociada al manejo activo de la urolitiasis igual o superior a las publicaciones internacionales.Palabras clave (Decs): urolitiasis, cálculos renales, cálculos de la vejiga urinaria, cálculos ureterales, mortalidad, complicaciones intraoperatorias, complicaciones postoperatorias. VIIComplicaciones y mortalidad en el manejo de la litiasis urinaria en Colombia:Análisis de una cohorte nacional retrospectiva.

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Xantogranulomatous pyelonephritis: The missed diagnosis

Cited by 3 publications

References 6 publications

Clear Cell Renal Cell Carcinoma with Immunotherapy Effect Mimicking Xanthogranulomatous Pyelonephritis

Clear Cell Renal Cell Carcinoma with Immunotherapy Effect Mimicking Xanthogranulomatous Pyelonephritis

Xanthogranulomatous pyelonephritis mimicking renal cell carcinoma: a case report

Complications of Urolithiasis

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