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      Atypical focal xanthogranulomatous pyelonephritis without clinical symptoms presenting as infiltrative renal cancer: a case report and literature review

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          Abstract

          Background

          Xanthogranulomatous pyelonephritis (XGP) is an uncommon form of chronic pyelonephritis. Most patients of XGP are diffuse in radiology and the clinical features are typical.

          Case presentation

          We present a case of 24-year-old female with the absence of symptoms and normal laboratory examinations. Contrast computed tomography and intravenous pyelography demonstrate infiltrative renal mass and renal cell carcinoma is presumed. Laparoscopic right radical nephrectomy is performed, but the final pathological result shows XGP.

          Conclusions

          As far as we know, this is the first case report of XGP without any symptoms/signs and with normal laboratory examinations. The diagnosis of atypical XGP is challenging and preoperative renal mass biopsy should be considered in special cases.

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          Most cited references16

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          Xanthogranulomatous pyelonephritis.

          Li Li, Anil V Parwani (2011)
          Xanthogranulomatous pyelonephritis is an uncommon chronic destructive granulomatous process of renal parenchyma in association with long-term urinary tract obstruction and infection. It affects females more often than males, with a wide range of age, from newborn to elderly. Almost all patients are symptomatic and the most common symptoms are flank or abdominal pain, lower urinary tract symptoms, fever, palpable mass, gross hematuria, and weight loss. The common laboratory findings are leukocytosis and anemia. Urine cultures most often reveal Escherichia coli and Proteus mirabilis . Computed tomography is the mainstay of diagnostic imaging for xanthogranulomatous pyelonephritis. Imaging studies may demonstrate diffuse or focal form. Histologically, xanthogranulomatous pyelonephritis presents a granulomatous inflammatory infiltrate composed of neutrophils, lymphocytes, plasma cells, xanthomatous histiocytes, and multinucleated giant cells. The differential diagnosis includes clear cell renal cell carcinoma, papillary renal cell carcinoma, sarcomatoid renal cell carcinoma, leiomyosarcoma, malakoplakia, and megalocytic interstitial nephritis. Both antibiotics and surgery can be treatment options depending on the patient's disease status.
          Article 0 comments Cited 39 times – based on 0 reviews     Review now
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            Xanthogranulomatous Pyelonephritis: A Retrospective Review of 16 Cases

            Sujatha Siddappa, Kowsalya Ramprasad, Mythri MuddeGowda (2011)
            Purpose Xanthogranulomatous pyelonephritis is an uncommon disorder of unknown etiology that is characterized by extensive destruction of the involved kidney. It is being increasingly recognized as an important cause of renal morbidity around the world. Materials and Methods This retrospective study was undertaken to review the xanthogranulomatous pyelonephritis cases presented at our tertiary care referral center in Bangalore, India. Results A total of 16 biopsy-proven cases of xanthogranulomatous pyelonephritis from October 2007 to March 2010 treated at our institute were included in the study. There were 10 females and 6 males with a mean age of 51.5 years. Flank pain was the most common presenting symptom followed by fever. All patients had unilateral disease and underwent total nephrectomy of the affected nonfunctional kidney. Conclusions Xanthogranulomatous pyelonephritis is a chronic and unusual infectious inflammatory condition involving the renal parenchyma. The definite treatment is nephrectomy. Early identification and prompt treatment of this relatively benign and uncommon condition is important to minimize morbidity and mortality.
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              Xanthogranulomatous pyelonephritis in children: diagnostic and therapeutic aspects.

              M Bingöl-Koloğlu, A O Ciftci, M Senocak … (2002)
              Xanthogranulomatous pyelonephritis (XGP) is an uncommon chronic, inflammatory disease of the kidney. Etio-pathogenesis, diagnosis and management of pediatric XGP is still obscure due to the limited number of cases. Therefore, a retrospective clinical study was carried out to present an updated picture of the entire spectrum of pediatric XGP based on our 30 years' experience covering one of the largest non-collected series treated in a single medical center.
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                Author and article information

                Contributors
                Xiaobo Ding: dingxiaobo_2008@126.com
                Gang Wang: 24552504@qq.com
                Tiejun Wang: mypiers@139.com
                Xiaobo Ma: mxbcmu@163.com
                Yanbo Wang:
                ORCID: http://orcid.org/0000-0003-4052-6421
                wangyanb@jlu.edu.cn
                Journal
                Journal ID (nlm-ta): BMC Urol
                Journal ID (iso-abbrev): BMC Urol
                Title: BMC Urology
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1471-2490
                Publication date (Electronic): 3 June 2020
                Publication date PMC-release: 3 June 2020
                Publication date Collection: 2020
                Volume: 20
                Electronic Location Identifier: 63
                Affiliations
                [1 ]GRID grid.430605.4, Department of Radiology, , First Hospital of Jilin University, ; Changchun, Jilin 130021 P.R. China
                [2 ]GRID grid.430605.4, Second Operating Room, , First Hospital of Jilin University, ; Changchun, Jilin 130021 P.R. China
                [3 ]GRID grid.430605.4, Department of Orthopedic Traumatology, , First Hospital of Jilin University, ; Changchun, Jilin 130021 P.R. China
                [4 ]GRID grid.430605.4, Department of Pathology, , First Hospital of Jilin University, ; Changchun, Jilin 130021 P.R. China
                [5 ]GRID grid.430605.4, Department of Urology, , First Hospital of Jilin University, ; Changchun, Jilin 130021 P.R. China
                Author information
                http://orcid.org/0000-0003-4052-6421
                Article
                Publisher ID: 632
                DOI: 10.1186/s12894-020-00632-3
                PMC ID: 7268720
                PubMed ID: 32493295
                SO-VID: dcd796d0-9a34-4476-b5dd-1526b421bb05
                Copyright © © The Author(s) 2020
                License:

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                Date received : 22 November 2018
                Date accepted : 21 May 2020
                Funding
                Funded by: Jilin Provincial Science & Technology Department
                Award ID: 20160520146JH
                Award Recipient :
                Funded by: Norman Bethune Program of Jilin University
                Award ID: 2015423
                Award ID: 2015324
                Award Recipient :
                Funded by: Jilin Provincial Science & Technology Department
                Award ID: 20160520144JH
                Award Recipient :
                Categories
                Subject: Case Report
                Custom metadata
                issue-copyright-statement © The Author(s) 2020

                ScienceOpen disciplines: Urology
                Keywords: xanthogranulomatous pyelonephritis,infiltrative renal cancer,renal cancer,kidney,case report
                Data availability:
                ScienceOpen disciplines: Urology
                Keywords: xanthogranulomatous pyelonephritis, infiltrative renal cancer, renal cancer, kidney, case report

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