Abstract
Xanthogranulomatous pyelonephritis (XGP) is a rare benign condition with unknown aetiology and chronic infection of kidney. Commonly, most cases are related with urinary tract obstruction, nephrolithiasis, infection, diabetes, and/or immune compromise. XGP is associated with destruction of the renal parenchyma and granulomatous inflammation with foamy lipid-laden macrophages resulting from obstructive uropathy. It closely mimics a malignancy, exhibiting local tissue invasion and destruction. Adjacent organs especially duodenum as well as very rarely pancreas or spleen may be involved. Additionally, XGP is known as notorious for fistulisations, such as pyelocutaneous and ureterocutaneous fistulae, which have been reported as well described. XGP may be indistinguishable from renal cell carcinoma by radiographic and clinic consultation so it must be diagnosed based on the histopathologic examinations. Furthermore, macroscopic appearance of XGP is a mass of yellow tissue with focal haemorrhage besides necrosis and in this regard, it grossly resembles renal cell carcinoma. Here, we report the case of a 32-year-old female, preoperatively diagnosed as malignancy by clinical examination. Our further pathological evaluations revealed very rarely adhesion of XGP to pancreas tissue.
Similar content being viewed by others
References
Craig WD, Wagner BJ, Travis MD. Pyelonephritis: radiologic-pathologic review. Radiographics. 2008;28(1):255–77.
Korkes F, Favoretto RL, Bro´ glio M, Silva CA, Castro MG, Perez MD. Xanthogranulomatous pyelonephritis: clinical experience with 41 cases. Urology. 2008;71(2):178–80.
Chaudhary R, Singh K, Jain N, Biswas R. Chronic flank pain, fever and an unusual diagnosis. BMJ Case Rep. 2011. https://doi.org/10.1136/bcr.08.2011.4646.
Dwivedi US, Goyal NK, Saxena V, Acharya RL, Trivedi S, Singh PB, Vyas N, Datta B, Kumar A, Das S. Xanthogranulomatous pyelonephritis: our experience with review of published reports. Anz J Surg. 2006;76:1007–9.
Ghoz HM, Williams M, Perepletchikov A, James N, Babeir AA. An unusual presentation of xanthogranulomatous pyelonephritis: psoas abscess with reno-colic fistula. Oxford Med Case Rep. 2016;7:150–3.
Chlif M, Chakroun M, Rhouma SB, Chehida MAB, Sellami A, Gargouri MM, Nouira Y. Xanthogranulomatous pyelonephritis presenting as a pseudotumour. Can Urol Assoc J. 2016;10(1–2):E36-40.
Kuo C, Wu CF, Huang CC, Lee YJ, Lin WC, Tsai CW, Wu VC, Chen YM, Wu MS, Chu TS, Wu KD. Xanthogranulomatous pyelonephritis: critical analysis of 30 patients. Int Urol Nephrol. 2011;43(1):15–22.
Holton-Burke RC, M Varughese. A case of xanthogranulomatous pyelonephritis associated with renoduodenal fistula. Hindawi Case Rep Med. 2017. https://doi.org/10.1155/2017/8069205 (Article ID 8069205).
Li L, Parwani AV. Xanthogranulomatous pyelonephritis. Arch Pathol Lab Med. 2011;135(5):671–4.
Arrighi N, Antonelli A, Zani D, Zanotelli T, Corti S, Cunico SC, Simeone C. Review renal mass with caval thrombus as atypical presentation of xantogranulomatous pyelonephritis. A case report and literature review. Urologia. 2013;80:44–47.
Snoj Z, Savic N, Regvat J. Late complication of a renal calculus: fistulisation to the psoasmuscle, skin and bronchi. Int Braz J Urol. 2015;41(4):808–12.
Loffroy R, Guiu B, Watfa J, Michel F, Cercueil JP, Krause D. Xanthogranulomatous pyelonephritis in adults: clinical and radiological findings in diffuse and focal forms. Clin Radiol. 2007;62(9):884–90.
Chow J, Kabani R, Lithgow K, MA Sarna. Xanthogranulomatous pyelonephritis presenting as acute pleuritic chest pain: a case report. J Med Case Rep. 2017;11:101.
Wang Peter S. Xanthogranulomatous pyelonephritis. Ultrasound Q. 2016;32:310–1.
Pastore V, Niglio F, Basile A, Cocomazzi R, Faticato MG, Aceto G, Bartoli F. Laparascopic-assisted nephroureterectomy for shaped urolithiasis and xanthogranulomatous pyelonephritis: case report and review of literature. Afr J Paediatr Surg. 2013;10(3):285–8.
Friedl A, Tuerk C, Schima W, Broessner C. Xanthogranulomatous Pyelonephritis with staghorn calculus, acute gangrenous appendicitis and enterocolitis: a multidisciplinary challenge of kidney-preserving conservative therapy. Curr Urol. 2014;8:162–5.
Çaliskan S, Özsoy E, Kaba S, Koca O, Öztürk MI. Xanthogranulomatous pyelonephritis. Arch Iran Med. 2016;19(10):712–4.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
All the authors have declared no competing interest.
Informed consent
Informed consent was obtained from the patient in this case report.
About this article
Cite this article
Devrim, T., Atasoy, P. & Tuğlu, D. Xanthogranulomatous pyelonephritis: a case with rare adhesion to pancreas. CEN Case Rep 7, 44–47 (2018). https://doi.org/10.1007/s13730-017-0289-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13730-017-0289-7