Demet DOĞAN, ÖZGÜR ÇAKIR, Nagihan İNAN, Hasan Tahsin SARISOY, ALİ DEMİRCİ, Nuri GÖNÜLLÜ, Bahar MÜEZZİNOĞLU, Doğukan SÖKMEN, MESUDE TOSUN

Adrenal kitleyi taklit eden fokal ksantogranülomatöz pyelonefrit

Ksantogranülomatöz pyelonefrit (KGP) etiyolojisi tam olarak bilinmeyen ve nadir görülen kronik renal inflamasyondur. Tipik olarak taşa bağlı obstrüksiyon zemininde gelişir. Ultrasonografi (USG) bulgularının nonspesifik olması sebebiyle bilgisayarlı tomografi (BT) ve Manyetik Rezonans Görüntüleme (MRG) hastalığın tanısı ve preoperatif planlamada ekstrarenal uzanımının gösterilmesinde seçilebilecek diagnostik modalitelerdir. Ancak fokal tutulum gösteren KGP'i böbrek tümörlerinden ayırt etmek zor olabilir ve bazen tanı yalnızca nefrektomi sonrası konulabilir. Bu yazımızda adrenal kitleyi taklit eden ve histopatolojik olarak ksantogranulomatöz pyelonefrit tanısı alan olgu sunulmuştur.

Focal xanthogranulomatous pyelonephritis mimicking adrenal mass: Case report

Xanthogranulomatous pyelonephritis is a rare form of chronic renal infection which is unknown etiology exactly. Xanthogranulomatous pyelonephritis is typically associated with an obstructing calculus. Because of the nonspecific findings of ultrasonography, computed tomography and magnetic resonance imaging can be selected diagnostic modalities to show the extrarenal extension of the disease. However, it may be difficult to distinguish focal involvement of xanthogranulomatous pyelonephritis from renal tumors and sometimes diagnosis can only be made after nephrectomy. In this article we present a case of xanthogranulomatous pyelonephritis mimicking adrenal mass and histopathologically diagnosed.

PDF

___

1. Das, D. P, Pal, D. K. Dilip Kumar. Co-existing malakoplakia and xanthogranulomatous pyelonephritis of kidney: Two different spectrum of same disease process. Urology annals 2016; 2: 252.
2. Sadsmark M. Xanthomatous pyelonephritis. Acta Chir Scand 1978; 144: 329-333.
3. Goldman SM, Hartman DS, Fishman EK, Finizio JP, Gatewood OM, Siegelman SS. CT of xanthogranulomatous pyelonephritis: radiologicpathologic correlation. AJR Am J Roentgenol 1984;142:963-969.
4. Craig WD, Wagner BJ, Travis MD. From the archives of the AFIP: pyelonephritis-radiologicpathologic review. RadioGraphics 2008; 28:255-277.
5. Tüysüz G, Tayfun F, Canpolat F, Zeytun H, Goya C, Keleş AN, Özdemir N. A case of xanthogranulomatous pyelonephritis mimicking Wilms tumor. Turk J Pediatr 2015;57:409-412.
6. Khoo H. W, Lee C. H. Renal squamous cell carcinoma mimicking xanthogranulomatous pyelonephritis: case report and review of literature. Radiology Case Reports 2016;11:74-77.
7. Yeow Y, Chong Y. L. Xanthogranulomatous pyelonephritis presenting as Proteus preperitoneal abscess. Journal of Surgical Case Reports 2016;rjw211.
8. Eastham J, Ahlerıng T, Skınner E. Xantogranulomatous pyelonephritis: Clinical findings and surgical considerations. Urology 1994; 43: 295-299.
9. Dell'Aprovitola N, Guarino S, Del Vecchio W, et al. Xanthogranulomatous pyelonephritis mimicking a renal cell carcinoma: a unique and challenging case. Acta Radiol Short Rep 2014; 3: 1-4.
10. Acunas B, Acunas G, Rozanes I, et al. Coexistent xanthogranulomatous pyelonephritis and massive replacement lipomatosis of kidney: CT diagnosis. Urol Radiol 1990;12:88-90.
11. AlDarrab RM, AlAkrash HS, AlKhateeb SS, AlBqami NM. A case report of a xanthogranulomatous pyelonephritis case mimicking the recurrence of renal cell carcinoma after partial nephrectomy. Urol Ann 2015;7:524-6.
12. Xu H, Zhang J, Wang Y, Yu S, Zhou R , Zhang J. Clinicopathological analysis of renal inflammatory pseudotumors presenting as the unilateral solitary masses. Int J Clin Exp Pathol 2017;10:7734-7742.
13. Malek RS and Elder JS. Xanthogranulamatous pyelonephritis: detailed analysis of 26 cases and of the literature. J Urol 1978; 119: 589-592.
14. Chuang CK, Lai MK, Chang PL ve ark. Xanthogranulomatous pyelonephritis: Experience in 36 cases. J Urol 1992; 147: 333-336.
15. Cao D, Liu L, Gao L, Wei Q. Ureteral calculi combined with xanthogranulomatous pyelonephritis mimicking renal tuberculosis in a male child. Kaohsiung J Med Sci 2014;30:591-2.
16. Wang Z, Yan B, Wei YB, Hu NA, Shen Q, Li D, Yang JR, Yang X. Primary kidney parenchyma squamous cell carcinoma mimicking xanthogranulomatous pyelonephritis: A case report. Oncol Lett 2016;11:2179-2181.