Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Xanthogranulomatous Pyelonephritis Differential Diagnoses

  • Author: Samuel G Deem, DO; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
 
Updated: Nov 09, 2014
 
 

Diagnostic Considerations

Renal cell carcinoma may be indistinguishable from xanthogranulomatous pyelonephritis (XGP) radiographically and clinically.[9] A case of XGP involving thrombus of the renal vein has been reported.[10] XGP and renal cell carcinoma have even been observed in the same specimen.

Shah et al reported a mistaken diagnosis of renal XGP that was subsequently proved to be renal tuberculosis.[11] XGP must be diagnosed on the basis of histologic findings rather than solely on the basis of radiographic imaging studies.

 
 
Contributor Information and Disclosures
Author

Samuel G Deem, DO Faculty, Department of Urology, Charleston Area Medical Center

Samuel G Deem, DO is a member of the following medical societies: American College of Surgeons, American Osteopathic Association, American Urological Association, Endourological Society, Society of Urologic Oncology, American Society of Clinical Oncology, American College of Osteopathic Surgeons

Disclosure: Nothing to disclose.

Coauthor(s)

Joe D Mobley, III, MD, MPH Urologist, Kentucky Lake Urology Clinic

Joe D Mobley, III, MD, MPH is a member of the following medical societies: American College of Surgeons, American Medical Association, American Urological Association, Endourological Society, Tennessee Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Bradley Fields Schwartz, DO, FACS Professor of Urology, Director, Center for Laparoscopy and Endourology, Department of Surgery, Southern Illinois University School of Medicine

Bradley Fields Schwartz, DO, FACS is a member of the following medical societies: American College of Surgeons, Society of Laparoendoscopic Surgeons, Society of University Urologists, Association of Military Osteopathic Physicians and Surgeons, American Urological Association, Endourological Society

Disclosure: Nothing to disclose.

Acknowledgements

Gamal Mostafa Ghoniem, MD, FACS Professor of Urology, Chief, Division of Female Urology, Pelvic Reconstructive Surgery, and Voiding Dysfunction, Department of Urology, University of California, Irvine, School of Medicine

Gamal Mostafa Ghoniem, MD, FACS is a member of the following medical societies: American College of Surgeons, American Urogynecologic Society, American Urological Association, International Continence Society, International Urogynaecology Association, and Society of Urodynamics and Female Urology

Disclosure: Astellas Honoraria Speaking and teaching; Coloplasty Consulting fee Board membership; Uroplasty Consulting fee Consulting

Scott Rutchik, MD Assistant Professor, Department of Surgery, Division of Urology, University of Connecticut School of Medicine

Scott Rutchik, MD is a member of the following medical societies: American Urological Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

References
  1. Schlagenhaufer F. Uber eigentumlich staphylomykosender neiven und des pararenalen bindegewebes. Frankfurt Z Pathol. 1916. 19:139-48.

  2. Peréz LM, Thrasher JB, Anderson EE. Successful management of bilateral xanthogranulomatous pyelonephritis by bilateral partial nephrectomy. J Urol. 1993 Jan. 149(1):100-2. [Medline].

  3. Kuo CC, Wu CF, Huang CC, et al. Xanthogranulomatous pyelonephritis: critical analysis of 30 patients. Int Urol Nephrol. 2011 Mar. 43(1):15-22. [Medline].

  4. Malek RS, Elder JS. Xanthogranulomatous pyelonephritis: a critical analysis of 26 cases and of the literature. J Urol. 1978 May. 119(5):589-93. [Medline].

  5. Gregg CR, Rogers TE, Munford RS. Xanthogranulomatous pyelonephritis. Curr Clin Top Infect Dis. 1999. 19:287-304.

  6. Kim SW, Yoon BI, Ha US, Sohn DW, Cho YH. Xanthogranulomatous pyelonephritis: clinical experience with 21 cases. J Infect Chemother. 2013 Dec. 19(6):1221-4. [Medline].

  7. Hitti W, Drachenberg C, Cooper M, et al. Xanthogranulomatous pyelonephritis in a renal allograft associated with xanthogranulomatous diverticulitis: report of the first case and review of the literature. Nephrol Dial Transplant. 2007 Nov. 22(11):3344-7. [Medline].

  8. Loffroy R, Guiu B, Varbédian O, Michel F, Sagot P, Cercueil JP, et al. Diffuse xanthogranulomatous pyelonephritis with psoas abscess in a pregnant woman. Can J Urol. 2007 Apr. 14(2):3507-9. [Medline].

  9. Inouye BM, Chiang G, Newbury RO, Holmes N. Adolescent xanthogranulomatous pyelonephritis mimicking renal cell carcinoma on urine cytology: an atypical presentation. Urology. 2013 Apr. 81(4):885-7. [Medline].

  10. Tiguert R, Gheiler EL, Yousif R, et al. Focal xanthogranulomatous pyelonephritis presenting as a renal tumor with vena caval thrombus. J Urol. 1998 Jul. 160(1):117-8. [Medline].

  11. Shah HN, Jain P, Chibber PJ. Renal tuberculosis simulating xanthogranulomatous pyelonephritis with contagious hepatic involvement. Int J Urol. 2006 Jan. 13(1):67-8. [Medline].

  12. Rajesh A, Jakanani G, Mayer N, et al. Computed tomography findings in xanthogranulomatous pyelonephritis. J Clin Imaging Sci. 2011. 1:45. [Medline]. [Full Text].

  13. Osca JM, Peiro MJ, Rodrigo M, Martinez-Jabaloyas JM, Jimenez-Cruz JF. Focal xanthogranulomatous pyelonephritis: partial nephrectomy as definitive treatment. Eur Urol. 1997. 32(3):375-9. [Medline].

  14. Bercowsky E, Shalhav AL, Portis A, Elbahnasy AM, McDougall EM, Clayman RV. Is the laparoscopic approach justified in patients with xanthogranulomatous pyelonephritis?. Urology. 1999 Sep. 54(3):437-42; discussion 442-3. [Medline].

  15. Mahesan N, Choudhury SM, Khan MS, et al. One hand is better than two: conversion from pure laparoscopic to the hand-assisted approach during difficult nephrectomy. Ann R Coll Surg Engl. 2011 Apr. 93(3):229-31. [Medline].

  16. Shah KJ, Ganpule AP, Kurien A, Muthu V, Sabnis RB, Desai MR. Laparoscopic versus open nephrectomy for xanthogranulomatous pyelonephritis: An outcome analysis. Indian J Urol. 2011 Oct. 27(4):470-4. [Medline]. [Full Text].

  17. American Urological Association. Best Practice Policy Statement on Urologic Surgery Antimicrobial Prophylaxis. Available at http://www.auanet.org/content/media/antimicroprop08.pdf.

Previous
Next
 
Xanthogranulomatous pyelonephritis.
Xanthogranulomatous pyelonephritis with obstruction and staghorn calculus.
Xanthogranulomatous pyelonephritis appearing as nonenhancing, low-attenuation areas of the dilated collecting system surrounded by enhancing, high-attenuation parenchyma (known as the "bear paw" sign).
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.