Difference between revisions of "Xanthogranulomatous pyelonephritis"

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**[[Nephrolithiasis]].
**[[Nephrolithiasis]].
**GU obstruction.<ref name=pmid17098659>{{cite journal |author=Al-Ghazo MA, Ghalayini IF, Matalka II, Al-Kaisi NS, Khader YS |title=Xanthogranulomatous pyelonephritis: Analysis of 18 cases |journal=Asian J Surg |volume=29 |issue=4 |pages=257–61 |year=2006 |month=October |pmid=17098659 |doi= |url=}}</ref>
**GU obstruction.<ref name=pmid17098659>{{cite journal |author=Al-Ghazo MA, Ghalayini IF, Matalka II, Al-Kaisi NS, Khader YS |title=Xanthogranulomatous pyelonephritis: Analysis of 18 cases |journal=Asian J Surg |volume=29 |issue=4 |pages=257–61 |year=2006 |month=October |pmid=17098659 |doi= |url=}}</ref>
*Occasionally an indication of nephrectomy.<ref name=pmid17987581/><ref name=pmid17098659/>
*Occasionally an indication for nephrectomy.<ref name=pmid17987581/><ref name=pmid17098659/>
*Most common organism (in the context of nephrectomy specimens) - ''Proteus mirabilis''.<ref name=pmid17098659/>
*Most common organism (in the context of nephrectomy specimens) - ''Proteus mirabilis''.<ref name=pmid17098659/>



Revision as of 13:16, 5 April 2014

Xanthogranulomatous pyelonephritis, abbreviated XGP, is an inflammatory process of the kidney that can mimic renal cell carcinoma.

General

Microscopic

  • Abundant macrophages.
  • +/-Giant cells.

DDx:

Image

Stains

  • PAS-D -ve.
    • Done to look for malakoplakia.

IHC

  • CD68 +ve.
  • RCC markers (CD10, RCC) all negative.

Sign out

RIGHT KIDNEY, NEPHRECTOMY:
- XANTHOGRANULOMATOUS PYELONEPHRITIS.
- CHRONIC INTERSTITIAL NEPHRITIS.
- INCREASED NUMBERS OF TOTALLY SCLEROSED GLOMERULI AND GLOMERULI WITH FOCAL 
  SEGMENTAL GLOMERULOSCLEROSIS.
- MARKED INTERSTITIAL FIBROSIS.
- NEGATIVE FOR MALIGNANCY.

COMMENT:
Immunostaining demonstrates abundant CD68 positive cells (macrophages).  A CD10 immunostain 
is non-concerning (it highlights glomeruli). A pankeratin immunostain is non-concerning 
(it highlights benign renal tubules).

Compatible XGP

"KIDNEY" LESION, LEFT, BIOPSY:
- FIBROMUSCULAR TISSUE WITH A MIXED INFLAMMATORY INFILTRATE.
- CELLULAR DEBRIS WITH SURROUNDING LOOSELY AGGREGATED HISTIOCYTES.
- NO RENAL PARENCHYMA IDENTIFIED.
- NEGATIVE FOR MALIGNANCY.

COMMENT:
A SMA immunostain highlights the muscle component, and a CD68 immunostain marks 
abundant histiocytes. No epithelial component is identified with a pankeratin 
immunostain. 

See also

References

  1. 1.0 1.1 Afgan F, Mumtaz S, Ather MH (2007). "Preoperative diagnosis of xanthogranulomatous pyelonephritis". Urol J 4 (3): 169–73. PMID 17987581.
  2. 2.0 2.1 2.2 Al-Ghazo MA, Ghalayini IF, Matalka II, Al-Kaisi NS, Khader YS (October 2006). "Xanthogranulomatous pyelonephritis: Analysis of 18 cases". Asian J Surg 29 (4): 257–61. PMID 17098659.