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Introduction: For a range of kidney abnormalities, including both neoplastic and nonneoplastic disorders, nephrectomy is a popular surgical treatment. We conducted this study to examine the range of lesions found in the nephrectomy specimens obtained and to ascertain the distribution of these lesions by age and sex. MaterialsandMethods: This study was conducted in the department of pathology, from 2017 to 2022. All nephrectomy specimens received during 5 years were included. Results: The spectrum of renal lesions observed in the study included both neoplastic (43.75%) and nonneoplastic (56.25%) conditions. Nineteen patients were males (59.37%) and 13 were females (40.62%) (M: F = 1.4:1). The most common entity in the nonneoplastic category was chronicpyelonephritis (n = 9, 28.12%). In our study, we documented two unusual cases of renal replacement lipomatosis (RRL), a type of pseudotumor related to nonfunctioning kidneys. Fourteen patients underwent nephrectomy for neoplastic conditions such as Wilm’stumor and renal cell carcinoma (RCC). Conclusion: Nephrectomy for the nonneoplastic condition was performed more frequentlyin our series. Histopathological evaluation of nonneoplastic nephrectomy specimens must be thoroughly considered, particularly in unusual circumstances such as RRL, where a preoperative erroneous initial impression of a malignant lesion such as angiomyolipoma or liposarcoma is possible.
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Nephrectomy brings in relief to patients from various chronic and life threatening diseases and in some cases makes way for renal transplant. Renal cell carcinoma accounts for 3% of all cancer deaths. Staging and grading remain the most useful indicators. Hence the present study was undertaken to become familiar with the morphological features and to explore, elucidate and document the kidney lesions at nephrectomy. We wanted to study the spectrum of renal lesions post nephrectomy, obtain the overall frequency, the age and sex incidence of various lesions at nephrectomy along with detailed histomorphology study of various lesions encountered in nephrectomy specimens and evaluate the histomorphological study of renal tumours including the classification of cell type, architectural pattern and grading. MethodsThis prospective study was done on 85 nephrectomy specimens received in the department of pathology, N.I.M.S. Medical College, Jaipur, over a period of three years (2016 to 2019). ResultsOf these 85 nephrectomy specimens, 44 cases (51.7%) were neoplastic and remaining 41 cases (48.2%) were non-neoplastic. ConclusionsThe youngest patient was 40 days and oldest was 75 years. Chronic pyelonephritis was the commonest non-neoplastic lesion. Renal cell carcinoma was the commonest tumour and was commoner in males with clear cell variant being the most frequent. Monophasic Wilms tumour was the commonest neoplastic lesion in the paediatric population.
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Acute and chronic pyelonephritis are known afflictions to the kidney in diabetics and in patients of abnormal urinary anatomy. And its presentation as a spontaneous sinus opening on the anterior abdominal wall is a rare phenomenon. We present one such rare case of a 71-year-old male with pus discharge from the anterior abdominal wall for 7 months. On investigating, it was found to be a nephrocutaneous fistula arising from the left non-functional kidney. This was dealt with left nephrectomy along with excision of the sinus tract. Though a very rare condition, a possibility of nephrocutaneous fistula must be kept when dealing with discharging sinus in lumbar region.
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Background: Nephrectomy is a standard surgical procedure in urology indicated in patients with organ confined renal malignancies and irreversible kidney damage resulting from chronic infection, trauma, obstruction and congenital malformation. This study aims to study the histomorphological features of lesions in nephrectomy specimens in a tertiary care hospital, to analyse the neoplastic and non-neoplastic lesions of kidney according to age, gender and site and observe any variation from the conventional pattern.Methods: The present study was conducted in department of pathology, Tertiary care hospital over a period of 5 years and 7 months (1 Jan 2013 to July 31, 2018). This included 4 years retrospective and 1 year 7 months prospective. A total of 73 cases of were studied.Results: Males constituted 65.73% and females constituted 35.27% of all nephrectomy cases. Right kidney was more commonly affected. Highest percentage of patients belonged to 41-50 years age group. 45 cases were of non-neoplastic lesions and 28 cases were of neoplastic lesions. Among neoplastic lesions, one case was benign while remaining 27 cases were malignant. Chronic Pyelonephritis was the most common indication overall and also amongst non-neoplastic lesions with stone identified in 55% cases. Most common neoplastic lesion in nephrectomy specimen was Renal Cell carcinoma (71.4.1%) followed by Wilms tumour (14%).Conclusions: This study gives a fair insight of the current state of incidence of neoplastic and non-neoplastic lesions of kidney requiring surgical intervention.
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Objective To study the influence of Compound Salvia injection combined with cefoperazone sulbactam sodium on renal function and renal interstitial fibrosis in elderly patients with chronic pyelonephritis (CPN).Methods From April 2013 to July 2014, 126 cases of CPN were divided into observation group ( n =63 ) and control group ( n =63 ) according to the order of admission to hospital.All patients were given cefoperazone sulbactam sodium, and patients in observation group were added Compound Salvia injection.The clinical efficacy of treatment were evaluated between two groups, renal function and TGF-β1 were observed and compared before and after treatment in two groups.Results After treatment, HE staining of nephridial tissue showed renal interstitial fibrosis in observation group obvious improved more.The overall response rate of observation patients (90.48%) was significantly higher (74.60%) than control group, and the relapse rate of observation group (1.59%) was significantly lower than control group (14.29%), and there were statistically significant differences (P<0.05).After treatment, urinary albumin (11.4 ±3.1) mg/L, BUN (5.7 ±0.5) mmol/L, and Scr (103.2 ±10.4)μmol/L of observation group were significantly lower than control group, respectively (P<0.05).After treatment, TGF-β1 level (103.4 ±32.5) ng/L of observation group was significantly lower than control group (202.4 ±35.2) ng/L(P<0.05).There was no significant difference in adverse reactions between two groups.Conclusions Compound Salvia injection combined with cefoperazone sulbactam sodium has good efficacy.can significantly improve renal function, delay renal interstitial fibrosis in treatment of elderly patients with chronic pyelonephritis.
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La fístula nefrobronquial es una complicación infrecuente de las infecciones renales, que ocurre habitualmente en pacientes adultos con pielonefritis xantogranulomatosa. Comunicamos el caso de una paciente de 12 años con antecedentes de mielomeningocele operado e infección urinaria recurrente, quien consultó con historia de cuatro semanas de fiebre, tos y disnea. Ingresó en shock séptico y presentó inundación de la vía aérea por pus, que le ocasionó episodio de asistolia. Mediante tomografía computarizada de abdomen, se diagnosticó extensa colección perirrenal izquierda. Se efectuó un drenaje percutáneo, que dio salida a pus y aire. TAC de tórax y abdomen mostró fístula transdiafragmática entre la base pulmonar izquierda y colección intraabdominal. Se realizó nefrectomía total. La paciente mostró mejoría progresiva poscirugía y regresión total de la sintomatología. Este infrecuente caso clínico en niños ilustra la importancia del diagnóstico precoz de infección urinaria en pacientes con patologías asociadas y de presentar un elevado índice de sospecha ante una complicación potencialmente letal
Nephrobronchial fistula is a rare complication of kidney infections, usually occurring in adult patients with xanthogranulomatous pyelonephritis and very occasionally in children. We reported a 12-year-old girl, with a history of myelomeningocele and recurrent urinary tract infection, who presented with a four-week fever, cough and dyspnea, developing septic shock and presenting flood of airway by pus which caused cardiac arrest. A diagnosis of left perirenal extensive collection was established by abdominal computed tomography (CT). The patient first had antibiotic therapy and percutaneous drainage was performed draining pus and air. Thoracic and abdominal CT scan was performed corroborating transdiaphragmatic fistula. Total nephrectomy was performed. The patient showed gradual improvement after surgery and total regression of symptoms. Pathologic examination concluded chronic pyelonephritis. This case report illustrates a rare complication in children, the importance of early diagnosis of urinary tract infection in patients with comorbidities and of exhibiting a high index of suspicion to a potentially lethal complication.
Subject(s)
Humans , Female , Child , Bronchial Fistula/etiology , Bronchial Fistula/diagnostic imaging , Urinary Fistula/etiology , Urinary Fistula/diagnostic imaging , Kidney Diseases/etiology , Kidney Diseases/diagnostic imaging , Urinary Tract Infections/complications , Tomography, X-Ray ComputedABSTRACT
OBJECTIVE: To study the links between chronic pyelonephritis (CPN) and immune function, and the action mechanism of Yishenkang granule on CPN. METHODS: A total of 120 CPN cases were randomly assigned to Yishenkang granule group, Sanjing tablet group and western medicine group, which were compared with healthy control group. The levels of the peripheral blood T lymphocyte subsets, serum immunoglobulin, complement, secretory IgA in urine and the cell factor IL-2 in CPN cases before and after treatment were detected by monoclonal antibody method, agar diffusion method, radioimmunoassay, radioimmune balancing method and compared with those in healthy control group. RESULTS: In CPN cases compared with healthy control group, the levels of serum immunoglobulin, complement, secretory IgA in urine were significantly lower while the level of cell factor IL-2 were significnatly higher (P