ABSTRACT
Xanthogranulomatous pyelonephritis (XGP) is a chronic renal inflammatory lesion that is rarely diagnosed in children. We present a case of a 16-year-old boy presenting with gross hematuria and a lack of laboratory and radiographic findings for XGP who was suspected of having renal cell carcinoma on urine cytology. Left radical nephrectomy was performed, confirming the diagnosis of XGP. The cytologic mimicking of renal cell carcinoma by XGP emphasizes that physicians should consider XGP in the differential diagnosis. The inability of urine cytopathology to distinguish XGP from renal cell carcinoma suggests a need for the development of new pathology techniques.
Subject(s)
Carcinoma, Renal Cell/diagnosis , Kidney Neoplasms/diagnosis , Pyelonephritis, Xanthogranulomatous/diagnosis , Adolescent , Carcinoma, Renal Cell/surgery , Carcinoma, Renal Cell/urine , Diagnosis, Differential , Humans , Kidney Neoplasms/surgery , Kidney Neoplasms/urine , Male , Nephrectomy , Pyelonephritis, Xanthogranulomatous/surgery , Pyelonephritis, Xanthogranulomatous/urineABSTRACT
OBJECTIVES: Three new cases of xanthogranulomatous pyelonephritis are described in children. METHODS: Laboratory examinations including white and red blood cell counts, erythrocyte sedimentation rate, renal function, urinalysis and cystography were performed. RESULTS: All of the patients had a palpable abdominal mass. Urine culture was positive (Proteus mirabilis) in only 1 patient. Associated urological abnormalities were found in 2 cases. Urographically a functionless kidney was encountered in 2 children and a renal mass in the other. None could be diagnosed preoperatively. CONCLUSIONS: Although nephrectomy has been said to be the treatment of choice, conservative treatment can be successful as shown by 1 of our patients.
