Moss Basil Francis, Potter Laura, Cliff Andrew, Kumar Manal
Department of Urology, Wirral University Teaching Hospital NHS Foundation Trust, Wirral, UK
Department of Pathology, Wirral University Teaching Hospital NHS Foundation Trust, Wirral, UK.
BMJ Case Rep. 2019 Oct 5;12(10):e232097. doi: 10.1136/bcr-2019-232097.
Xanthogranulomatous pyelonephritis is associated with obstruction, stones and infection. CT is the mainstay of diagnosis, but appearances can mimic other conditions, including renal cell carcinoma. Nephrectomy is commonly recommended, but conservative treatment with antibiotics has been described after tissue diagnosis. We present a case of xanthogranulomatous pyelonephritis with concomitant renal cell carcinoma, which was an association that was suggested in 1988 and supported by subsequently reported cases. Conservative management of biopsy or cytology proven xanthogranulomatous pyelonephritis is unsafe, as an area of synchronous malignant tumour may be missed: we recommend it only in patients unfit for nephrectomy.
黄色肉芽肿性肾盂肾炎与梗阻、结石及感染相关。CT是主要的诊断手段，但表现可能与其他疾病相似，包括肾细胞癌。通常建议行肾切除术，但在组织诊断后也有采用抗生素保守治疗的报道。我们报告1例黄色肉芽肿性肾盂肾炎合并肾细胞癌的病例，这种关联在1988年被提出，并得到随后报道病例的支持。经活检或细胞学检查证实的黄色肉芽肿性肾盂肾炎采用保守治疗不安全，因为可能漏诊同步存在的恶性肿瘤区域：我们仅建议在不适合行肾切除术的患者中采用。
