Val-Bernal J F, Castro F
Anatomical Pathology Department, Marqués de Valdecilla University Hospital, Medical Faculty, University of Cantabria, Santander, Spain.
Urol Int. 1996;57(4):240-5. doi: 10.1159/000282924.
Xanthogranulomatous pyelonephritis (XPN) is an uncommon, but not rare, type of bacterial infection of the kidneys. Malignancies originating within the renal pelvis are uncommon. We report a case of XPN associated with a transitional cell carcinoma (TCC) of the renal pelvis in a 70-year-old woman. The pathogenesis of carcinoma of the renal pelvis in the presence of XPN is related to obstruction, chronic inflammation, and mechanical irritation caused by calculi. In the case reported here, obstruction was due to a concomitant TCC of the ureter without the presence of calculi. A review of the twelve published case reports of XPN with TCC of the renal pelvis, including the present case, showed that the frequency of this association is 3.3%, the average age at presentation is 65.3 (range 49-78) years, and that the male:female ratio is 2:1. Moreover, 25% of the patients had TCC of the ureter and 8.3% TCC of the bladder. The combination of XPN, TCC of the renal pelvis, and lithiasis occurred in 33.3% of the cases. XPN must be treated by nephrectomy not only because it is a destructive inflammatory process leading to complete loss of renal function, but also because the kidney may be harboring a malignant tumor.
黄色肉芽肿性肾盂肾炎（XPN）是一种不常见但也不算罕见的肾脏细菌感染类型。起源于肾盂的恶性肿瘤并不常见。我们报告一例70岁女性患者，其黄色肉芽肿性肾盂肾炎与肾盂移行细胞癌（TCC）相关。在存在黄色肉芽肿性肾盂肾炎的情况下，肾盂癌的发病机制与结石引起的梗阻、慢性炎症和机械刺激有关。在本文报道的病例中，梗阻是由输尿管同时存在的移行细胞癌引起，而无结石存在。对包括本病例在内的12篇已发表的黄色肉芽肿性肾盂肾炎合并肾盂移行细胞癌病例报告的回顾显示，这种关联的发生率为3.3%，发病时的平均年龄为65.3岁（范围49 - 78岁），男女比例为2:1。此外，25%的患者有输尿管移行细胞癌，8.3%有膀胱移行细胞癌。黄色肉芽肿性肾盂肾炎、肾盂移行细胞癌和结石同时存在的情况在33.3%的病例中出现。黄色肉芽肿性肾盂肾炎必须通过肾切除术进行治疗，这不仅是因为它是一种导致肾功能完全丧失的破坏性炎症过程，还因为肾脏可能隐藏着恶性肿瘤。
