Journal of Postgraduate Medicine
 Open access journal indexed with Index Medicus & ISI's SCI  
Users online: 2150  
Home | Subscribe | Feedback | Login 
About Latest Articles Back-Issues Articlesmenu-bullet Search Instructions Online Submission Subscribe Etcetera Contact
 :: Next article
 :: Previous article 
 :: Table of Contents
 ::  Similar in PUBMED
 ::  Search Pubmed for
 ::  Search in Google Scholar for
 ::Related articles
 ::  [PDF Not available] *
 ::  Citation Manager
 ::  Access Statistics
 ::  Reader Comments
 ::  Email Alert *
 ::  Add to My List *
* Registration required (free) 

  IN THIS Article
 ::  Abstract
 ::  Introduction
 ::  Case report
 ::  Discussion
 ::  References
 ::  Article Figures

 Article Access Statistics
    PDF Downloaded0    
    Comments [Add]    

Recommend this journal


Year : 1989  |  Volume : 35  |  Issue : 4  |  Page : 215-6

Ureteral involvement in stage I xanthogranulomatous pyelonephritis--(a case report).

Correspondence Address:
A K Mandal

Login to access the Email id

Source of Support: None, Conflict of Interest: None

PMID: 0002641521

Rights and PermissionsRights and Permissions

 :: Abstract 

A case of xanthogranulomatous pyelonephritis (Stage-I: Nephric) with ureteral involvement is described. The patient had undergone right nephrectomy with the working diagnosis of calculus pyonephrosis and non-functioning kidney. Histopathological examination of the nephrectomy specimen revealed xanthogranulomatous pyelonephritis confined to the kidney and non-contiguous involvement of ureter. Post-operative recovery was uneventful and there had been no evidence of disease recurrence till one year's follow-up.

Keywords: Case Report, Human, Male, Middle Age, Pyelonephritis, Xanthogranulomatous, complications,Ureteral Diseases, etiology,pathology,

How to cite this article:
Mandal A K, Vaiphei K K, Bhusnurmath S R, Vaidyanathan S S. Ureteral involvement in stage I xanthogranulomatous pyelonephritis--(a case report). J Postgrad Med 1989;35:215

How to cite this URL:
Mandal A K, Vaiphei K K, Bhusnurmath S R, Vaidyanathan S S. Ureteral involvement in stage I xanthogranulomatous pyelonephritis--(a case report). J Postgrad Med [serial online] 1989 [cited 2023 Jun 5];35:215. Available from:

 :: Introduction Top

Ureteral involvement in xanthogranulomatous pyelonephritis (XGP) appears to be very rare as it has not been mentioned in recent review articles on the subject.[1],[2],[3],[5] We herein report a case of XGP localised to the kidney, yet involving the ureter by the xanthogranulomatous process.

 :: Case report Top

A 55 year old male presented with intermittent fever and pyuria of one year's duration. He developed a discharging sinus following incision and drainage of the right flank abscess, one month back. Ten years ago, he had undergone right pyelolithotomy. Physical examination revealed a moderately nourished individual, with a discharging right flank sinus, just below the scar of the previous operation and a firm, tender mass in the right renal area. Hemogram, blood urea, serum creatinine, liver function tests and skiagram of the chest were normal. Erythrocyte sedimentation rate was 32 mm (First hour, Westergren). Urinary sediment showed many pus cells. The cultures of the sinus-discharge and urine revealed growth of mixed contaminants and were negative for acid fast bacilli. X-ray of the KUB region showed multiple, irregular, radioopacities in the right renal area. Ultrasonography revealed an enlarged and hydronephrotic right kidney with multiple calculi in it. Intravenous urography showed normal left reno-ureteral unit. The right kidney was not visualised even in delayed films. Biopsy from the sinus tract showed a picture of non-specific chronic inflammation.

A right flank exploration revealed pus pockets in the kidney in direct communication with the flank sinus. A right nephrectomy and excision of the sinus tract was performed. The postoperative recovery was uneventful. Cut surface of the kidney revealed multiple pus pockets, scattered areas of hard, yellow granulomatous material, multiple phosphatic calculi and no identifiable healthy renal parenchyma. Microscopic examination confirmed the diagnosis of xanthogranulomatous pyelonephritis with foci of granulation tissue containing ieucocytes, lipid-laden mononuclear macrophages and multiple foreign body giant cells. The renal capsule and perinephric fat showed chronic inflammatory cellular infiltrates but were not involved by the xanthogranulomatous process. Sections from the ureter showed ulceration of the lining epithelium and inflammatory cell infiltrate, characteristic of xanthogranulomatous process [Figs. 1] and [Fig 2].

 :: Discussion Top

Malek et al[2] has classified XGP into three stages: (i) nephric; (ii) nephric and perinephric; and (iii) nephric, perinephric, and paranephric. In the present case, the xanthogranulomatous process was localised to the kidney (Stage I: Nephric); yet there was non-contiguous involvement of the ureter. Remigio et al[4] reported a case of xanthogranulomatous ureteritis, managed by excision of the terminal segment of the ureter and ureteroneocystostomy. In the present case, only nephrectomy was done as xanthogranulomatous involvement of the ureter was diagnosed on histopathology. The wound had healed without any sinus formation; there has been no evidence of recurrence of the disease during the one year follow-up. Recurrences of XGP were never documented contralaterally, or ipsilaterally in case of conservative procedures.[5] In conclusion, non-contiguous involvement of the ureter in XGP may occur which, however, may not necessitate excision of the ureteral stump.

 :: References Top

1.Cohen, M. S.: Granulomatous nephritis. Urol. Clin. North Amer., 13: 647-659, 1986.  Back to cited text no. 1    
2.Malek, R. S., Greene, L. F., DeWeerd, J. If. and Farrow, G. M.: Xanthogranulomatous pyelonephritis. Brit. J. Urol., 44: 296-308, 1972.  Back to cited text no. 2    
3.Oosterhof, G. O. and Delaere, K. P.: Xanthogranulomatous pyelonephritis, A review with 2 case reports. Urol. Int , 41: 180-186. 1986.  Back to cited text no. 3    
4.Remigio, P., Ramos, C. and Basirico, P.: Xanthogranulomatous ureteritis. J. Urol., 114: 621-623, 1975.  Back to cited text no. 4    
5.Rosi, P., Selli, C., Carini, M., Rosi, M. F. and Mottola, A.: Xanthogranulomatous pyelonephritis: clinical experience with 62 cases. Eur. Urol., 12: 96-100, 1986.  Back to cited text no. 5    


[Figure - 1], [Figure - 2]


Print this article  Email this article
Previous article Next article
Online since 12th February '04
2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
Published by Wolters Kluwer - Medknow