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Complicated pyelonephritis associated with chronic renal stone disease

PURPOSE: This article reviews imaging manifestations of complicated pyelonephritis associated with chronic renal stones disease, in particular xanthogranulomatous pyelonephritis (XGP) and emphysematous pyelonephritis (EPN), as potential mimics of other renal diseases and malignances and provides hel...

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Autores principales: Ciccarese, Federica, Brandi, Nicolò, Corcioni, Beniamino, Golfieri, Rita, Gaudiano, Caterina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Milan 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8007507/
https://www.ncbi.nlm.nih.gov/pubmed/33245481
http://dx.doi.org/10.1007/s11547-020-01315-7
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author Ciccarese, Federica
Brandi, Nicolò
Corcioni, Beniamino
Golfieri, Rita
Gaudiano, Caterina
author_facet Ciccarese, Federica
Brandi, Nicolò
Corcioni, Beniamino
Golfieri, Rita
Gaudiano, Caterina
author_sort Ciccarese, Federica
collection PubMed
description PURPOSE: This article reviews imaging manifestations of complicated pyelonephritis associated with chronic renal stones disease, in particular xanthogranulomatous pyelonephritis (XGP) and emphysematous pyelonephritis (EPN), as potential mimics of other renal diseases and malignances and provides helpful tips and differentiating features that may alert the radiologist to suspect a diagnosis of infection. MATERIALS AND METHODS: A retrospective review of the records from 6 adult patients (5 females and 1 male, mean age 72,3 years) with diagnosis of XGP associated with chronic nephrolithiasis and 7 adult patients (6 females and 1 male, mean age 59,3 years) with diagnosis of EPN associated with chronic nephrolithiasis from January 2010 to January 2020 was carried out. Computed tomography urography (CTU) with at least an unenhanced scan, and the parenchymal and excretory phases after contrast medium administration performed at our Teaching Hospital were included. When available images related to conventional radiography, ultrasound (US) and magnetic resonance imaging of the same patients, the comparison with CTU images was carried out. CONCLUSION: A possible diagnosis of XGP or EPN must always be taken into account when a pyelonephritis is associated with untreated kidney stones, especially whenever clinical presentation is atypical, current therapy is not effective and imaging shows features of dubious interpretation. Due to their rarity and atypical presentation, a multidisciplinary approach is required and an expert radiologist represents a key figure in the multidisciplinary team as he can help to differentiate between benign and malignant lesions and thus avoid unnecessary radical surgical procedures.
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spelling pubmed-80075072021-04-16 Complicated pyelonephritis associated with chronic renal stone disease Ciccarese, Federica Brandi, Nicolò Corcioni, Beniamino Golfieri, Rita Gaudiano, Caterina Radiol Med Abdominal Radiology PURPOSE: This article reviews imaging manifestations of complicated pyelonephritis associated with chronic renal stones disease, in particular xanthogranulomatous pyelonephritis (XGP) and emphysematous pyelonephritis (EPN), as potential mimics of other renal diseases and malignances and provides helpful tips and differentiating features that may alert the radiologist to suspect a diagnosis of infection. MATERIALS AND METHODS: A retrospective review of the records from 6 adult patients (5 females and 1 male, mean age 72,3 years) with diagnosis of XGP associated with chronic nephrolithiasis and 7 adult patients (6 females and 1 male, mean age 59,3 years) with diagnosis of EPN associated with chronic nephrolithiasis from January 2010 to January 2020 was carried out. Computed tomography urography (CTU) with at least an unenhanced scan, and the parenchymal and excretory phases after contrast medium administration performed at our Teaching Hospital were included. When available images related to conventional radiography, ultrasound (US) and magnetic resonance imaging of the same patients, the comparison with CTU images was carried out. CONCLUSION: A possible diagnosis of XGP or EPN must always be taken into account when a pyelonephritis is associated with untreated kidney stones, especially whenever clinical presentation is atypical, current therapy is not effective and imaging shows features of dubious interpretation. Due to their rarity and atypical presentation, a multidisciplinary approach is required and an expert radiologist represents a key figure in the multidisciplinary team as he can help to differentiate between benign and malignant lesions and thus avoid unnecessary radical surgical procedures. Springer Milan 2020-11-27 2021 /pmc/articles/PMC8007507/ /pubmed/33245481 http://dx.doi.org/10.1007/s11547-020-01315-7 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Abdominal Radiology
Ciccarese, Federica
Brandi, Nicolò
Corcioni, Beniamino
Golfieri, Rita
Gaudiano, Caterina
Complicated pyelonephritis associated with chronic renal stone disease
title Complicated pyelonephritis associated with chronic renal stone disease
title_full Complicated pyelonephritis associated with chronic renal stone disease
title_fullStr Complicated pyelonephritis associated with chronic renal stone disease
title_full_unstemmed Complicated pyelonephritis associated with chronic renal stone disease
title_short Complicated pyelonephritis associated with chronic renal stone disease
title_sort complicated pyelonephritis associated with chronic renal stone disease
topic Abdominal Radiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8007507/
https://www.ncbi.nlm.nih.gov/pubmed/33245481
http://dx.doi.org/10.1007/s11547-020-01315-7
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