Malakoplakia and xanthogranulomatous pyelonephritis treated with nephrectomy: A case report

Medicine (Baltimore). 2021 Sep 10;100(36):e27137. doi: 10.1097/MD.0000000000027137.

Abstract

Rationale: Malakoplakia and xanthogranulomatous pyelonephritis are chronic inflammatory conditions of the kidney characterized by the infiltration of inflammatory cells.

Patient concerns: An 82-year-old female patient had a history of hypertension, type 2 diabetes mellitus, dyslipidemia, and end-stage renal disease under hemodialysis. She was admitted repeatedly 4 times within 4 months due to urosepsis.

Diagnosis: The enlarged right kidney with a low-density lesion at the right middle calyx, and a well-enhanced ureter were noted on the computed tomography scan. Therefore, xanthogranulomatous inflammation was suspected. Semi-rigid ureteroscopy with biopsy was performed, and xanthogranulomatous inflammation of the ureter was confirmed on the pathology report.

Interventions: After right open radical nephrectomy was performed, the final pathology report revealed malakoplakia with xanthogranulomatous pyelonephritis.

Outcomes: After the surgery, she has no longer suffered from urosepsis for 8 months, and there were no adverse event or recurrence noted.

Lessons: With this case report, we aim to emphasize that these 2 diseases are not mutually exclusive, but they may exist simultaneously in the same patient.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Diagnosis, Differential
  • Female
  • Humans
  • Kidney Failure, Chronic*
  • Malacoplakia / diagnosis*
  • Malacoplakia / diagnostic imaging
  • Malacoplakia / surgery
  • Nephrectomy
  • Pyelonephritis, Xanthogranulomatous / diagnosis*
  • Pyelonephritis, Xanthogranulomatous / diagnostic imaging
  • Pyelonephritis, Xanthogranulomatous / surgery
  • Tomography, X-Ray Computed