Malakoplakia and xanthogranulomatous pyelonephritis treated with nephrectomy: A case report
Yueh Pan1,2,3, Ying Chui Hong4, Hung-Jen Shih1
1Division of Urology, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan.
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.
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