XANTHOGRANULOMATOUS GLOMERULONEPHRITIS MIMICKING MALIGNANCY IN A TWO-YEAR-OLD CHILD: A RARE CASE REPORT

Öz

Xanthogranulomatous glomerulonephritis/pyelonephritis is an uncommon inflammatory condition in children and can present as a renal mass, closely mimicking malignant tumors on imaging. We report a two-year-old girl who presented with abdominal distension and severe anemia. Ultrasound, computed tomography (CT), and magnetic resonance imaging demonstrated an enlarged, non-functioning left kidney with necrotic-appearing areas and diffusion restriction, raising suspicion for malignancy. Because imaging could not exclude a tumor and the mass persisted despite antibiotics, nephrectomy with lymph node sampling was performed. Histopathology confirmed xanthogranulomatous inflammation and excluded malignancy. This case underscores the diagnostic challenge and the importance of timely surgical and histopathological confirmation when pediatric renal masses mimic cancer.

Anahtar Kelimeler

• Xanthogranulomatous pyelonephritis (XGPN)
• Hodgkin lymphoma
• Autoimmune hemolytic anemia

Kaynakça

1. Sangüesa Nebot, C., Picó Aliaga, S., Serrano Durbá, A. et al. Xantogranulomatous pyeloneprhritis in children. Insights Imaging. 2018; 9, 643–651. https://doi.org/10.1007/s 13244-018-0631-4 google scholar
2. Stoica I, O’Kelly F, McDermott MB, Quinn FMJ. Xanthogranulomatous pyelonephritis in a pediatric cohort (1963-2016): Outcomes from a large single-center series. J Pediatr Urol. 2018;14(2):169.e1-169.e7. doi:10.1016/j.jpurol.2017.10.017. google scholar
3. Malek RS, Elder JS. Xanthogranulomatous pyelonephritis: a critical analysis of 26 cases and of the literature. J Urol. 1978;119(5):589-593. doi:10.1016/s0022-5347(17)57559-x. google scholar
4. Okuno SH, Hoyer JD, Ristow K, Witzig TE. Primary renal nonHodgkin’s lymphoma. An unusual extranodal site. Cancer. 1995;75(9):2258-2261. doi:10.1002/1097-0142(19950501)75:93.0.co;2-s google scholar
5. Sheth S, Ali S, Fishman E. Imaging of renal lymphoma: patterns of disease with pathologic correlation. Radiographics. 2006;26(4):1151-1168. doi:10.1148/rg.264055125. google scholar
6. Sengottaiyan J, Jayaraman D, Kumar S, Shanmugam SG, Scott JX. Autoimmune hemolytic anemia as paraneoplastic phenotype in Hodgkins lymphoma in children - A rare occurrence. EJIFCC. 2024;35(1):52-54. Published 2024 Apr 11. google scholar
7. Nguyen T, Gupta A, Bhatt S. Multimodality imaging of renal lymphoma and its mimics. Insights Imaging. 2022;13(1):131. Published 2022 Aug 13. doi:10.1186/ s13244-022-01260-1 google scholar
8. Deng QF, Chu H, Peng B, Liu X, Cao YS. Case report: Localized xanthogranulomatous pyelonephritis in children: A case report and literature review. Front Pediatr. 2022;10:952989. Published 2022 Jul 18. doi:10.3389/fped.2022.952989. google scholar

9. Arrighi N, Antonelli A, Zani D, et al. Renal mass with caval thrombus as atypical presentation of xantogranulomatous pyelonephritis. A case report and literature review. Urologia. 2013;80:44-47. doi:10.5301/ru.2013.11050. google scholar
10. Al-Ghazo MA, Ghalayini IF, Matalka II, Al-Kaisi NS, Khader YS. Xanthogranulomatous pyelonephritis: Analysis of 18 cases. Asian J Surg. 2006;29(4):257-261. doi:10.1016/ S1015-9584(09)60099-3. google scholar
11. Kim SW, Yoon BI, Ha US, Sohn DW, Cho YH. Xanthogranulomatous pyelonephritis: clinical experience with 21 cases. J Infect Chemother. 2013;19(6):1221-1224. doi:10.1007/ s10156-013-0611-z. google scholar
12. Xie L, Tapiero S, Flores AR, et al. Long-term antibiotic treatment before laparoscopic nephrectomy for Xanthogranulomatous pyelonephritis improves postoperative outcomes: results from a multicenter study. J Urol. 2021;205(3):820-825. doi:10.1097/ JU.0000000000001429. google scholar