Kazemi R, Paymannejad S. A case of xanthogranulomatous pyelonephritis leading to nephrobronchial fistula and lung abscess: does it always manifest with respiratory symptoms?
AMERICAN JOURNAL OF CLINICAL AND EXPERIMENTAL UROLOGY 2022;
10:358-365. [PMID:
36313207 PMCID:
PMC9605941]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
Xanthogranulomatous pyelonephritis (XGP) is a serious manifestation of chronic kidney inflammation that can expand to adjacent structures. Here we report a case of XGP extending beyond the diaphragm through a nephrobronchial fistula to form a lung abscess in a 70-year-old man. The patient presented to the emergency department with severe right flank colic pain, nausea, vomiting and nonspecific constitutional symptoms for the past 4 months. Although the patient did not complain of any respiratory symptoms, initial evaluations revealed severe right-sided hydroureteronephrosis with debris, as well as an area of infiltration in the right lung lower lobe (RLL). Given the patient's condition, a thorough work-up was expedited to investigate the potential association between the symptoms. Ultimately, a diagnosis of XGP with expansion to the RLL through the right hemidiaphragm was developed. A right radical nephrectomy, right lower lobectomy and right hemidiaphragm resection were carried out. XGP was confirmed on the basis of the pathological evaluation of the resected specimens.
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