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The presenting symptoms of RCC (renal cell carcinoma) overlap closely with those of XGP (Xanthogranulomatous pyelonephritis) and can clinically as well as pathologically be confused with XGP which is an unusual inflammatory disorder. Most of the patients present with varied symptoms from the constellation of flank pain, fever, malaise, weight loss, and hematuria. We hereby report here a case of 52 year old male who presented with right flank pain, diagnosed erroneously as XGP on preoperative CT guided biopsy from the renal mass, on two occasions which eventually turned out to be clear cell variant of renal cell carcinoma. Right radical nephrectomy was done where the final histopathological diagnosis was of clear cell variant of RCC.

Hypophysitis is classified into primary and secondary. Xanthomatous hypophysitis is one of the rare types of primary hypophysitis. A 55-year-old female presented with headache, vomiting, and blurring of vision. She also had endocrine dysfunction in the form of low serum T3, T4, and low cortisol levels. MRI scan showed a sellar expansile lesion suggestive of pituitary macroadenoma. Microscopy showed pituitary tissue replaced by inflammatory infiltrate made up of foamy histiocytes arranged in sheets along with lymphoplasmacytic infiltrate. Interspersed areas of fibrosis, hyalinization, few congested and sclerosed blood vessels were seen. Compressed residual pituitary tissue was identified at the periphery. Xanthomatous hypophysitis is a rare entity which can mimic as pituitary adenoma both clinically and radiologically. Accurate diagnosis at an early stage with postsurgical steroid therapy may help to prevent permanent pituitary damage.

Xanthogranulomatous endometritis is an uncommon benign lesion characterized by the destruction of endometrium and replacement by the sheets of foamy histiocytes, lymphocytes, plasma cells, multinucleated giant cells, fibrosis, calcification, and accompanying polymorphonuclear leukocytes. It is commonly mistaken for malignancy clinicoradiologically, and therefore, histopathological examination is of utmost importance. We report the case of a 61-year-old postmenopausal female who presented with pyometra, bulky uterus, and cervical stenosis, and histopathology revealed XGE.

Xanthogranulomatous inflammation of female genital tract is uncommon and is usually seen in endometrium. Only a few cases involving the ovary have been reported. Its clinical manifestations, imaging modalities, and gross features can mimic ovarian malignancy. Thus, a preoperative diagnosis of this entity is important to avoid radical surgical treatment. We report a case of xanthogranulomatous oophoritis in a 24 years female, which was clinically and radiologically misdiagnosed as ovarian neoplasm. The approach to such a case and the differential diagnosis has also been discussed.

Xanthogranulomatous inflammation is a special type of inflammatory process with unknown etiology. Commonly involved organs are gallbladder and kidney. So far, only a negligible number of cases of xanthogranulomatous appendicitis (XA) have been reported in different literatures. Herein, we report a case of XA in a 49-year-old female patient, who presented with recurrent right iliac fossa pain. Clinically, appendicitis was diagnosed and appendectomy was performed. Histopathological examination revealed it as a case of XA. No other form of treatment was given and the patient is doing well 1 month postoperatively.

Xanthogranulomatous inflammation of gallbladder wall can extend and infiltrate adjacent organs which can be mistaken for malignancy on preoperative investigations and, intraoperatively, often leads to extensive surgical resections. Only the histopathologic examination of the specimen allows correct diagnosis. We hereby review clinicopathologic findings of six cases which underwent extensive surgeries on clinical, radiological and intraoperative suspicion of gallbladder carcinoma which turned out to be xanthogranulomatous cholecystitis (XGC). There was no evidence of malignancy on histopathologic examination. Xanthogranulomatous inflammation extended into liver, duodenum, colon and stomach in case 1; liver and colon in case 2; liver, duodenum, colon in case 3; stomach, duodenum, colon in case 4; stomach and duodenum in case 5 and duodenum and colon in case 6. Lymph nodes in all the six cases showed reactive hyperplasia. We present here the clinico-radiologic findings of these cases, techniques which may help differentiate between an XGC and a gallbladder carcinoma and also discuss the management of these cases.

Xanthogranulomatous cholecystitis (XGC) is an uncommon benign focal or diffuse destructive inflammatory disease of the gallbladder. Pre-operative and intra-operative diagnosis is difficult and it often mimics a gallbladder carcinoma (GBC). This diagnostic dilemma caused by equivocal imaging studies and intra-operative findings can at times be aggravated by a histological picture which mimics a neoplasm. Apart from occasionally presenting as an infiltrating mass lesion with adjacent organ invasion like a malignant neoplasm, XGC can also infrequently be associated with GBC. Lack of awareness that both XGC and carcinoma can co-exist as well as interpreter′s inexperience may lead to a missed diagnosis. We present a case of to illustrate this coexistence and conclude that XGC and carcinoma of the gall bladder may co-exist and present a diagnostic dilemma. We recommend increased awareness of this knowledge among radiologists, surgeons and pathologists to raise its awareness.

Xanthogranulomatous pyelonephritis is an uncommon chronic destructive granulomatous disease of the kidney. A rare case of xanthogranulomatous pyelonephritis with extrarenal extension that had coexistence of renal actinomycosis is described in this article.

Xanthogranulomatous pyelonephritis (XGP) is an uncommon entity affecting predominantly females between the ages 45-55 years. The disease is usually associated with urinary tract infection and the patient presents with flank pain, dysuria and fever. It has to be differentiated from various benign and malignant conditions including tuberculosis (TB) and renal cell carcinoma. Surgery is the definitive treatment of choice. Hereby, a case of 45-year-old, hypertensive female, who presented with uncommon condition is being reported.