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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. [ABSTRACT FROM AUTHOR]

There are several benign prostatic pathologies that can clinically mimic a prostate adenocarcinoma. Xanthogranulomatous prostatitis is a benign inflammatory condition of the prostate and a rare entity. A 47-year old male, with 3 years of lower urinary tract symptoms, with a palpable hypogastric tumor, digital rectal examination: solid prostate, of approximately 60 g. Initial PSA was 0.90 ng/mL. He underwent surgical excision of the lower abdominal nodule and prostatectomy. Histopathology showed xanthogranulomatous prostatitis, without malignancy. Xanthogranulomatous prostatitis is an extremely rare entity that can simulate prostate adenocarcinoma, therefore having a correct histopathological diagnosis is essential.

Xanthomas or xanthelasmas are rare benign tumours characterised by localised lipid deposits within an organ system which can be an important sign of systemic disease. These tumours have a predilection for skin and subcutaneous tissue, the most common visceral site being the Gastrointestinal (GI) tract. Xanthoma in female genital tract is a rare finding and should be considered as a differential diagnosis for abdominal pain in a reproductive age group. This is an unusual case of xanthoma of fallopian tube in a 27-year-old female presenting with lower abdominal pain. Ultrasonography (USG) revealed right hydrosalpinx. The histopathological examination of fallopian tube showed sheets of foamy macrophages with peripherally placed nucleus and abundant vacuolated cytoplasm in the lamina propria which was positive for Cluster of Differentiation 68 (CD68) and negative for Cytokeratins (CK). A final diagnosis of xanthoma of right fallopian tube was made. Fallopian tube xanthomas must be distinguished from xanthogranulomatous salpingitis, which is associated with an inflammatory cell infiltrate, often including giant cells and plasma cells. [ABSTRACT FROM AUTHOR]

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.

Erdheim-Chester disease (ECD) is a rare xanthogranulomatous disease in which orbital involvement can have devastating outcomes. Through a case report and review of the ophthalmic literature, we explore orbital findings, disease progression, and treatment options. Cases of orbital involvement in Erdheim-Chester disease were identified in the ophthalmic literature with a PubMed query and review of cited references. A total of 14 publications reporting 19 separate cases that included ophthalmic examination data were identified. Patient ages ranged from 26–77 years with a mean age of 50 years. Seventy-four percent (14/19) were men. Vision progression to no light perception was found in 32% (6/19) of the patients. Reviewed cases reported a variety of medical and surgical treatment approaches, however, only 53% reported cases (10/19) demonstrated disease improvement or stabilization. Erdheim–Chester disease with orbital involvement is a devastating disease with a poor prognosis. Awareness of this entity by the ophthalmologist is important as orbital signs and symptoms may manifest early, and orbital biopsy is often crucial to the definitive diagnosis. [ABSTRACT FROM PUBLISHER]

Xanthogranulomatous inflammation (XGI) is characterized histologically by the deposition of foamy macrophages and infiltration of inflammatory cells. While XGI is extremely rare, it has been reported in the gallbladder, kidney, stomach, and lymph nodes. A 61-year-old woman presented with epigastric pain for 2 weeks. Abdominal computed tomography and magnetic resonance imaging showed a pancreatic head mass with distal common bile duct wall thickening. Endoscopic ultrasonography followed by fine needle aspiration was performed, and subsequent pathology report revealed a benign disease. Because uncontrolled abdominal pain persisted and possibility of malignancy could not be excluded, Whipple’s operation was eventually performed, and pathology report showed xanthogranulomatous pancreatitis (XGP). Herein, we report a case of symptomatic XGP mimicking of pancreas cancer. Although XGP is extremely rare, it should be considered as a differential diagnosis of neoplastic lesions of the pancreas. [ABSTRACT FROM AUTHOR]

Acute appendicitis (AA) is the most common acute surgical condition of the abdomen. Most resected specimens have been reported to have marked cellular infiltration, predominantly by neutrophils. By contrast, the occurrence of a xanthogranulomatous (XG) lesion is extremely rare. To date, only a few cases have been reported in the literature. Moreover, its clinical implications remain to be evaluated. Here, we report the case of a 16-year-old boy who presented with a typical history of AA for 2 days. He had no sepsis or local peritonitis. He experienced a similar attack 1 year ago, which was successfully and conservatively managed at our center. An interval appendectomy was performed 3 months later as requested by his parents. Furthermore, he responded well to the antibiotics administered. Intraoperatively, the appendix appeared fibrotic with a small lump at its base. Some adhesion was noted between the appendix and the omentum. His postoperative recovery was uneventful. Moreover, the histopathological examination of the appendix revealed features typical of an XG lesion. In addition, we conducted a literature search to establish the clinical implications of XG lesions. [ABSTRACT FROM AUTHOR]

Xanthogranulomatous inflammation is a well-described entity with involvement of various body organs. But the involvement of vermiform appendix in the disease process is quite rare with only few cases are reported in literature. This case report describes a 50-year-old man, who was diagnosed as a case of acute appendicitis with appendicular lump on the basis of clinical history, physical examination, and hematological and radiological investigations. Patient underwent surgical interventions twice. But, he succumbed to the disease. We are reporting this case in view of rarity of the disease and the fulminant course, which has not been described in any other reports.

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.

Colloid cysts are the most common benign neoplasms of the anterior third ventricle, mostly located at the level of the foramen of Monro and can often manifest as sudden onset headache or loss of consciousness. These cysts often have a well-defined cyst wall, mucinous or watery intracystic fluid and have a fairly good plane with the surrounding parenchyma. Occasionally, intracystic haemorrhage can lead to xanthogranulomatous inflammatory changes within the cyst resulting in focal thickening of the cyst wall and adhesion to the surrounding structures. Here we describe a case of xanthogranulomatous colloid cyst which is a very rare variant of colloid cyst. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Xanthogranulomatous cholecystitis (XGC) is an unusual form of chronic cholecystitis characterised by marked thickening of the gallbladder wall and accumulation of lipid laden macrophages. It is frequently misdiagnosed preoperatively with gallbladder carcinoma. The aim of this study was to assess the preoperative clinical and radiological characteristics, operative findings and histological features of patients with XGC based on the experience of a single institution. In addition a literature search was performed to identify previously reported cases. PATIENTS AND METHODS: This retrospective study was conducted from January 2009 to December 2014. 1,989 consecutive patients who underwent elective cholecystectomy at the Surgical Unit-I, Liaquat University Hospital, Jamshoro, Pakistan were included in this study. Seventeen patients were identified to have XGC on histopathology. RESULTS: Seventeen (0.8%) cases of XGC were identified in 1,989 cholecystectomy specimens performed. The female to male ratio was 7.5:1. The average age in our series was 51.6 (range from 18 to 77 years). Two (11.7%) cases, suspected of malignancy during preoperative work-up, were reported as XGC on histopathology. CONCLUSION: Preoperative differentiation between XGC and carcinoma of the gallbladder remains challenging due to similarities in clinical presentation, radiological and operative findings. In view of this there should be a low threshold for conversion from a laparoscopic to an open procedure. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to evaluate the incidence of xantogranulomatous pyelonephritis and characterize the clinical features of patients who underwent surgical intervention to treat renal masses. Methods: The medical records of 420 patients who underwent radical nephrectomy or nephron sparing surgery due to a renal mass between 2005 and 2011 were retrospectively analyzed. The clinical and histopahological features of the patients who were diagnosed with xantogranulomatous pyelonephritis based on pathology results were retrieved and retrospectively evaluated. Results: Xantogranulomatous pyelonephritis was detected in 36 patients out of 420 who underwent surgery because of renal mass. The incidence of xantogranulomatous pyelonephritis was determined to be 8.5% in histopathological examination. The mean age of patients with xantogranulomatous pyelonephritis was 38 years. The ratio of female to male patients was 2:1. Diabetes mellitus was detected in 18 patients. In 28 (78%) patients there was a history of nephrolithiasis or surgery, while there was no relevant medical history in eight (22%) patients. Conclusion: The incidence of xantogranulomatous pyelonephritis was 8.5% in the present case series. Patients in which xantogranulomatous pyelonephritis is suspected based on clinical history and radiographic imaging should be treated with antibiotics and supportive care. In cases of delayed diagnosis, surgical treatment approaches should take into account the clinical state of the patient. [ABSTRACT FROM AUTHOR]

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.

This article addresses questions posed by a renal mass in early infancy. Are changes required in the standard approach to a renal mass in this age group? Are diagnostic possibilities transformed enough to warrant a change of approach in a setting like this? What are the 'benign' lesions that require consideration? What is the physician's liability in performing a nephrectomy in a patient with a problem like this? A review of the literature suggests that the vast majority of renal space occupying lesions in children of this age are still Wilms' tumor. Unless diagnostic refinements reach a higher level, the present protocols should be persisted with. [ABSTRACT FROM AUTHOR]

Xanthogranulomatous pyelonephritis is an unusual type of the kidney infection which is characterized by infiltration of mononuclear inflammatory cells and lipid laden macrophages ( foam cells). It is manifested by a firm, lobulated and yellowish kidney mass which is difficult to differentiate from renal cell carcinoma grossly. Six out of 1000 cases of cryonic pyelonephritis which are treated surgically , are turned out to be diagnosed as a xanthogranulomatous pyelonephritis. The number of diagnosed cases are increasing in recent years. This may be due to improvement in radiological diagnostic methods and characteristic clinical manifestation. In the study, we report a case of xanthogranulomatous pyelonephritis in a 5 year old boy with a kidney mass, recurrent urinary tract infection and nonfunctional kidney which is diagnosed clinically and confirmed histopathologically.

Purpose: Xanthogranulomatous pyelonephritis (XGP) is rare among children. In most cases, XGP is diffusely or focally enlarged, mimicking the neoplastic process. The aim of this study was to examine clinical characteristics and outcomes of Korean children with XGP. Materials and Methods: Fourteen children (9 boys, 5 girls) with XGP were reviewed retrospectively. The cohort included 2 children managed at our institution and 12 children reported in the Korean literature. The patients' records were reviewed with respect to age at diagnosis, clinical presentation, management method, and other characteristic features. Results: The mean age was 79.4±66.5 months (range 1-168 months). Common clinical presentations included fever (85.7%), abdominal pain (57.1%), and palpable mass (28.6%). Laboratory abnormalities included leukocytosis (57.1%), anemia (57.1%), and pyuria (57.1%). The types of XGP that were diagnosed based on preoperative radiologic studies included the focal form in 9 children and the diffuse form in 5. Thirteen children underwent nephrectomy, and 1 child received conservative medical therapy. Conclusion: The possibility of XGP should be considered if a child is diagnosed with a renal mass, especially if it is a small renal mass associated with fever, leukocytosis, or stone. Nephrectomy is the treatment of choice for the diffuse form, whereas partial nephrectomy or conservative medical therapy may be indicated to manage focal XGP. [ABSTRACT FROM AUTHOR]

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Xanthogranulomatous pancreatitis (XGP) is a rare inflammatory disease of the pancreas. A correct diagnosis is usually made only after pathological examination. A 76-year-old man was referred to our hospital for investigation of erythroderma, muscle weakness, and weight loss. We suspected dermatomyositis as a paraneoplastic phenomenon and investigated accordingly. Computed tomography showed a cystic lesion encapsulated by a thick wall in the pancreatic body. On magnetic resonance imaging, the lesion had low intensity on the T1-weighted images and heterogeneously high intensity on the T2-weighted images. F-Fluorodeoxyglucose positron emission tomography showed abnormal uptake with a maximum standardized uptake value of 9.1. Based on these findings, we made a preoperative diagnosis of intraductal papillary-mucinous carcinoma and performed a distal pancreatectomy. Macroscopically, the cyst was surrounded by a yellow-tan mass with an unclear border, and was filled with hemorrhagic and necrotic tissue. Microscopically, the mass contained an aggregation of many foamy histiocytes, lymphocytes, and plasma cells. These microscopic findings were consistent with xanthogranulomatous inflammation, and the lesion was diagnosed as XGP. Although it is a rare benign pancreatic lesion, XGP should nevertheless be considered in the differential diagnosis of cystic lesions of the pancreas. [ABSTRACT FROM AUTHOR]

Xanthogranulomatous pyelonephritis (XGP) is a chronic suppurative infectious process that only rarely affects pediatric patients, and most commonly occurs in the setting of a large obstructing calculus. Histologically, XGP is characterized by the presence of chronic inflammation and lipid-laden macrophages. This case report illustrates the radiological, surgical, and pathologic findings in a young patient who presented to our institution for treatment of this uncommon condition. Although rare, xanthogranulomatous pyelonephritis is a clinically important entity that can affect pediatric patients. This condition should be considered in the differential diagnosis for an atypical-appearing renal mass. [ABSTRACT FROM AUTHOR]

Background. Xanthogranulomatous cholecystitis (XGC) is a rare, benign, chronic inflammatory disease of the gallbladder. Its importance lies in the fact that imaging studies and intraoperative appearance that may be confused with tumour of the gallbladder. This study aimed to evaluate pre-and intraoperative findings of XGC and to remind it in difficult cholecystectomy patients. Patients and methods. The clinical data of 24 patients with XGC over a period of 7 years were analyzed retrospectively (mean age, 53 years (32-68) M/F ratio 1:1.4). Results. The clinical symptoms were abdominal pain, nausea and jaundice in 79%, 62% and 12% of the patients. Preoperative ultrasonography for 24 patients revealed gallstone (95.8%) and bile sludge (8%). Pericholecystic fluid, polyp and tumour of the gallbladder was present in 20%, 4% and 4% of the patients. The gallbladder was thickened (>3mm) in 10 patients. On computed tomography, all patients showed abnormal findings. The intraoperative findings were as follows: gallstones (100%), chronic cholecystitis (54%), hydropic gallbladder, emphysematous gallbladder, adhesions of the gallbladder to adjacent organs and tumoural mass of gallbladder. Conclusions. XGC is difficult to diagnose pre-or intraoperatively and remains a challenge in medical practice. The definitive diagnosis depends on the histopathologic examination. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 57-year-old woman diagnosed with xanthogranulomatous inflammation. The patient presented has a cecal mass that caused recurrent lower gastrointestinal bleeding and anemia. According to the authors, the case is the first report of lesion involving the cecum with typical macroscopic as well as microscopic features but with atypical clinical findings.

Summary: Background: Xanthogranulomatous pyelonephritis is a chronic renal inflammatory condition associated with significant renal and peri-renal inflammation. Consequently, operative treatment of this condition has traditionally been by open nephrectomy rather than the laparoscopic approach. We report our experience with the diagnosis and management of XGP in our department, which has subsequently been histologically confirmed. Patients and methods: We reviewed records of all patients with a histological diagnosis of XGP between 1984 and 2007. 20 patients with a diagnosis were included. Patient demographics, preoperative presentation, diagnostic imaging, operative details, post-operative recovery and complications were included in our data. Results: 13 patients underwent open nephrectomy and 7 patients underwent a laparoscopic procedure, of which 1 was subsequently converted to an open procedure. Blood loss, analgesic requirement, time to first meal and length of stay (LOS) in hospital were all lower in the laparoscopic group compared with the open group (362.5ml vs. 723.6ml, p =0.049; 65.3mg vs. 146.9mg, p =0.153; 2.8 days vs. 4.2 days, p =0.184; 4.4 days vs. 9.8 days, p =0.084). Operative times were similar in both groups (157.5min vs. 154.2min, p =0.888). There were 5 complications in the laparoscopic group and 13 in the open group. Conclusion: The laparoscopic approach, although technically challenging, provides superior intra-operative and post-operative recovery results compared to the open approach with comparable operative times and incidences of complications. In specialised centres and in experienced hands, laparoscopic nephrectomy should be considered as the first choice procedure in those patients with a suspected diagnosis of XGP. [Copyright &y& Elsevier]

Background: Xanthogranulomatous pyelonephritis (XGP) is a rare form of chronic infection of the kidneys and the retroperitoneal spaces. It happens in approximately 0.6 % of the cases of pyelonephritis, this documented by an anatomopathological study. The disease was described for the first time by Slagenhaufer in 1916. Objective: To analyze the clinical aspects of this rare variant of pyelonephritis, to know more about it. Methods: Seven patients were studied with the anatomopathological diagnosis of XGP from January of 2000 to October of 2005. They were studied in the "Dr. Jose Eleuterio Gonzalez" University Hospital. Results: Six of the seven patients were female and only one male, with ages between 29 to 50 years. Three patients were found to be diabetic, one had a history of urolithiasis, one of obesity and 2 did not have any relevant past medical history. The triggering factors were lithiasis in 5 patients, carcinoma of the ureter in another patient and in the other patient there was no apparent cause. Conclusion: XGP is a benign renal affection and unfortunately the clinical presentation is not specific and does not have a certain and defined time to establish itself. [ABSTRACT FROM AUTHOR]

Hypophysitis is an inflammatory disease of the pituitary gland that clinically and radiologically mimics pituitary tumors. We report here a case of xanthogranulomatous hypophysitis mimicking a pituitary neoplasm. A 65-yr-old woman presented with weight loss, fatigue, and visual disturbance. Computed tomography demonstrated a round cystic low-density mass with calcification in the sella. A T1-weighted magnetic resonance imaging scan showed most of the mass as hyperintense. The capsule of the mass was strongly enhanced by gadolinium. Endocrinologic examination revealed hypocorticism and hypothyroidism. Diabetes insipidus (DI) developed after the administration of hydrocortisone. The patient also had hallucination and delusions of persecution. Transsphenoidal surgery was performed. Histologic examination of the removed tissue showed central necrosis surrounded by accumulation of foamy cells and epithelioid cells. Several multinucleated giant cells were also seen. The foamy cells and epithelioid cells were immunopositive for Kp-1, a marker of macrophages. The patient made an uneventful postoperative recovery. Although DI and hypofunction of adenohypophysis persisted, the visual disturbance and psychiatric disorder were resolved. We have described an unusual inflammatory lesion of the pituitary in the sellar region that was mimicking neoplasm. A high level of clinical suspicion of inflammatory disorders is necessary for correct diagnosis and optimal management. [ABSTRACT FROM AUTHOR]

Endoscopic ultrasonography (EUS) has greater spatial resolution than other diagnostic imaging modalities. In addition, if gallbladder lesions are found and gallbladder cancer is suspected, EUS is an indispensable modality, enabling detailed tests for invasion depth evaluation using the Doppler mode and ultrasound agents. Furthermore, for gallbladder lesions, EUS fine-needle aspiration (EUS-FNA) can be used to differentiate benign and malignant forms of conditions, such as xanthogranulomatous cholecystitis, and collect evidence before chemotherapy. EUS-FNA is also useful for highly precise and specific diagnoses. However, the prevention of bile leakage, an accidental symptom, is highly important. Advancements in next-generation sequencing (NGS) technologies facilitate the application of multiple parallel sequencing to EUS-FNA samples. Several biomarkers are expected to stratify treatment for gallbladder cancer; however, NGS can unveil potential predictive genomic biomarkers for the treatment response. It is believed that NGS may be feasible with samples obtained using EUS-FNA, further increasing the demand for EUS-FNA. [ABSTRACT FROM AUTHOR]