{"id":2258,"date":"2022-03-07T17:57:14","date_gmt":"2022-03-07T17:57:14","guid":{"rendered":"https:\/\/iboblr.in\/gupathsociety\/?page_id=2258"},"modified":"2022-06-03T09:44:44","modified_gmt":"2022-06-03T09:44:44","slug":"cow-2021-50","status":"publish","type":"page","link":"https:\/\/iboblr.in\/gupathsociety\/cow-2021-50\/","title":{"rendered":"COW-2021-50"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"2258\" class=\"elementor elementor-2258\" data-elementor-settings=\"[]\">\n\t\t\t\t\t\t\t<div class=\"elementor-section-wrap\">\n\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-0e10247 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"0e10247\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-5114a22\" data-id=\"5114a22\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-008a171 elementor-widget elementor-widget-heading\" data-id=\"008a171\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.5.6 - 28-02-2022 *\/\n.elementor-heading-title{padding:0;margin:0;line-height:1}.elementor-widget-heading .elementor-heading-title[class*=elementor-size-]>a{color:inherit;font-size:inherit;line-height:inherit}.elementor-widget-heading .elementor-heading-title.elementor-size-small{font-size:15px}.elementor-widget-heading .elementor-heading-title.elementor-size-medium{font-size:19px}.elementor-widget-heading .elementor-heading-title.elementor-size-large{font-size:29px}.elementor-widget-heading .elementor-heading-title.elementor-size-xl{font-size:39px}.elementor-widget-heading .elementor-heading-title.elementor-size-xxl{font-size:59px}<\/style><h2 class=\"elementor-heading-title elementor-size-default\">CASE OF THE WEEK<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-85021b9 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"85021b9\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-32ae531\" data-id=\"32ae531\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-45dcd3a elementor-widget elementor-widget-text-editor\" data-id=\"45dcd3a\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.5.6 - 28-02-2022 *\/\n.elementor-widget-text-editor.elementor-drop-cap-view-stacked .elementor-drop-cap{background-color:#818a91;color:#fff}.elementor-widget-text-editor.elementor-drop-cap-view-framed .elementor-drop-cap{color:#818a91;border:3px solid;background-color:transparent}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap{margin-top:8px}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap-letter{width:1em;height:1em}.elementor-widget-text-editor .elementor-drop-cap{float:left;text-align:center;line-height:1;font-size:50px}.elementor-widget-text-editor .elementor-drop-cap-letter{display:inline-block}<\/style>\t\t\t\t<p><span style=\"font-family: Ubuntu;\"><span>Editors:\u00a0<\/span><\/span><span style=\"font-family: Ubuntu;\"><span>Francesca Khani\u00a0 (<a href=\"https:\/\/mail.google.com\/mail\/?view=cm&amp;fs=1&amp;tf=1&amp;to=Frk9007@med.cornell.edu\" target=\"_blank\" rel=\"noopener\">Frk9007@med.cornell.edu<\/a><span style=\"color: #0d1418;\">) and\u00a0<\/span><\/span><\/span><span>Mahmut Akgul (<a href=\"https:\/\/mail.google.com\/mail\/?view=cm&amp;fs=1&amp;tf=1&amp;to=akgulm@amc.edu\" target=\"_blank\" rel=\"noopener\">akgulm@amc.edu<\/a>)<\/span><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-c04e2a4 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"c04e2a4\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-3dfa410\" data-id=\"3dfa410\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-d65d1fc elementor-widget elementor-widget-text-editor\" data-id=\"d65d1fc\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><strong>2021-50\/December 13<\/strong><\/p><p><strong>Contributors:\u00a0Stephanie J Conrad,\u00a0Hongzhi, Xu,\u00a0Elizabeth Genega\u00a0<\/strong><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-829b15d elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"829b15d\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-6629b7f\" data-id=\"6629b7f\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-8576330 elementor-widget elementor-widget-text-editor\" data-id=\"8576330\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><span>A woman in her 60s with a history of COPD, GERD and arthritis presented with a one week history of right flank pain. Work-up revealed an obstructed right kidney with a staghorn calculus and a cystic renal mass. Urine cultures grew\u00a0<em>E. coli<\/em>\u00a0and\u00a0<em>P. mirabilis<\/em>.<\/span>\u00a0<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-8d78dfd elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"8d78dfd\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-43ee2d8\" data-id=\"43ee2d8\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-9c71328 elementor-arrows-position-inside elementor-pagination-position-outside elementor-widget elementor-widget-image-carousel\" 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swiper-wrapper\">\n\t\t\t\t\t\t\t\t<div class=\"swiper-slide\"><a data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-slideshow=\"9c71328\" data-elementor-lightbox-title=\"1-XPN 1X\" e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6Mzc2NiwidXJsIjoiaHR0cHM6XC9cL2lib2Jsci5pblwvZ3VwYXRoc29jaWV0eVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyMlwvMDRcLzEtWFBOLTFYLTEuanBnIiwic2xpZGVzaG93IjoiOWM3MTMyOCJ9\" href=\"https:\/\/iboblr.in\/gupathsociety\/wp-content\/uploads\/2022\/04\/1-XPN-1X-1.jpg\"><figure class=\"swiper-slide-inner\"><img decoding=\"async\" class=\"swiper-slide-image\" src=\"https:\/\/iboblr.in\/gupathsociety\/wp-content\/uploads\/2022\/04\/1-XPN-1X-1.jpg\" alt=\"1-XPN 1X\" \/><\/figure><\/a><\/div><div class=\"swiper-slide\"><a data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-slideshow=\"9c71328\" data-elementor-lightbox-title=\"2-XPN 2X\" 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class=\"elementor-screen-only\">Previous<\/span>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div class=\"elementor-swiper-button elementor-swiper-button-next\">\n\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"eicon-chevron-right\"><\/i>\t\t\t\t\t\t<span class=\"elementor-screen-only\">Next<\/span>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-c1abf97 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"c1abf97\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-d15014a\" data-id=\"d15014a\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-e6391c0 elementor-widget elementor-widget-heading\" data-id=\"e6391c0\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">QUIZ<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-3d5b9cf elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"3d5b9cf\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-6399030\" data-id=\"6399030\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-59f7470 elementor-widget elementor-widget-text-editor\" data-id=\"59f7470\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><strong>1. What is the correct diagnosis?<\/strong><\/p><p>\u00a0\u00a0\u00a0\u00a0 a. Clear cell renal cell carcinoma<\/p><p>\u00a0\u00a0\u00a0\u00a0 b. Xanthogranulomatous pyelonephritis\u00a0\u00a0<\/p><p>\u00a0\u00a0\u00a0\u00a0 c. Mycobacterial infection<\/p><p>\u00a0\u00a0\u00a0\u00a0 d. Spindle cell neoplasm<\/p><p>\u00a0\u00a0\u00a0\u00a0 e. Malakoplakia\u00a0<\/p><p><strong>2.\u00a0 Which of the immunohistochemical stains, when positive, supports the diagnosis?<\/strong><\/p><p>\u00a0\u00a0\u00a0\u00a0\u00a0 a. CD68<\/p><p>\u00a0\u00a0\u00a0\u00a0\u00a0 b. Acid Fast<\/p><p>\u00a0\u00a0\u00a0\u00a0\u00a0 c. Pankeratin<\/p><p>\u00a0\u00a0\u00a0\u00a0\u00a0 d. PAX-8<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-a731d2c elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"a731d2c\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-adb1e0c\" data-id=\"adb1e0c\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-94b0036 elementor-widget elementor-widget-accordion\" data-id=\"94b0036\" data-element_type=\"widget\" data-widget_type=\"accordion.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.5.6 - 28-02-2022 *\/\n.elementor-accordion{text-align:left}.elementor-accordion .elementor-accordion-item{border:1px solid #d4d4d4}.elementor-accordion .elementor-accordion-item+.elementor-accordion-item{border-top:none}.elementor-accordion .elementor-tab-title{margin:0;padding:15px 20px;font-weight:700;line-height:1;cursor:pointer;outline:none}.elementor-accordion .elementor-tab-title .elementor-accordion-icon{display:inline-block;width:1.5em}.elementor-accordion .elementor-tab-title .elementor-accordion-icon svg{width:1em;height:1em}.elementor-accordion .elementor-tab-title .elementor-accordion-icon.elementor-accordion-icon-right{float:right;text-align:right}.elementor-accordion .elementor-tab-title .elementor-accordion-icon.elementor-accordion-icon-left{float:left;text-align:left}.elementor-accordion .elementor-tab-title .elementor-accordion-icon .elementor-accordion-icon-closed{display:block}.elementor-accordion .elementor-tab-title .elementor-accordion-icon .elementor-accordion-icon-opened,.elementor-accordion .elementor-tab-title.elementor-active .elementor-accordion-icon-closed{display:none}.elementor-accordion .elementor-tab-title.elementor-active .elementor-accordion-icon-opened{display:block}.elementor-accordion .elementor-tab-content{display:none;padding:15px 20px;border-top:1px solid #d4d4d4}@media (max-width:767px){.elementor-accordion .elementor-tab-title{padding:12px 15px}.elementor-accordion .elementor-tab-title .elementor-accordion-icon{width:1.2em}.elementor-accordion .elementor-tab-content{padding:7px 15px}}<\/style>\t\t<div class=\"elementor-accordion\" role=\"tablist\">\n\t\t\t\t\t\t\t<div class=\"elementor-accordion-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-1551\" class=\"elementor-tab-title\" data-tab=\"1\" role=\"tab\" aria-controls=\"elementor-tab-content-1551\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon elementor-accordion-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-closed\"><i class=\"fas fa-plus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-opened\"><i class=\"fas fa-minus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-accordion-title\" href=\"\">Quiz Answers<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div id=\"elementor-tab-content-1551\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"1\" role=\"tabpanel\" aria-labelledby=\"elementor-tab-title-1551\"><p>1. b; 2. a<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-accordion-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-1552\" class=\"elementor-tab-title\" data-tab=\"2\" role=\"tab\" aria-controls=\"elementor-tab-content-1552\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon elementor-accordion-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-closed\"><i class=\"fas fa-plus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-opened\"><i class=\"fas fa-minus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-accordion-title\" href=\"\">Diagnosis<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div id=\"elementor-tab-content-1552\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"2\" role=\"tabpanel\" aria-labelledby=\"elementor-tab-title-1552\"><p>Xanthogranulomatous pyelonephritis<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-accordion-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-1553\" class=\"elementor-tab-title\" data-tab=\"3\" role=\"tab\" aria-controls=\"elementor-tab-content-1553\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon elementor-accordion-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-closed\"><i class=\"fas fa-plus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-opened\"><i class=\"fas fa-minus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-accordion-title\" href=\"\">Discussion<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div id=\"elementor-tab-content-1553\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"3\" role=\"tabpanel\" aria-labelledby=\"elementor-tab-title-1553\"><p>Xanthogranulomatous pyelonephritis (XPN) is the consequence of chronic bacterial infections in an obstructed kidney with calculi (1, 2, 3, 5 and 6). Gram negative bacterial infections are the main cause with E.coli being the most common culprit organism (2, 4, 5, 6). Most patients are female and usually present with flank pain, fever, fatigue, and lower urinary tract symptoms with gross hematuria (5, 6). However, patients may present with a renal mass (4, 6).<br \/><br \/>XPN is more commonly a diffuse process but may be segmental or focal. On gross exam, the pelvic-calyceal system maybe dilated with thickened mucosa and may contain yellow material. Yellow, irregular mass-like tissue may involve the renal medulla and extend into the cortex. Calculi are usually present. Microscopically, the disease process begins as areas of abscess formation and necrosis in the pelvis and sinus fat. As the disease progresses, there is adjacent accumulation of foamy lipid-laden macrophages (xanthoma cells) which can form larger nodules. The inflammatory infiltrate may also contain plasma cells and lymphocytes. Peripherally, there is fibrosis. The process can extend to involve the renal parenchyma and peri-nephric adipose tissue (1, 2, 5, 6). Treatment is based on extent of renal involvement. Initially it involves antimicrobial therapy before surgical intervention (2, 3).<br \/><br \/>The differential diagnosis for xanthogranulomatous pyelonephritis includes clear cell renal cell carcinoma (CCRCC), spindle cell neoplasms including sarcomatoid renal cell carcinoma (2,3,5) and other granulomatous processes such as malakoplakia (6), acid fast and fungal infections and sarcoidosis (2,3,5). Usually, careful microscopic evaluation can differentiate XPN from these other entities. CCRCC tumors cells have clear to eosinophilic cytoplasm that is not foamy and these tumors are not usually associated with a prominent inflammatory reaction (2). When necessary, immunohistochemical stains can be performed. Foamy macrophages are positive for CD68 but not for epithelial markers, while carcinoma is positive for keratin (5, 6). The fibroblastic proliferation in XPN is bland; sarcomatoid carcinoma more often has atypical spindle cells (2). Co-existing CCRCC in XPN can occur and thus careful attention on histological examination is required (3). Special stains such as AFB and GMS may assist in the diagnosis if infection with acid fast or fungal organisms is a concern.<br \/><br \/>This case serves as a reminder to consider XPN in the differential diagnosis of a renal mass and emphasizing the importance of obtaining patient history.<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-accordion-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-1554\" class=\"elementor-tab-title\" data-tab=\"4\" role=\"tab\" aria-controls=\"elementor-tab-content-1554\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon elementor-accordion-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-closed\"><i class=\"fas fa-plus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-opened\"><i class=\"fas fa-minus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-accordion-title\" href=\"\">References<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div id=\"elementor-tab-content-1554\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"4\" role=\"tabpanel\" aria-labelledby=\"elementor-tab-title-1554\"><p>1. Xi Xie1, Ning Wang, Yuyong Wang, Huadong He, Fanlei Kong and Nin. Non-invasive papillary urothelial carcinoma, low-grade of the renal pelvis mimicking a xanthogranulomatous pyelonephritis in a male patient: A case report and review of literature. International Journal of Immunopahtology and Pharmacology, 2020 Jan-Dec; 34:2058738420925720.<br \/><br \/>2. Jha SK, Aeddula NR. Pyelonephritis Xanthogranulomatous. [Updated 2020 May 30]. In: Stat Pearls [Internet]. Treasure Island (FL): Stat Pearls Publishing; 2020 Jan-. Available from: https:\/\/pmlegacy-ncbi-nlm-nih-gov.ezproxy.library.tufts.edu\/books\/NBK557399.<br \/><br \/>3. Moss BF, Potter L, Cliff A, et al Xanthogranulomatous pyelonephritis with associated renal cell carcinoma BMJ Case Reports CP 2019;12:e232097.<br \/><br \/>4. Zhou Ming, Netto J. Gorge, Epstein I. Jonathan. 2012 High yeild pathology: Uropathology.Elsevier.<br \/><br \/>5. Yang J. Ximing, Zhou Ming. 2021 Practical genitourinary pathology. Frequently asked questions. Springer.<br \/><br \/>6. Murphy MW, Grignon JD, Perlam JE. 2004. Tumors of the kidney, bladder and related urinary structures. AFIP Atlas of Tumor Pathology. American Registry of Pathology.<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-accordion-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-1555\" class=\"elementor-tab-title\" data-tab=\"5\" role=\"tab\" aria-controls=\"elementor-tab-content-1555\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon elementor-accordion-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-closed\"><i class=\"fas fa-plus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-opened\"><i class=\"fas fa-minus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-accordion-title\" href=\"\">Contributors<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div id=\"elementor-tab-content-1555\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"5\" role=\"tabpanel\" aria-labelledby=\"elementor-tab-title-1555\"><p>Stephanie J Conrad, Hongzhi Xu, Elizabeth Genega<br \/>Department of pathology, Tufts Medical Center, Boston, MA<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-accordion-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-1556\" class=\"elementor-tab-title\" data-tab=\"6\" role=\"tab\" aria-controls=\"elementor-tab-content-1556\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon elementor-accordion-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-closed\"><i class=\"fas fa-plus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-opened\"><i class=\"fas fa-minus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-accordion-title\" href=\"\">Organ Site<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div id=\"elementor-tab-content-1556\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"6\" role=\"tabpanel\" aria-labelledby=\"elementor-tab-title-1556\"><p>Kidney<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-accordion-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-1557\" class=\"elementor-tab-title\" data-tab=\"7\" role=\"tab\" aria-controls=\"elementor-tab-content-1557\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon elementor-accordion-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-closed\"><i class=\"fas fa-plus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-accordion-icon-opened\"><i class=\"fas fa-minus\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-accordion-title\" href=\"\">Keywords<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div id=\"elementor-tab-content-1557\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"7\" role=\"tabpanel\" aria-labelledby=\"elementor-tab-title-1557\"><p>Kidney, xanthogranulomatous pyelonephritis, macrophage<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>CASE OF THE WEEK Editors:\u00a0Francesca Khani\u00a0 (Frk9007@med.cornell.edu) and\u00a0Mahmut Akgul (akgulm@amc.edu) 2021-50\/December 13 Contributors:\u00a0Stephanie J Conrad,\u00a0Hongzhi, Xu,\u00a0Elizabeth Genega\u00a0 A woman in her 60s with a history of COPD, GERD and arthritis presented with a one week history of right flank pain. Work-up revealed an obstructed right kidney with a staghorn calculus and a cystic renal mass.<br \/><a class=\"moretag\" href=\"https:\/\/iboblr.in\/gupathsociety\/cow-2021-50\/\">+ Read More<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"templates\/page-fullwidth_template.php","meta":{"pmpro_default_level":0,"footnotes":""},"class_list":["post-2258","page","type-page","status-publish","hentry","pmpro-has-access"],"_links":{"self":[{"href":"https:\/\/iboblr.in\/gupathsociety\/wp-json\/wp\/v2\/pages\/2258","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/iboblr.in\/gupathsociety\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/iboblr.in\/gupathsociety\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/iboblr.in\/gupathsociety\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/iboblr.in\/gupathsociety\/wp-json\/wp\/v2\/comments?post=2258"}],"version-history":[{"count":43,"href":"https:\/\/iboblr.in\/gupathsociety\/wp-json\/wp\/v2\/pages\/2258\/revisions"}],"predecessor-version":[{"id":6694,"href":"https:\/\/iboblr.in\/gupathsociety\/wp-json\/wp\/v2\/pages\/2258\/revisions\/6694"}],"wp:attachment":[{"href":"https:\/\/iboblr.in\/gupathsociety\/wp-json\/wp\/v2\/media?parent=2258"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}