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Nonneoplastic Disease Presenting as a Renal Lesion

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The Kidney

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Abstract

Nonneoplastic renal processes can present a diagnostic challenge for clinicians due to their ability to mimic malignant masses, both clinically and radiographically. This chapter will review benign renal diseases that can present clinically as a renal mass, including inflammatory conditions such as pyelonephritis, renal abscess, xanthogranulomatous pyelonephritis, and renal malakoplakia; cystic kidney disease including autosomal dominant and autosomal recessive polycystic disease; acquired cystic disease of the kidney; and other miscellaneous lesions. Radiographic images, gross pathology, and histological features will be discussed, as well as common management strategies for these entities.

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References

  1. Bhatt S, MacLennan G, Dogra V. Renal pseudotumors. AJR Am J Roentgenol. 2007;188(5):1380–7.

    Article  PubMed  Google Scholar 

  2. Conley SP, Frumkin K. Acute lobar nephronia: a case report and literature review. J Emerg Med. 2014;46(5):624–6.

    Article  PubMed  Google Scholar 

  3. Huang JJ, Sung JM, Chen KW, Ruaan MK, Shu GH, Chuang YC. Acute bacterial nephritis: a clinicoradiologic correlation based on computed tomography. Am J Med. 1992;93(3):289–98.

    Article  CAS  PubMed  Google Scholar 

  4. Li Y, Zhang Y. Diagnosis and treatment of acute focal bacterial nephritis. Chin Med J (Engl). 1996;109(2):168–72.

    CAS  Google Scholar 

  5. Yang CC, Shao PL, Lu CY, Tsau YK, Tsai IJ, Lee PI, et al. Comparison of acute lobar nephronia and uncomplicated urinary tract infection in children. J Microbiol Immunol Infect. 2010;43(3):207–14.

    Article  PubMed  Google Scholar 

  6. Klar A, Hurvitz H, Berkun Y, Nadjari M, Blinder G, Israeli T, et al. Focal bacterial nephritis (lobar nephronia) in children. J Pediatr. 1996;128(6):850–3.

    Article  CAS  PubMed  Google Scholar 

  7. Cheng CH, Tsau YK, Lin TY. Effective duration of antimicrobial therapy for the treatment of acute lobar nephronia. Pediatrics. 2006;117(1):e84–9.

    Article  PubMed  Google Scholar 

  8. Anderson KA, McAninch JW. Renal abscesses: classification and review of 40 cases. Urology. 1980;16(4):333–8.

    Article  CAS  PubMed  Google Scholar 

  9. Meng MV, Mario LA, McAninch JW. Current treatment and outcomes of perinephric abscesses. J Urol. 2002;168(4 Pt 1):1337–40.

    Article  PubMed  Google Scholar 

  10. Cancelinha C, Santos L, Ferreira C, Gomes C. Renal abscesses in childhood: report of two uncommon cases. BMJ Case Rep. 2014. doi:10.1136/bcr-2013-202408.

    PubMed  Google Scholar 

  11. Doolittle KH, Taylor JN. Renal abscess in differential diagnosis of mass in kidney. J Urol. 1963;89(5):649.

    Google Scholar 

  12. Caplan LH, Siegelman SS, Bosniak MA. Angiography in inflammatory space-occupying lesions of the kidney. Radiology. 1967;88(1):14–23.

    Article  CAS  PubMed  Google Scholar 

  13. Merenich WM, Popky GL. Radiology of renal infection. Med Clin North Am. 1991;75(2):425–69.

    CAS  PubMed  Google Scholar 

  14. Wang YT, Lin KY, Chen MJ, Chiou YY. Renal abscess in children: a clinical retrospective study. Acta Paediatr Taiwan. 2003;44(4):197–201.

    PubMed  Google Scholar 

  15. Seguias L, Srinivasan K, Mehta A. Pediatric renal abscess: a 10-year single-center retrospective analysis. Hosp Pediatr. 2012;2(3):161–6.

    Article  PubMed  Google Scholar 

  16. Rabushka LS, Fishman EK, Goldman SM. Pictorial review: computed tomography of renal inflammatory disease. Urology. 1994;44(4):473–80.

    Article  CAS  PubMed  Google Scholar 

  17. Zia-ul-Miraj M, Cheema MA. Xanthogranulomatous pyelonephritis presenting as a pseudotumor in a 2-month-old boy. J Pediatr Surg. 2000;35(8):1256–8.

    Article  CAS  PubMed  Google Scholar 

  18. Dell’Aprovitola N, Guarino S, Del Vecchio W, Camera L, Chiancone F, Imbimbo C, et al. Xanthogranulomatous pyelonephritis mimicking a renal cell carcinoma: a unique and challenging case. Acta Radiol Short Rep. 2014;3(1):2047981613513763.

    PubMed Central  PubMed  Google Scholar 

  19. Dembry LM, Andriole VT. Renal and perirenal abscesses. Infect Dis Clin North Am. 1997;11(3):663–80.

    Article  CAS  PubMed  Google Scholar 

  20. Eastham J, Ahlering T, Skinner E. Xanthogranu-lomatous pyelonephritis: clinical findings and surgical considerations. Urology. 1994;43(3):295–9.

    Article  CAS  PubMed  Google Scholar 

  21. Goodman M, Curry T, Russell T. Xanthogranulomatous pyelonephritis (XGP): a local disease with systemic manifestations. Report of 23 patients and review of the literature. Medicine. 1979;58(2):171–81.

    Article  CAS  PubMed  Google Scholar 

  22. Kim JC. US and CT findings of xanthogranulomatous pyelonephritis. Clin Imaging. 2001;25(2):118–21.

    Article  CAS  PubMed  Google Scholar 

  23. Loffroy R, Guiu B, Watfa J, Michel F, Cercueil JP, Krause D. Xanthogranulomatous pyelonephritis in adults: clinical and radiological findings in diffuse and focal forms. Clin Radiol. 2007;62(9):884–90.

    Article  CAS  PubMed  Google Scholar 

  24. Ganpule A, Jagtap J, Ganpule S, Bhattu A, Soni S, Sabnis R, et al. Xanthogranulomatous pyelonephritis (XGPN) mimicking a “renal cell carcinoma with renal vein thrombus and paracaval lymphadenopathy”. F1000Research. 2013;2:263.

    PubMed Central  PubMed  Google Scholar 

  25. Gupta G, Singh R, Kotasthane DS, Kotasthane VD, Kumar S. Xanthogranulomatous pyelonephritis in a male child with renal vein thrombus extending into the inferior vena cava: a case report. BMC Pediatr. 2010;10:47.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Ozcan H, Akyar S, Atasoy C. An unusual manifestation of xanthogranulomatous pyelonephritis: bilateral focal solid renal masses. AJR Am J Roentgenol. 1995;165(6):1552–3.

    Article  CAS  PubMed  Google Scholar 

  27. Korkes F, Favoretto RL, Broglio M, Silva CA, Castro MG, Perez MD. Xanthogranulomatous pyelonephritis: clinical experience with 41 cases. Urology. 2008;71(2):178–80.

    Article  PubMed  Google Scholar 

  28. Tobias-Machado M, Lasmar MT, Batista LT, Forseto Jr PH, Juliano RV, Wroclawski ER. Laparoscopic nephrectomy in inflammatory renal disease: proposal for a staged approach. Int Braz J Urol. 2005;31(1):22–8.

    Article  CAS  PubMed  Google Scholar 

  29. Osca JM, Peiro MJ, Rodrigo M, Martinez-Jabaloyas JM, Jimenez-Cruz JF. Focal xanthogranulomatous pyelonephritis: partial nephrectomy as definitive treatment. Eur Urol. 1997;32(3):375–9.

    CAS  PubMed  Google Scholar 

  30. Mollier S, Descotes JL, Pasquier D, Coquillat P, Michel A, Dalsoglio S, et al. Pseudoneoplastic xanthogranulomatous pyelonephritis. A typical clinical presentation but unusual diagnosis and treatment. Eur Urol. 1995;27(2):170–3.

    CAS  PubMed  Google Scholar 

  31. Reul O, Waltregny D, Boverie J, de Leval J, Andrianne R. Pseudotumoral xanthogranulomatous pyelonephritis: diagnosis with percutaneous biopsy and success of conservative treatment. Prog Urol. 2001;11(6):1274–6.

    CAS  PubMed  Google Scholar 

  32. Li L, Parwani AV. Xanthogranulomatous pyelonephritis. Arch Pathol Lab Med. 2011;135(5):671–4.

    PubMed  Google Scholar 

  33. Sugie S, Tanaka T, Nishikawa A, Yoshimi N, Kato K, Mori H, et al. Fine-needle aspiration cytology of xanthogranulomatous pyelonephritis. Urology. 1991;37(4):376–9.

    Article  CAS  PubMed  Google Scholar 

  34. Kumar N, Jain S. Aspiration cytology of focal xanthogranulomatous pyelonephritis: a diagnostic challenge. Diagn Cytopathol. 2004;30(2):111–4.

    Article  PubMed  Google Scholar 

  35. Diwakar R, Else J, Wong V, Carne A, Banerjee D, MacPhee I. Enlarged kidneys and acute renal failure--why is a renal biopsy necessary for diagnosis and treatment? Nephrol Dial Transplant. 2008;23(1):401–3.

    Article  PubMed  Google Scholar 

  36. Hammond NA, Nikolaidis P, Miller FH. Infectious and inflammatory diseases of the kidney. Radiol Clin North Am. 2012;50(2):259–70. vi.

    Article  PubMed  Google Scholar 

  37. Vourganti S, Agarwal PK, Bodner DR, Dogra VS. Ultrasonographic evaluation of renal infections. Radiol Clin North Am. 2006;44(6):763–75.

    Article  PubMed  Google Scholar 

  38. Abolhasani M, Jafari AM, Asgari M, Salimi H. Renal malakoplakia presenting as a renal mass in a 55-year-old man: a case report. J Med Case Reports. 2012;6:379.

    Article  Google Scholar 

  39. Pickhardt PJ, Lonergan GJ, Davis Jr CJ, Kashitani N, Wagner BJ. From the archives of the AFIP. Infiltrative renal lesions: radiologic-pathologic correlation. Armed Forces Institute of Pathology. Radiographics. 2000;20(1):215–43.

    Article  CAS  PubMed  Google Scholar 

  40. Venkatesh SK, Mehrotra N, Gujral RB. Sonographic findings in renal parenchymal malacoplakia. J Clin Ultrasound. 2000;28(7):353–7.

    Article  CAS  PubMed  Google Scholar 

  41. Stanton MJ, Maxted W. Malacoplakia: a study of the literature and current concepts of pathogenesis, diagnosis and treatment. J Urol. 1981;125(2):139–46.

    CAS  PubMed  Google Scholar 

  42. Tam VK, Kung WH, Li R, Chan KW. Renal parenchymal malacoplakia: a rare cause of ARF with a review of recent literature. Am J Kidney Dis. 2003;41(6):E13–7.

    Article  PubMed  Google Scholar 

  43. Mochizuki T, Tsuchiya K, Nitta K. Autosomal dominant polycystic kidney disease: recent advances in pathogenesis and potential therapies. Clin Exp Nephrol. 2013;17(3):317–26.

    Article  CAS  PubMed  Google Scholar 

  44. Collins AJ, Foley RN, Chavers B, Gilbertson D, Herzog C, Ishani A, et al. US renal data system 2013 annual data report. Am J Kidney Dis. 2014;63(1 Suppl):A7.

    Article  PubMed  Google Scholar 

  45. Torres VE, Harris PC. Autosomal dominant polycystic kidney disease: the last 3 years. Kidney Int. 2009;76(2):149–68.

    Article  PubMed Central  PubMed  Google Scholar 

  46. Grantham JJ. Clinical practice. Autosomal dominant polycystic kidney disease. N Engl J Med. 2008;359(14):1477–85.

    Article  CAS  PubMed  Google Scholar 

  47. Srivastava A, Patel N. Autosomal dominant polycystic kidney disease. Am Fam Physician. 2014;90(5):303–7.

    PubMed  Google Scholar 

  48. Pei Y, Obaji J, Dupuis A, Paterson AD, Magistroni R, Dicks E, et al. Unified criteria for ultrasonographic diagnosis of ADPKD. J Am Soc Nephrol. 2009;20(1):205–12.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  49. Huang E, Samaniego-Picota M, McCune T, Melancon JK, Montgomery RA, Ugarte R, et al. DNA testing for live kidney donors at risk for autosomal dominant polycystic kidney disease. Transplantation. 2009;87(1):133–7.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  50. Nascimento AB, Mitchell DG, Zhang XM, Kamishima T, Parker L, Holland GA. Rapid MR imaging detection of renal cysts: age-based standards. Radiology. 2001;221(3):628–32.

    Article  CAS  PubMed  Google Scholar 

  51. Lee DI, Andreoni CR, Rehman J, Landman J, Ragab M, Yan Y, et al. Laparoscopic cyst decortication in autosomal dominant polycystic kidney disease: impact on pain, hypertension, and renal function. J Endourol. 2003;17(6):345–54.

    Article  PubMed  Google Scholar 

  52. Dunn MD, Portis AJ, Elbahnasy AM, Shalhav AL, Rothstein M, McDougall EM, et al. Laparoscopic nephrectomy in patients with end-stage renal disease and autosomal dominant polycystic kidney disease. Am J Kidney Dis. 2000;35(4):720–5.

    Article  CAS  PubMed  Google Scholar 

  53. Wisenbaugh ES, Tyson 2nd MD, Castle EP, Humphreys MR, Andrews PE. Massive renal size is not a contraindication to a laparoscopic approach for bilateral native nephrectomies in autosomal dominant polycystic kidney disease (ADPKD). BJU Int. 2015;115(5):796–801.

    Article  PubMed  Google Scholar 

  54. Jilg CA, Drendel V, Bacher J, Pisarski P, Neeff H, Drognitz O, et al. Autosomal dominant polycystic kidney disease: prevalence of renal neoplasias in surgical kidney specimens. Nephron Clin Pract. 2013;123(1–2):13–21.

    Article  PubMed  Google Scholar 

  55. Gupta K, Vankalakunti M, Sachdeva MU. Glomerulocystic kidney disease and its rare associations: an autopsy report of two unrelated cases. Diagn Pathol. 2007;2:12.

    Article  PubMed Central  PubMed  Google Scholar 

  56. Bissler JJ, Siroky BJ, Yin H. Glomerulocystic kidney disease. Pediatr Nephrol. 2010;25(10):2049–56. quiz 56–9.

    Article  PubMed Central  PubMed  Google Scholar 

  57. Buscher R, Buscher AK, Weber S, Mohr J, Hegen B, Vester U, et al. Clinical manifestations of autosomal recessive polycystic kidney disease (ARPKD): kidney-related and non-kidney-related phenotypes. Pediatr Nephrol. 2014;29:1915–25.

    Article  PubMed  Google Scholar 

  58. Roy S, Dillon MJ, Trompeter RS, Barratt TM. Autosomal recessive polycystic kidney disease: long-term outcome of neonatal survivors. Pediatr Nephrol. 1997;11(3):302–6.

    Article  CAS  PubMed  Google Scholar 

  59. Adeva M, El-Youssef M, Rossetti S, Kamath PS, Kubly V, Consugar MB, et al. Clinical and molecular characterization defines a broadened spectrum of autosomal recessive polycystic kidney disease (ARPKD). Medicine. 2006;85(1):1–21.

    Article  PubMed  Google Scholar 

  60. Reuss A, Wladimiroff JW, Niermeyer MF. Sonographic, clinical and genetic aspects of prenatal diagnosis of cystic kidney disease. Ultrasound Med Biol. 1991;17(7):687–94.

    Article  CAS  PubMed  Google Scholar 

  61. Consugar MB, Anderson SA, Rossetti S, Pankratz VS, Ward CJ, Torra R, et al. Haplotype analysis improves molecular diagnostics of autosomal recessive polycystic kidney disease. Am J Kidney Dis. 2005;45(1):77–87.

    Article  CAS  PubMed  Google Scholar 

  62. Beaunoyer M, Snehal M, Li L, Concepcion W, Salvatierra Jr O, Sarwal M. Optimizing outcomes for neonatal ARPKD. Pediatr Transplant. 2007;11(3):267–71.

    Article  PubMed  Google Scholar 

  63. Bean SA, Bednarek FJ, Primack WA. Aggressive respiratory support and unilateral nephrectomy for infants with severe perinatal autosomal recessive polycystic kidney disease. J Pediatr. 1995;127(2):311–3.

    Article  CAS  PubMed  Google Scholar 

  64. Shukla AR, Kiddoo DA, Canning DA. Unilateral nephrectomy as palliative therapy in an infant with autosomal recessive polycystic kidney disease. J Urol. 2004;172(5 Pt 1):2000–1.

    Article  PubMed  Google Scholar 

  65. Martignoni G, Bonetti F, Pea M, Tardanico R, Brunelli M, Eble JN. Renal disease in adults with TSC2/PKD1 contiguous gene syndrome. Am J Surg Pathol. 2002;26(2):198–205.

    Article  PubMed  Google Scholar 

  66. Rajanna DK, Reddy A, Srinivas NS, Aneja A. Autosomal recessive polycystic kidney disease: antenatal diagnosis and histopathological correlation. J Clin Imaging Sci. 2013;3:13.

    Article  PubMed Central  PubMed  Google Scholar 

  67. Dunnill MS, Millard PR, Oliver D. Acquired cystic disease of the kidneys: a hazard of long-term intermittent maintenance haemodialysis. J Clin Pathol. 1977;30(9):868–77.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  68. Waterman J. Diagnosis and evaluation of renal cysts. Prim Care. 2014;41(4):823–35.

    Article  PubMed  Google Scholar 

  69. Grantham JJ. Acquired cystic kidney disease. Kidney Int. 1991;40(1):143–52.

    Article  CAS  PubMed  Google Scholar 

  70. Truong LD, Krishnan B, Cao JT, Barrios R, Suki WN. Renal neoplasm in acquired cystic kidney disease. Am J Kidney Dis. 1995;26(1):1–12.

    Article  CAS  PubMed  Google Scholar 

  71. Hosseini M, Antic T, Paner GP, Chang A. Pathologic spectrum of cysts in end-stage kidneys: possible precursors to renal neoplasia. Hum Pathol. 2014;45(7):1406–13.

    Article  PubMed  Google Scholar 

  72. Honore LH, O’Hara KE. Combined adrenorenal fusion and adrenohepatic adhesion: a case report with review of the literature and discussion of pathogenesis. J Urol. 1976;115(3):323–5.

    CAS  PubMed  Google Scholar 

  73. Ye H, Yoon GS, Epstein JI. Intrarenal ectopic adrenal tissue and renal-adrenal fusion: a report of nine cases. Mod Pathol. 2009;22(2):175–81.

    Article  PubMed  Google Scholar 

  74. Carneiro F, Sobreira Mde N, Dos Santos A, de Magalhaes A, Maurmo R. Splenorenal fusion mimicking renal neoplasm in a patient with von Hippel-Lindau disease. Intern Med. 2010;49(5):513–4.

    Article  PubMed  Google Scholar 

  75. Forino M, Davis GL, Zins JH. Renal splenic heterotopia, a rare mimic of renal neoplasia: case report of imaging and fine-needle aspiration biopsy. Diagn Cytopathol. 1993;9(5):565–9.

    Article  CAS  PubMed  Google Scholar 

  76. Karabulut N, Elmas N. Contrast agents used in MR imaging of the liver. Diagn Interv Radiol. 2006;12(1):22–30.

    PubMed  Google Scholar 

  77. Gibbins J, Pankhurst T, Murray J, McCafferty I, Baiden-Amissahk K, Shafeek S, et al. Extramedullary haematopoiesis in the kidney: a case report and review of literature. Clin Lab Haematol. 2005;27(6):391–4.

    Article  CAS  PubMed  Google Scholar 

  78. Ricci D, Mandreoli M, Valentino M, Sabattini E, Santoro A. Extramedullary haematopoiesis in the kidney. Clin Kidney J. 2012;5:143.

    Article  Google Scholar 

  79. Coyne JD. Extramedullary haemopoiesis. J Clin Pathol. 2005;58(4):448.

    PubMed Central  CAS  PubMed  Google Scholar 

  80. Saisorn I, Leewansangtong S, Sukpanichnant S, Ruchutrakool T, Leemanont P. Intrarenal extramedullary hematopoiesis as a renal mass in a patient with thalassemia. J Urol. 2001;165(2):507–8.

    Article  CAS  PubMed  Google Scholar 

  81. Talmon GA. Pure erythropoiesis in clear cell renal cell carcinoma. Int J Surg Pathol. 2010;18(6):544–6.

    PubMed  Google Scholar 

  82. Choi H, David CL, Katz RL, Podoloff DA. Case 69: extramedullary hematopoiesis. Radiology. 2004;231(1):52–6.

    Article  PubMed  Google Scholar 

  83. Rapezzi D, Racchi O, Ferraris AM. Perirenal extramedullary hematopoiesis in agnogenic myeloid metaplasia: MR imaging findings. AJR Am J Roentgenol. 1997;168(5):1388–9.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Section of Urology, University of Chicago, 5841 South Maryland Avenue, MC 6038, Chicago, IL, 60637, USA

    Shane M. Pearce M.D. & Scott E. Eggener M.D.

  2. Department of Pathology, MD Anderson Cancer Center, The University of Texas, Houston, TX, 77030, USA

    Priya Rao M.D.

  3. Department of Radiology, University of Chicago, Chicago, IL, 60637, USA

    Stephen Thomas M.D.

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  1. Shane M. Pearce M.D.
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  2. Priya Rao M.D.
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  3. Stephen Thomas M.D.
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  4. Scott E. Eggener M.D.
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Correspondence to Shane M. Pearce M.D. .

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Editors and Affiliations

  1. Department of Pathology, University of California at San Diego Department of Pathology, San Diego, California, USA

    Donna E. Hansel

  2. Department of Urology, University of California at San Diego Department of Urology, San Diego, California, USA

    Christopher J. Kane

  3. Department of Pathology and Surgery, University of Chicago, Chicago, Illinois, USA

    Gladell P. Paner

  4. Department of Urologic Surgery, Vanderbilt University Medical Center Department of Urologic Surgery, Nashville, Tennessee, USA

    Sam S. Chang

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Pearce, S.M., Rao, P., Thomas, S., Eggener, S.E. (2016). Nonneoplastic Disease Presenting as a Renal Lesion. In: Hansel, D., Kane, C., Paner, G., Chang, S. (eds) The Kidney. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-3286-3_3

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