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Renal Solid Mass as a Rare Presentation of Wagener's Granulomatosis: A Case Report.

Mohammadi Sichani M, Hadi M, Talebi A, Khalighinejad P - Case Rep Urol (2012)

Bottom Line: Renal involvement in Wagener's granulomatosis represents as a segmental necrotizing glomerulonephritis which is not visible with imaging techniques and usually presents with proteinuria, microhematuria, and hypertension.A rare presentation of the disease is a renal mass which can be mistaken as renal tumors, abscess, or lymphoma.We report a 22-year-old female with flank pain and fever who was admitted in our hospital.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Isfahan University of Medical Sciences, Isfahan 81746-75731, Iran.

ABSTRACT
Wagener's granulomatosis (WG) is a rheumatologic disease with unknown etiology which renal and pulmonary involvement is commonly seen. Renal involvement in Wagener's granulomatosis represents as a segmental necrotizing glomerulonephritis which is not visible with imaging techniques and usually presents with proteinuria, microhematuria, and hypertension. A rare presentation of the disease is a renal mass which can be mistaken as renal tumors, abscess, or lymphoma. We report a 22-year-old female with flank pain and fever who was admitted in our hospital. The patient underwent renal tumor biopsy and diagnosed with Wagener's granulomatosis in pathologic staining. The aim of this work is introduction of Wagener's granulomatosis as a differential diagnosis of renal tumors, to prevent unnecessary interventions and delayed treatment.

No MeSH data available.


Related in: MedlinePlus

Photomicrograph (Jones staining ×400) showing sclerosis of a glomerulus.
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fig4: Photomicrograph (Jones staining ×400) showing sclerosis of a glomerulus.

Mentions: The initial diagnosis was a renal abscess considering persistent fever and flank pain for 48 hours despite broad spectrum antibiotic therapy. Percutaneous ultrasound guided drainage of the presumed renal abscess was done, however, the aspirated fluid was clear without any pus or debris. She then underwent a core needle biopsy. The patient tolerated the procedure well and there was no immediate complication. Rheumatologic screening tests were also sent off. The ANCA test was positive and pathologic study of the tissue sample with H&E, Masson, and Jones revealed sclerosis, granulomatosis inflammation, multinucleated giant cells, vasculitis, and severe fibrinoid necrosis without any malignant cell suggestive of Wagener's granulomatosis (Figures 2, 3, and 4). Unfortunately, a day after the biopsy, the patient died due to massive hemoptysis, and cardiopulmonary arrest.


Renal Solid Mass as a Rare Presentation of Wagener's Granulomatosis: A Case Report.

Mohammadi Sichani M, Hadi M, Talebi A, Khalighinejad P - Case Rep Urol (2012)

Photomicrograph (Jones staining ×400) showing sclerosis of a glomerulus.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3420076&req=5

fig4: Photomicrograph (Jones staining ×400) showing sclerosis of a glomerulus.
Mentions: The initial diagnosis was a renal abscess considering persistent fever and flank pain for 48 hours despite broad spectrum antibiotic therapy. Percutaneous ultrasound guided drainage of the presumed renal abscess was done, however, the aspirated fluid was clear without any pus or debris. She then underwent a core needle biopsy. The patient tolerated the procedure well and there was no immediate complication. Rheumatologic screening tests were also sent off. The ANCA test was positive and pathologic study of the tissue sample with H&E, Masson, and Jones revealed sclerosis, granulomatosis inflammation, multinucleated giant cells, vasculitis, and severe fibrinoid necrosis without any malignant cell suggestive of Wagener's granulomatosis (Figures 2, 3, and 4). Unfortunately, a day after the biopsy, the patient died due to massive hemoptysis, and cardiopulmonary arrest.

Bottom Line: Renal involvement in Wagener's granulomatosis represents as a segmental necrotizing glomerulonephritis which is not visible with imaging techniques and usually presents with proteinuria, microhematuria, and hypertension.A rare presentation of the disease is a renal mass which can be mistaken as renal tumors, abscess, or lymphoma.We report a 22-year-old female with flank pain and fever who was admitted in our hospital.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Isfahan University of Medical Sciences, Isfahan 81746-75731, Iran.

ABSTRACT
Wagener's granulomatosis (WG) is a rheumatologic disease with unknown etiology which renal and pulmonary involvement is commonly seen. Renal involvement in Wagener's granulomatosis represents as a segmental necrotizing glomerulonephritis which is not visible with imaging techniques and usually presents with proteinuria, microhematuria, and hypertension. A rare presentation of the disease is a renal mass which can be mistaken as renal tumors, abscess, or lymphoma. We report a 22-year-old female with flank pain and fever who was admitted in our hospital. The patient underwent renal tumor biopsy and diagnosed with Wagener's granulomatosis in pathologic staining. The aim of this work is introduction of Wagener's granulomatosis as a differential diagnosis of renal tumors, to prevent unnecessary interventions and delayed treatment.

No MeSH data available.


Related in: MedlinePlus