Focal xanthogranulomatous pyelonephritis mimicking adrenal mass: Case report

Ksantogranülomatöz pyelonefrit (KGP) etiyolojisi tam olarak bilinmeyen ve nadir görülen kronik renal inflamasyondur. Tipik olarak taşa bağlı obstrüksiyon zemininde gelişir. Ultrasonografi (USG) bulgularının nonspesifik olması sebebiyle bilgisayarlı tomografi (BT) ve Manyetik Rezonans Görüntüleme (MRG) hastalığın tanısı ve preoperatif planlamada ekstrarenal uzanımının gösterilmesinde seçilebilecek diagnostik modalitelerdir. Ancak fokal tutulum gösteren KGP'i böbrek tümörlerinden ayırt etmek zor olabilir ve bazen tanı yalnızca nefrektomi sonrası konulabilir. Bu yazımızda adrenal kitleyi taklit eden ve histopatolojik olarak ksantogranulomatöz pyelonefrit tanısı alan olgu sunulmuştur.Xanthogranulomatous pyelonephritis is a rare form of chronic renal infection which is unknown etiology exactly. Xanthogranulomatous pyelonephritis is typically associated with an obstructing calculus. Because of the nonspecific findings of ultrasonography, computed tomography and magnetic resonance imaging can be selected diagnostic modalities to show the extrarenal extension of the disease. However, it may be difficult to distinguish focal involvement of xanthogranulomatous pyelonephritis from renal tumors and sometimes diagnosis can only be made after nephrectomy. In this article we present a case of xanthogranulomatous pyelonephritis mimicking adrenal mass and histopathologically diagnosed

Evaluation of abdominal computed tomography findings in patients with COVID-19: a multicenter study

PURPOSE To evaluate the frequency of abdominal computed tomography (CT) findings in patients with coronavirus disease-2019 (COVID-19) and interrogate the relationship between abdominal CT findings and patient demographic features, clinical findings, and laboratory test results as well as the CT atherosclerosis score in the abdominal aorta. METHODS This study was designed as a multicenter retrospective study. The abdominal CT findings of 1.181 patients with positive abdominal symptoms from 26 tertiary medical centers with a positive polymerase chain-reaction test for severe acute respiratory syndrome coronavirus 2 were reviewed. The frequency of ischemic and non-ischemic CT findings as well as the association between CT findings, clinical features, and abdominal aortic calcific atherosclerosis score (AA-CAS) were recorded. RESULTS Ischemic and non-ischemic abdominal CT findings were detected in 240 (20.3%) and 328 (27.7%) patients, respectively. In 147 patients (12.4%), intra-abdominal malignancy was present. The most frequent ischemic abdominal CT findings were bowel wall thickening (n = 120; 10.2%) and perivascular infiltration (n = 40; 3.4%). As for non-ischemic findings, colitis (n = 91; 7.7%) and small bowel inflammation (n = 73; 6.2%) constituted the most frequent disease processes. The duration of hospital stay was found to be higher in patients with abdominal CT findings than in patients without any positive findings (13.8 ± 13 vs. 10.4 ± 12.8 days, P < 0.001). The frequency of abdominal CT findings was significantly higher in patients who did not survive the infection than in patients who were discharged after recovery (41.7% vs. 27.4%, P < 0.001). Increased AA-CAS was found to be associated with a higher risk of ischemic conditions in abdominal CT examinations. CONCLUSION Abdominal symptoms in patients with COVID-19 are usually associated with positive CT findings. The presence of ischemic findings on CT correlates with poor COVID-19 outcomes. A high AA-CAS is associated with abdominal ischemic findings in patients with COVID-19