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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 90-year-old man with no known history of tuberculosis was admitted for abdominal pain&#46; Computed tomography confirmed the presence of acute appendicitis&#46; Multiple calcifications were incidentally detected in the left kidney&#44; along with notable cortical atrophy and a renal parenchyma partially replaced by pseudonodular lesions with low attenuation content with no contrast uptake&#44; findings compatible with mastic kidney &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> A&#8211;C&#44; in cross-sectional&#44; frontal and sagittal slices&#44; respectively&#41;&#46; The patient reported episodes of self-limiting hematuria&#44; with negative urine cultures&#46; The direct smears for bacilli and the urinary mycobacteria cultures were positive&#44; confirming renal tuberculosis&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Urogenital tuberculosis is the third most common form of extrapulmonary tuberculosis after lymph node tuberculosis and pleural effusion&#46; Unilateral involvement of the pelvis&#44; calyxes&#44; ureters and bladder is more common than parenchymal involvement&#46; The condition can present as persistent pyuria with repeatedly negative cultures or as painless micro&#47;macroscopic hematuria&#44; with systemic symptoms being rare&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The demonstration of bacilli in urine establishes the diagnosis&#46; Concomitant radiological disorders in the upper and lower urinary tract are highly suggestive&#46; Stricture of the collecting system&#44; asymmetric caliectasis&#44; calcification&#44; hydronephrosis and even autonephrectomy are possible&#46; Based on suggestive radiological findings and negative urine tests&#44; fine-needle aspiration cytology and renal or bladder biopsy should be performed for cultures and histopathology studies&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The treatment is similar to that of pulmonary tuberculosis&#46; Surgery should be deferred until after at least 4 weeks of treatment&#46; Nephrectomy&#44; dilation&#47;reconstruction of the ureteral stricture or urinary diversion may be performed&#46; Nephrectomy would be indicated for nonfunctioning kidneys&#44; extensive disease with hypertension and obstruction of the ureteropelvic junction or for the coexistence of renal carcinoma&#46;</p></span>"
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Vol. 219. Issue 1.
Pages 53-54 (January - February 2019)
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Vol. 219. Issue 1.
Pages 53-54 (January - February 2019)
Medicine in Images
Mastic kidney
Riñón mastic
Visits
10
S.M. Santos-Seoanea,
Corresponding author
smsspulp@yahoo.es

Corresponding author.
, V. Arenas-Garcíaa, R.J. Delgado-Sevillanob
a Servicio de Medicina Interna, Hospital Universitario San Agustín, Avilés, Asturias, Spain
b Servicio de Radiología, Hospital Universitario San Agustín, Avilés, Asturias, Spain
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