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Sonographic features of xanthogranulomatous pyelonephritis
1Department of Radiology, Veterans General Hospital-Taipei and National Yang-Ming University School of Medicine, 201 Shih-Pai Road, Section 2, Taipei 11217, Taiwan.
Journal of Clinical Ultrasound : JCU
|August 7, 2001
Summary
Xanthogranulomatous pyelonephritis (XGP) shows varied sonographic features, often including hydronephrosis and perinephric fluid. Definitive diagnosis may require CT or biopsy for suspected XGP cases.
Area of Science:
- Radiology
- Medical Imaging
- Urology
Background:
- Xanthogranulomatous pyelonephritis (XGP) is a rare, chronic destructive inflammation of the kidney.
- Accurate diagnosis is crucial for appropriate management and to differentiate it from renal tumors.
Purpose of the Study:
- To delineate the spectrum of sonographic findings associated with Xanthogranulomatous Pyelonephritis (XGP).
- To identify sonographic characteristics that may suggest XGP.
Main Methods:
- Retrospective review of CT, sonographic, and medical records of 27 histopathologically confirmed XGP cases.
- Analysis of renal size, shape, outline, perinephric fluid, obstructive uropathy, and parenchymal echotexture.
Main Results:
- XGP was categorized into four sonographic patterns: diffuse hydronephrotic, diffuse parenchymal, diffuse contracted, and segmental/focal.
- Common findings included hydronephrosis (44%), parenchymal changes, and perinephric fluid (15%).
- Preoperative sonographic diagnoses varied, with XGP suspected in only 41% of cases.
Conclusions:
- XGP lacks pathognomonic sonographic features but may be indicated by parenchymal thinning, hydronephrosis, and perinephric fluid.
- Sonographic signs of chronic obstructive uropathy and echoes within the collecting system are suggestive.
- CT or needle biopsy is recommended for definitive diagnosis of sonographically suspected XGP.