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Related Experiment Videos

Xanthogranulomatous pyelonephritis, perinephric type--a case report.

Y Akagi1, A Jimi, K Kosai

  • 1Department of Pathology, Kurume University School of Medicine, Japan.

The Kurume Medical Journal
|January 1, 1991
PubMed
Summary

Xanthogranulomatous pyelonephritis is a rare kidney infection. This case highlights a perinephric variant presenting as an abscess, requiring nephrectomy for treatment.

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Area of Science:

  • Nephrology
  • Pathology
  • Radiology

Background:

  • Xanthogranulomatous pyelonephritis (XGP) is an uncommon chronic destructive kidney infection.
  • Perinephric XGP, a variant, involves inflammation and lipid-laden macrophages in the tissue surrounding the kidney.

Observation:

  • A 46-year-old woman presented with flank pain, fever, and a palpable mass.
  • Initial investigations revealed anemia, leukocytosis, and Enterobacter in urine, with a non-functioning right kidney on intravenous pyelogram.
  • Imaging suggested a perinephric abscess, leading to right nephrectomy.

Findings:

  • The resected kidney showed a tumor-like mass with hemorrhage, abscess, and a characteristic brownish-yellow area in the perinephric fat.
  • Histological examination confirmed granulomatous inflammation with lipid-laden foam cells in the perinephric tissue.

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  • The renal parenchyma exhibited non-specific chronic pyelonephritis.

    • Implications:

    • This case underscores the importance of considering perinephric xanthogranulomatous pyelonephritis in the differential diagnosis of flank masses and kidney abscesses.
    • Accurate diagnosis through imaging and histology is crucial for appropriate management, which may include nephrectomy.
    • Understanding the lipid-laden foam cells is key to the histological diagnosis of this xanthogranulomatous condition.