A chronic inflammatory process involving the right kidney, with multiple staghorn calculi filling the pyelocaliceal system. Atrophy of the renal parenchyma and urothelial thickening; diffuse infiltration of the perirenal and periureteral fat planes as well as of the pararenal fascia.
There is a trans-diaphragmatic fistulous tract between the upper pole of the right kidney and the posteroinferior region of the right hemithorax, with intrapulmonary stones in the posterior segment of the right lower lobe. Areas of consolidation in the lower lobe of the right lung around the stones. There is a small ipsilateral pleural effusion.