Xanthogranulomatous pyelonephritis

Case contributed by Michael P Hartung
Diagnosis almost certain

Presentation

Evaluate renal abnormality.

Patient Data

Gender: Female

Enlarged left kidney with dilated calyces filled with low-attenuation material and a few small calcifications. Central staghorn calculus. Perinephric fluid/stranding with a small collection along the anterior upper pole. Ureteral thickening leading into an ill defined area of soft tissue stranding in the pelvis adjacent to a large cystic pelvic mass.

Case Discussion

Typical appearance of XGP which was treated with nephrectomy. During surgery, there were dense inflammatory adhesions surrounding the kidney and ureter, resulting in a very challenging surgery. The distal ureteral thickening was related to chronic inflammation and infection (and not the pelvic cyst).

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