Weight loss, fever, dull pain in the right flank and back.
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CT scan demonstrates low density rounded parenchymal collections throughout the right kidney with a central large (presumably staghorn) calculus. Appearances are characteristic of xanthogranulomatous pyelonephritis and the appearance of the kidney has been likened to that of a bear's paw.
Also note the enlarged inflammatory periaortal and pericaval lymph nodes.