Xanthogranulomatous pyelonephritis: gross pathology and histology

Case contributed by A.Prof Frank Gaillard


Case Discussion

Xanthogranulomatous pyelonephritis in a 36 year old female

Gross: The specimen is received in OR and consistent with a resected kidney with abundent perirenal adipose tissue. The kidney is bivalved during intraoperative surgical pathology gross consultation. The dilated renal pelvis is filled with a large amount of pus material. The pus is sampled for culture. After washing the specimen, the walls of dilated calyces and renal pelvis are thickened with multiple yellow nodules. The renal cortex is largely atrophic.

Micro: Sections through the yellow nodules show replacement of renal parenchyma with foamy histiocytes, occasional multinucleated giant cells, and inflammatory cells. The inflammatory cells are composed of lymphocytes, plasma cells, and neutrophils. Lymphoid aggregates are also noted. A few renal tubules are filled with cellular debris and possible bacterial clumps.

Author: Jian-Hua Qiao, MD, FCAP, Los Angeles, CA, USA.

Original file: PathXchange.org case here

Modifications: square crop

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Case information

rID: 9949
Case created: 2nd Jun 2010
Last edited: 11th Sep 2016
System: Urogenital
Inclusion in quiz mode: Included

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