Coexistence xanthogranulomatous pyelonephritis with renal replacement lipomatosis. Computed tomography. Сlinical case
https://doi.org/10.24835/1607-0763-2018-5-65-72
Abstract
Xanthogranulomatous pyelonephritis is a relatively rare form of chronic pyelonephritis. It is characterized by combination of destructive and proliferative processes with proliferation in the kidney of granulomatous tissue with a large number of lipid-containing macrophages, which are called xanthomous or "foamy" cells. Replacement kidney lipomatosis is also a rare disease that is characterized by proliferation of adipose tissue of the kidney sinus and perirenal adipose tissue with pronounced atrophy of the renal parenchyma. This is the result of renal atrophy, chronic inflammation, nephrolithiasis or long-term current hydronephrosis with the proliferation of adipose tissue in the renal sinus and paranephric fiber. The article presents a case of combining the above-mentioned pathological processes in a patient of the 93-ies. According to clinical manifestations and examination data, xanthogranulomatous pyelonephritis can occur under the guise of pionephrosis, carbuncle, abscess. Deservedly this disease is called "great imitator", because today there are no clear diagnostic criteria, and the diagnosis is established, as a rule, in the postoperative period.
About the Authors
Yu. A. Abovich
Pirogov Russian National Research Medical University
Russian Federation
cand. of med. sci., Associate Professor of Department of radiation diagnostics and therapy
Russian Federation
cand. of med. sci., Associate Professor of Department of radiation diagnostics and therapy
O. A. Afukova
Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
cand. of med. sci., Associate Professor of Department of radiation diagnostics and therapy
117321 Moscow, Ostrovityanova str., 1
+7-905-545-19-88.
A. L. Yudin
Pirogov Russian National Research Medical University, Head of Radiology department,
Central Clinical Hospital Russian
Russian Federation
Russian Federation
doct. of med. sci., Professor, Head of Radiology department
radiologist
References
1. Aliaev Iu.G., Grigorev N.A., Ganzen T.N. Xanthogranulomatous pyelonephritis. M.: Medicina, 2000. 128 p. (In Russian)
2. Aliaev Iu.G., Grigorev N.A. Xanthogranulomatous pyelonephritis: modern view of the problem. Vrach. 2009; 4: 8–12. (In Russian)
3. Neimark A.I., Pavlovskaia Z.A.Our experience of diagnostics and treatment of patients with xanthogranulomatous pyelonephritis. Kazan medical magazine. 2008; 89 (4): 472–475. (In Russian)
4. Sawazaki H., Araki D., Miyata K., Ito K. Massive Renal Replacement Lipomatosis With Foci of Xantho granulomatous Pyelonephritis in a Horseshoe Kidney. Urology Case Reports. 2017; 13: 45–47. DOI: 10.1016/j.eucr.2016.10.014.
5. Ambos M.A., Bosniak M.A., Gordon R., Madayag M.A. Replacement lipomatosis of the kidney. Am. J. Roentgenol. 1978; 130: 1087–1091. DOI: 10.2214/ajr.130.6.1087.
6. Bruno Van Vlem, Jean-Marie Billiouw. Xantho granulomatous рyelonephritis. N. Engl. J. Med. 2000; 342:1572. DOI: 10.1056/NEJM200005253422105.
7. D'ippolito G., Tokechi D., Shigueoka D.C., Ajzen S. Tomographic aspects of xanthogranulomatous pyelonephritis and related complications. Sao Paulo Medical J. RPM. 1996; 114 (1): 1091–1096. DOI: 10.1590/S1516-3180199600010000.
8. Tanuj M., Hetal P., Dattu V., Kunjan S., Viral P. Renal replacement lipomatosis “too much fat at wrong place”. Global J. Res. Analysis. 2015; 4 (4): 1–2. DOI: 10.15373/22778160.
9. Sanjib Kumar Das. A rare case of incidentally detected renal replacement lipomatosis. Imaging Med. 2017; 9 (4): 77–79.
10. Kim J. Ch. US and CT findings of xanthogranulo matous pyelonephritis. Clin. Imaging. 2001; 25 (2): 118–121. DOI: 10.1016/S0899-7071(01)00262-5.
11. Rajesh A., Jakanani G., Mayer N., Mulcahy K. Computed Tomography Findings in Xanthogranulomatous Pyelonephritis. J. Clin. Imaging Sci. 2011; 1: 45. DOI: 0.4103/2156-7514.84323.
12. Loffroy R., Guiu B., Watfa J. et al. Xanthogranulomatous pyelonephritis in adults: clinical and radiological findings in diffuse and focal forms. Clin. Radiol. 2007; 62 (9): 884–890. DOI: 10.1016/j.crad.2007.04.008.
13. Guy Aristide B., Eric Patrick S., Agnes E., Daniel H.E., Bernadette N.N. Xanthogranulomatous Pyelonephritis with Spontaneous Nephrocutaneous Fistula. JSM Clin. Case Rep. 2016; 4 (2): 1099. DOI: 10.4111/kju.2008.49.12.1158.
14. Luca Apicella, Gianfranco Vallone, Sossio Vitale, Gianluca Garofalo, Luig Russo, Riccardo Gallo, Stefano Federico, Massimo Sabbatini. Renal sinus lipomatosis in transplanted kidneys: an unusual clinical case. Case Rep. Transplant. 2011, Article ID 161759, 3 p. DOI: 10.1155/2011/161759.
15. Kullendorff B., Nyman U., Aspelin P. Computed tomography in renal replacement lipomatosis. Acta Radiol. 1987; 8 (4): 447–450. DOI: 10.3109/02841858709177379.
16. Sakata Y.1., Kinoshita N., Kato H., Yamada Y., Sugimura Y. Coexistence of renal replacement lipomatosis with xanthogranulomatous pyelonephritis. Int. J. Urol. 2004; 11 (1): 44–46.
17. Khan M., Nazir S.S., Ahangar S., Farooq Qadri S.J., Salroo N.A. Total renal replacement lipomatosis. Int. J. Surg. 2010; 8: 263–265. DOI: 10.1016/j.ijsu.2010.02.009.
Review
For citations:
Abovich Yu.A., Afukova O.A., Yudin A.L. Coexistence xanthogranulomatous pyelonephritis with renal replacement lipomatosis. Computed tomography. Сlinical case. Medical Visualization. 2018;(5):65-72. (In Russ.) https://doi.org/10.24835/1607-0763-2018-5-65-72
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