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Original research article

Computed tomography findings in xanthogranulomatous pyelonephritis

Arumugam RajeshGeorge JakananiNick MayerKevin Mulcahy
Departments of Clinical Radiology and Pathology, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, United Kingdom
Date of Submission: 15-Jun-2011, Date of Acceptance: 31-Jul-2011, Date of Web Publication: 27-Aug-2011.
Corresponding Author:
Corresponding Author

Arumugam Rajesh

E-mail: arajesh27@hotmail.com

Corresponding Author:
Corresponding Author

Arumugam Rajesh

E-mail: arajesh27@hotmail.com

DOI: 10.4103/2156-7514.84323 Facebook Twitter Google Linkedin


Background: Xanthogranulomatous pyelonephritis (XGN) is an uncommon condition characterized by chronic suppurative renal inflammation that leads to progressive parenchymal destruction. Purpose: To review the computed tomography (CT) findings of patients diagnosed with XGN.
Materials and Methods: A retrospective review of CT findings in patients with histologically proven XGN was carried out.
Results: Thirteen CT examinations of 11 patients were analyzed. Renal enlargement was demonstrable on the affected side in all patients. Nine patients (82%) had multiple dilated calyces and abnormal parenchyma. Six patients (55%) had a renal pelvis or upper ureteric calculus causing obstruction. Three patients (27%) had focal fat deposits identifiable within the inflamed renal parenchyma. Two patients had renal abscesses. Ten patients (91%) had extrarenal extension of the inflammatory changes. Three patients (27%) demonstrated extensive retroperitoneal inflammation.
Conclusion: Unilateral renal enlargement and inflammation were the most consistent findings of XGN on CT. Perinephric inflammation and collections or abscess should also alert the radiologist to the possibility of this diagnosis.
Keywords: Xanthogranulomatous Pyelonephritis, Computed Tomography, Perinephric Inflammation

Cited in 11 Documents

  1. C. Aurégan, L. Berteloot, S. Pierrepont and G. Chéron (2015) Pyélonéphrite xanthogranulomateuse et pyonéphrose chez un enfant de 4 ans. Archives de Pédiatrie 22(3):287. doi: 10.1016/j.arcped.2014.11.012
  2. Bardia Moosavi, Najla Fasih, Vivek Virmani and Ania Kielar (2016) Beyond ureterolithiasis: gamut of abnormalities affecting the ureter. Clinical Imaging 40(4):678. doi: 10.1016/j.clinimag.2016.01.003
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  4. William Keith Ballentine, Fernandino Vilson, Raymond B Dyer and Majid Mirzazadeh (2018) Nephron-sparing management of Xanthogranulomatous pyelonephritis presenting as spontaneous renal hemorrhage: a case report and literature review. BMC Urol 18(1):. doi: 10.1186/s12894-018-0354-3
  5. Tomoya Tsukada, Tatsuo Nakano, Takashi Miyata, Shozo Sasaki and Kotaro Higashi (2012) Xanthogranulomatous gastritis mimicking malignant GIST on F-18 FDG PET. Ann Nucl Med 26(9):752. doi: 10.1007/s12149-012-0621-4
  6. Young Wook Kim, Young Sun Kim, Eun Young Ji, Jung Hoon Kim, Sun-Young Jun, Seok Joon Shin and Hye Eun Yoon (2015) A Case of Metastatic Papillary Renal Cell Carcinoma Mimicking a Renal Abscess. Korean J Med 88(5):587. doi: 10.3904/kjm.2015.88.5.587
  7. Kunal Kothari and John J. Hines (2018) CT Imaging of Emergent Renal Conditions. Seminars in Ultrasound, CT and MRI 39(2):129. doi: 10.1053/j.sult.2017.11.003
  8. Joseph Chandrankunnel, Burke A. Cunha, Andrew Petelin and Douglas Katz (2012) Fever of unknown origin (FUO) and a renal mass: Renal cell carcinoma, renal tuberculosis, renal malakoplakia, or xanthogranulomatous pyelonephritis?. Heart & Lung 41(6):606. doi: 10.1016/j.hrtlng.2012.03.008
  9. Massimo Tonolini (2018) Imaging and Intervention in Urinary Tract Infections and Urosepsis. (Chapter 10):99. doi: 10.1007/978-3-319-68276-1_10
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  11. V. Said Conti, C. Azzopardi, C. Fearne and P. Cuckow (2014) Xanthogranulomatous pyelonephritis: the case of a perplexing kidney. Case Reports 2014(sep19 2):bcr2014206172. doi: 10.1136/bcr-2014-206172

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