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.
C. Aurégan, L. Berteloot, S. Pierrepont and G. Chéron (2015) Pyélonéphrite xanthogranulomateuse et pyonéphrose chez un enfant de 4 ans. Archives de Pédiatrie22(3):287. doi: 10.1016/j.arcped.2014.11.012
Bardia Moosavi, Najla Fasih, Vivek Virmani and Ania Kielar (2016) Beyond ureterolithiasis: gamut of abnormalities affecting the ureter. Clinical Imaging40(4):678. doi: 10.1016/j.clinimag.2016.01.003
Humera M. Chaudhary, Anthony Abou Karam and Jesus Edmundo Calleros-Macias (2016) Everyday Practice. Contemporary Diagnostic Radiology39(19):1. doi: 10.1097/01.CDR.0000494659.65244.f7
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 Urol18(1):. doi: 10.1186/s12894-018-0354-3
Tomoya Tsukada, Tatsuo Nakano, Takashi Miyata, Shozo Sasaki and Kotaro Higashi (2012) Xanthogranulomatous gastritis mimicking malignant GIST on F-18 FDG PET. Ann Nucl Med26(9):752. doi: 10.1007/s12149-012-0621-4
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 Med88(5):587. doi: 10.3904/kjm.2015.88.5.587
Kunal Kothari and John J. Hines (2018) CT Imaging of Emergent Renal Conditions. Seminars in Ultrasound, CT and MRI39(2):129. doi: 10.1053/j.sult.2017.11.003
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 & Lung41(6):606. doi: 10.1016/j.hrtlng.2012.03.008
Massimo Tonolini (2018) Imaging and Intervention in Urinary Tract Infections and Urosepsis. (Chapter 10):99. doi: 10.1007/978-3-319-68276-1_10
Tze M Wah (2013) Unenhanced CT in the evaluation of renal/ureteric colic. Imaging in Medicine5(4):371. doi: 10.2217/iim.13.27
V. Said Conti, C. Azzopardi, C. Fearne and P. Cuckow (2014) Xanthogranulomatous pyelonephritis: the case of a perplexing kidney. Case Reports2014(sep19 2):bcr2014206172. doi: 10.1136/bcr-2014-206172
This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.