M. Zieger (Radiologisches Institut Olgahospital Stuttgart Deutschland)  

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3 Years  

Male  

Abdomen-Renals  

inflammatory or infectious  

3.5 year old boy, "never been sick until now".
Feels fatigued for the last few weeks with leg and abdominal pain. Oral antibiotic therapy without success. Urine after urinary catheterization sterile.  

The etiology is uncler, but chronic obstructions with infections are commonly seen. Calcifications are seen in 80% of the patients. Xanthogranulomatous pyelonephritis is often associated with diabetes or immunocomprimised patients, maybe even fatty acid metabolic disorders.
Pathology:
Localized tissue destruction, circumducted infiltration is possible. The process holds yellowish tissiue with necroses and hemorrhages.
Microscopically, there are spongy, fat-laden macrophages and chronic and acute inflammatory responses at the same time.  

<- view Ultrasound 1

Ultrasound 1: Nephromegaly, Calcifications with acoustic shadowing, calyectasia, lymphnodes in the renal hilus. The renal configuration is normal, but there are abscess-like lesions (nephromegaly in papillary region, the renal cortex is maintained).



<- view Ultrasound 2

Ultrasound 2: Renal hilus transversal:
enlarged lymphnodes



<- view Ultrasound 3

Ultrasound 3: Overview kidney:
Nephromegaly, Calcifications with acoustic shadowing, calyectasia, lymph nodes in the renal hilus. The renal configuration is normal, but there are abscess-like lesions (in papillary region, the renal cortex is maintained).




<- view Ultrasound 4

Ultrasound 4: Detailed image of the parenchymal structure





<- view OP-Situs 1

OP-Situs 1: Renal situs opened longitudinal

 

Surgery / Histo  

Tumor  

Surgery: Nephrectomy  

N/A  

1916 by Schlagenhaufer
“Über eigentümliche Staphylmykosen der Nieren und des pararenalen Bindegewebes” 1916; 19: 139-48 Frankfurt Z Pathol  

N/A  

Kidney, Kidneys, Xanthogranuloma , Pyelonephritis, xanthogranulomatous Pyelonephritis, inflammation of the Kidney , child, childhood, pediatric radiology  

M Zieger. Xanthogranulomatous Pyelonephritis. PedRad [serial online] vol 5, no. 10.
URL: www.PedRad.info/?search=20051005175954