History: 50 yo female with flank pain and fever.
Solution: Xanthogranulomatous pyelonephritis.
XGP is a chronic infection of the kidney and surrounding tissues, which is generally associated with a staghorn calculus, and characterized by replacement of the parenchyma by lipid laden macrophages. Usually presents with dull or persistent flank pain, variable fever, and often weight loss. It is generally unilateral and diffuse, although it can be bilateral and focal.
Should also consider RCC, TCC, renal abscess, metastases, and lymphoma in the differential as well. This case is an advanced case with extensive fibrofatty infiltration with a nearly absent nephrogram with no significant excretion.
XGP is a chronic infection of the kidney and surrounding tissues, which is generally associated with a staghorn calculus, and characterized by replacement of the parenchyma by lipid laden macrophages. Usually presents with dull or persistent flank pain, variable fever, and often weight loss. It is generally unilateral and diffuse, although it can be bilateral and focal.
Should also consider RCC, TCC, renal abscess, metastases, and lymphoma in the differential as well. This case is an advanced case with extensive fibrofatty infiltration with a nearly absent nephrogram with no significant excretion.
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