Diffuse xanthogranulomatous pyelonephritis: Analysis by computed tomography and sonography

Abstract

The sonographic and computed tomographic findings in 3 cases of diffuse xanthogranulomatous pyelonephritis are presented along with correlation with the pathological specimens. The combination of the findings in sonography and computed tomography in this condition enables one to make an accurate preoperative diagnosis. Calyces containing pus and/or xanthomatous tissue produced low-level echoes simulating preservation or thickening of the renal parenchyma on sonography. On CT the central low attenuation areas either gave negative values representing abundant xanthomatous tissue seen on gross pathology, or measured in the water density range representing a combination of pus and less abundant xanthomatous tissue.

Role of ultrasound and CT scan in evaluation of Renal Masses

“…The age range of patients was between 36 years to 80 years, with 50% of the cases seen in the age group of 51 to 60 yrs. This age relation has also been observed by Subramanayam & Bosniak 24 .…”

Xanthogranulomatous Pyelonephritis: Clinical Experience with 62 Cases

“…CT scan, seldom used so far [29,32], reveals multiple low-attenuation ares (-15, +10 HU) surrounding renal stones, mixed with higher density sections. The lowattenuation areas are due to lipid-rich xanthogranuloma tous tissue and calyces filled with pus.…”

Laparoscopic and Open Surgical Nephrectomy for Xanthogranulomatous Pyelonephritis

“…6 Specifically, low-attenuation lesions, between 10 and 15 HU, with little or no contrast uptake, will likely be noted. 7 Not uncommonly, these low-attenuation regions will border significant collecting-system dilation or normal, but compressed, functioning renal parenchyma. The extent of XGP can be well determined with CT scanning; involvement in the retroperitoneum, contiguous organs, and extension into Gerota's fascia can all be defined.…”