Xanthogranulomatous pyelonephritis: Comparison of extent using computed tomography and magnetic resonance imaging in one case

Abstract

In a case of diffuse xanthogranulomatous pyelonephritis, computed tomography (CT) and magnetic resonance (MR) were used. The MR proved to be more precise in the preoperative evaluation of inflammatory extension to the spleen and into the abdominal wall. The CT was more accurate in excluding spread to the colon.

Xanthogranulomatous pyelonephritis: MRI findings in the diffuse and the focal type

“…The content of the ªlocularº spaces or cavities was hypointense on T1-weighted images and hyperintense on T2-weighted images in the cases presented, indicating a long T2. This too is in agreement with the descriptions in the literature [6,7,8,9,10,11,12]. Intracavitary fluid±fluid levels were observed on T2-weighted images in both cases, the upper part being hyperintense and the dependent part more hypointense.…”

“…The signal intensity on T2-weighted images was isointense in both cases, compared with the contralateral (normal) kidney, in agreement with the current literature on MR imaging of XGP [6,7,8,9,10,11,12]. The content of the ªlocularº spaces or cavities was hypointense on T1-weighted images and hyperintense on T2-weighted images in the cases presented, indicating a long T2.…”

“…In the reports of Jöerg et al [8] and Laugareil et al [9] this hyperintensity was nearly equal to that of intra-abdominal fat. Other authors report a more isointense appearance of the solid component on T1-weighted images, as in the second case [6,10,11,12]. It is probable that the signal intensity of the solid component of XGP on T1-weighted images depends on the amount of xanthoma cells involved in the granulomatous process.…”

Xanthogranulomatous Pyelonephritis Associated with Renal Cell Carcinoma

“…With mag netic resonance imaging, infiltration of the inflammatory tumor into adjacent tissue structures (colon, spleen, psoas, abdominal wall) can be demonstrated very well [22].…”

“…The angiographic findings in XGP show vessels stretched around a hypovascular or avascular tumor, sometimes pathological vessels, but rarely with AV shunts [2], In most cases these masses cannot be distinguished with complete certainty from renal cell car cinoma [11,22].…”