Pyelonephritis Xanthogranulomatosa: A Case Report

Abstract

Pyelonephritis xanthogranulomatosa is a rare form of pyelonephritis chronica. The anamnesis includes recidivating urinary tract infections. The xanthogranulomatic reaction is caused both by an obstructive element and by an unknown predisposing factor. The diagnosis can be made only on the basis of the histological picture which, in addition to pyelonephritic changes, shows xanthogranules with lipid-containing “foam-cells” multinucleated giant cells, lymphocytes and plasma cells. The preoperative diagnosis is often pyonephrosis or malignant kidney disease. Only one of the kidneys is affected but this kidney, on the other hand, can be completely transformed and infiltrate the adjacent organs. In most cases, the treatment has been nephrectomy and the prognosis has been good. It is important to make the diagnosis to avoid unnecessary radical surgery and inaccurate and hopeless prognoses.