Coexistence xanthogranulomatous pyelonephritis with renal replacement lipomatosis. Computed tomography. Сlinical case

Abstract

Xanthogranulomatous pyelonephritis is a relatively rare form of chronic pyelonephritis. It is characterized by combination of destructive and proliferative processes with proliferation in the kidney of granulomatous tissue with a large number of lipid-containing macrophages, which are called xanthomous or "foamy" cells. Replacement kidney lipomatosis is also a rare disease that is characterized by proliferation of adipose tissue of the kidney sinus and perirenal adipose tissue with pronounced atrophy of the renal parenchyma. This is the result of renal atrophy, chronic inflammation, nephrolithiasis or long-term current hydronephrosis with the proliferation of adipose tissue in the renal sinus and paranephric fiber. The article presents a case of combining the above-mentioned pathological processes in a patient of the 93-ies. According to clinical manifestations and examination data, xanthogranulomatous pyelonephritis can occur under the guise of pionephrosis, carbuncle, abscess. Deservedly this disease is called "great imitator", because today there are no clear diagnostic criteria, and the diagnosis is established, as a rule, in the postoperative period.