Korean J Urol.  2006 Dec;47(12):1367-1370. 10.4111/kju.2006.47.12.1367.

Xanthogranulomatous Pyelonephritis in an Infant

• Lee HN
• Kim KH
• Ryu IW
• Han MC
• Chung WS

• KMID: 2139785
• DOI: http://doi.org/10.4111/kju.2006.47.12.1367

Abstract

Xanthogranulomatous pyelonephritis (XGP) is an uncommon, severe, chronic infection of the kidney, which results in the normal renal parenchyma being replaced by characteristic lipid-laden macrophages (foam cells). It can occur at any age, but is extremely rare in children. Herein, the case of a 6-month-3-week-old girl with XGP, pre-operatively diagnosed with a Wilms' tumor, is reported. This is the youngest age of any patient with such a condition reported in the Korean literatures. Excretory urography, abdominal sonogram, computed tomogram and magnetic resonance imaging revealed a right renal round mass, without any calcifications. Her pathological findings after a radical nephrectomy revealed XGP.

Keyword

Xanthogranulomatous pyelonephritis; Infant

MeSH Terms

Child
Female
Humans
Infant*
Kidney
Macrophages
Magnetic Resonance Imaging
Nephrectomy
Pyelonephritis, Xanthogranulomatous*
Urography
Wilms Tumor

Figure

• 

  Fig. 1 Radiological findings. (A) Ultrasonography of the abdomen shows a well demarcated heterogeneous echogenic lesion with a thin echogenic rim in the middle portion of the slightly enlarged right kidney. (B) Postcontrast enhancement of abdominal computerized tomography demonstrates a well demarcated, round soft tissue density mass at the upper pole of the right kidney. (C) T1-weighted image, coronal section of a magnetic resonance image shows a heterogeneous, diffuse enhancement and irregularly shaped low signal intensity mass at the anterior aspect of the middle portion of the right kidney.

• 

  Fig. 2 Microscopic findings of the specimen reveal extensive pyelonephritis, granulomas, atrophied glomerulus and tubules, and lipid-laden macrophages (foam cells) (black arrow) and plasma cells (white arrow) (H&E, ×200).

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