1994 Volume 55 Issue 2 Pages 472-476
We experienced a rare case of xanthogranulomatous pyelonephritis of abscess type which was difficult to differentiate from renal cell carcinoma. A 48-year-old woman was admitted to the hospital because of fever and lumbago on September 27 1988. From September 25 she had a high fever over 38°C which did not respond to oral antipyretics, and lumbago also occurred. White blood cell count was 10/vision. The patient was diagnosed as pyelonephritis. Abdominal US and CT revealed a mass in the upper pole of the right kidney, measured 4-5cm in diameter, which was irregular in the surface and was relatively isoechoic and isodensity in the inner mass. Renal angiography demonstrated a hypovascular area in the same pole. Right nephrectomy with regional lymph node dissection was performed under a tentative diagnosis of right renal cell carcinoma. The excised specimen macroscopically demonstrated a yellowish mass in the same pole which measured about 5cm in diameter, and microscopically revealed multiple microabscess and epithelioid cell granuloma. The patient was diagnosed as xanthogranulomatous pyelonephritis of abscess type. The patient has been enjoying a disease-free daily life, as of 4 years after the operation.
