Cases reported "Perinephritis"

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1/2. Xanthogranulomatous pyelonephritis, perinephric type--a case report.

    A 46 year-old woman with perinephric type of xanthogranulomatous pyelonephritis is described. She had a fever and pain with a palpable mass in her right flank. The blood analysis revealed anemia, leucocytosis, gamma-globulinemia, but no hyperlipidemia. The urine analysis showed nothing abnormal, but enterobacter was present in the urine. An intravenous pyelogram demonstrated a right non-functioning kidney. The diagnosis of a perinephric abscess was made from the x-ray and ultrasonogram, and a right nephrectomy was performed. The resected kidney had a tumor-like lump covered with Gerota's fascia at the postero-lateral side of the kidney. The cut surface of the kidney revealed an area of hemorrhage, blood clotting, abscess and a brownish yellow area in the perinephric fat tissue. The calyx and pelvis were normal. Histologically, the brownish yellow area was a granuloma with foam cell infiltration. The foam cells contained lipids. The renal parenchyma showed a non-specific chronic pyelonephritis.
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2/2. Xanthogranulomatous perinephritis: unusual cause of renal vein and vena caval thrombosis.

    Xanthogranulomatous pyelonephritis is an uncommon form of chronic renal infection which can be confused clinically, radiographically, and pathologically with renal carcinoma. Occasionally, xanthogranulomatous changes are more prominent in perinephric tissue than in the renal parenchyma itself. We present a case of locally invasive xanthogranulomatous perinephritis associated with thrombosis of the renal vein and inferior vena cava. With this constellation of findings, infections as well as malignant etiologies should be considered in the differential diagnosis.
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