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Sonographic features of xanthogranulomatous pyelonephritis
Author(s) -
Tiu ChuiMei,
Chou YiHong,
Chiou HongJen,
Lo ChaoBao,
Yang JinYi,
Chen KwangKuo,
Hsu MingHui,
Wang JiaHwia,
Su YeouGyi,
Chang ChengYen,
Yu Chun
Publication year - 2001
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.1034
Subject(s) - medicine , hydronephrosis , obstructive uropathy , adipose capsule of kidney , radiology , parenchyma , pyonephrosis , biopsy , urology , nephrectomy , kidney , pathology , urinary system
Purpose The purpose of this study was to describe the various sonographic features of xanthogranulomatous pyelonephritis (XGP). Methods We retrospectively reviewed the CT, sonographic, and medical records of patients diagnosed with XGP from January 1981 to December 1998. Twenty‐seven patients for whom XGP was histopathologically confirmed were included in the study. There were 12 men and 15 women, with an age range of 21–86 years (mean, 57 years). All patients had undergone sonography of the kidneys. The renal size, shape, and outline were recorded. The presence of perinephric fluid accumulation, of obstructive uropathy, or of internal echoes in the dilated collecting system and the echotexture of the renal parenchyma were documented. Results We categorized the XGP into 4 groups on the basis of the sonographic features: (1) diffuse hydronephrotic, 12 patients (44%); (2) diffuse parenchymal, 9 patients (33%); (3) diffuse contracted, 4 patients (15%); and (4) segmental or focal, 2 patients (7%). A localized perinephric fluid collection was present in 4 patients (15%). The preoperative sonographic diagnoses were pyonephrosis ( n = 14, 52%), renal pelvic tumor with possible associated infection ( n = 5, 19%), renal parenchymal mass ( n = 2, 7%), hydronephrosis ( n = 2, 7%), and chronic pyelonephritis with renal atrophy ( n = 4, 15%). XGP was considered a possible diagnosis in only 11 patients (41%). Conclusions XGP has no specific sonographic features but is suggested by parenchymal thinning and hydronephrosis, sonographic signs of chronic obstructive uropathy caused by stones; echoes in the dilated collecting system; and a perinephric fluid collection. CT, needle biopsy, or both are recommended to further evaluate and confirm sonographically suspected XGP. © 2001 John Wiley & Sons, Inc. J Clin Ultrasound 29:279–285, 2001.