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XANTHOGRANULOMATOUS PYELONEPHRITIS
Author(s) -
MØLLER JENS CHR.,
KRISTENSEN INGRID B.
Publication year - 1980
Publication title -
acta pathologica microbiologica scandinavica section a pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 88
eISSN - 1600-0463
pISSN - 0365-4184
DOI - 10.1111/j.1699-0463.1980.tb02471.x
Subject(s) - pathology , medicine , pathogenesis , excretory system , urinary tract obstruction , fibrosis , lipofuscin , urinary system , anatomy
Nineteen cases of xanthogranulomatous pyelonephritis (XP) were studied. There was a close relation to pyonephrosis, and urinary tract obstruction was present in all cases but one which represented the tumorous variety of XP. The degree of xanthogranulomatous involvement was correlated to the severity of the acute inflammatory affection as evidenced by the clinical findings and the urographical excretory function. The topography of the xanthogranulomas was related to the level of urinary tract obstruction in accordance with the pattern of reaction common to obstructive pyelonephritis. Haemorrhage and considerable fibrous thickening and stenosis of arteries surrounding the xanthogranulomatous foci were conspicious features. Based upon a morphological staging it was shown that the structural changes (towards fibrosis) were parallelled by a series of cellular events indicating removal of intracellular lipids in xanthoma cells by transformation to lipofuscin and transport in PAS‐positive interstitial macrophages. This was comparable to the findings in experimental XP suggesting a similar and simple way of pathogenesis. It is concluded that XP — with the possible exception of the tumorous variety — can be ascribed to local resorption phenomena caused by concurrent factors usually involved in pyelonephritis, urinary tract obstruction being the essential precondition, focal haemorrhage and ischaemia contributary elements.