Zia-ul-Miraj M, Cheema M A
Department of Paediatric Urology, The Children's Hospital and The Institute of Child Health, Lahore, Pakistan.
J Pediatr Surg. 2000 Aug;35(8):1256-8. doi: 10.1053/jpsu.2000.8767.
The authors report on a 2-month-old boy presenting with a right renal mass. Investigations including ultrasound scan and computed tomogram were suggestive of a renal tumor. A right nephrectomy was performed with great difficulty because of dense adhesions to the adjacent structures. Cut section of the specimen showed the entire kidney to be replaced by cheesy-yellow areas. Histological examination was suggestive of xanthogranulomatous pyelonephritis. Although rare at this age, xanthogranulomatous pyelonephritis should be considered in the differential diagnosis of a renal mass in children. The lesion is unique among the inflammatory conditions in closely mimicking renal tumours clinically. A thorough histological examination also is suggested because the features can get confused easily with those of renal tumors.
作者报告了一名2个月大的男婴,其右侧肾脏出现肿块。包括超声扫描和计算机断层扫描在内的检查提示为肾肿瘤。由于与相邻结构紧密粘连,进行右侧肾切除术时遇到了很大困难。标本的切面显示整个肾脏被干酪样黄色区域取代。组织学检查提示为黄色肉芽肿性肾盂肾炎。尽管这种疾病在这个年龄段很罕见,但在儿童肾肿块的鉴别诊断中应考虑到黄色肉芽肿性肾盂肾炎。该病变在炎症性疾病中独一无二,在临床上与肾肿瘤极为相似。还建议进行全面的组织学检查,因为其特征很容易与肾肿瘤的特征混淆。