Fujii A, Kuwayama M, Tomioka O, Yamamoto M, Nakatsuka E
Department of Urology, Himeji Red Cross Hospital.
Hinyokika Kiyo. 1992 Jan;38(1):43-6.
Xanthogranulomatous pyelonephritis (XGP) is an uncommon form of granulomatous inflammation characterized by destruction and replacement of the renal parenchyma by masses of lipid-laden macrophages. We report the first case of the pyonephrotic type of XGP in which Magnetic resonance imaging (MRI) was used in Japan, and summarize the clinical characteristics of 163 cases with XGP in the Japanese literature for age, sex, laboratory data, preoperative diagnosis and operation. A 56-year-old female was admitted with left flank pain. Left nephrectomy was performed following diagnosis of XGP by computed tomography (CT) and MRI. Histopathological findings confirmed the diagnosis of XGP. Furthermore, we evaluated the MR images in XGP. MR images correlated well with the CT images showing an enlarged multiloculated kidney. The internal portion of the loculated areas were of intermediate intensity on T1-weighted images, and became very intense on the T2-weighted sequences, indicating a long T2. MRI appears to be of value in the investigation of renal mass lesions.
黄色肉芽肿性肾盂肾炎(XGP)是一种罕见的肉芽肿性炎症,其特征是肾实质被大量充满脂质的巨噬细胞破坏并替代。我们报告了日本首例使用磁共振成像(MRI)诊断的脓性XGP病例,并总结了日本文献中163例XGP患者的年龄、性别、实验室数据、术前诊断及手术等临床特征。一名56岁女性因左侧腰痛入院。经计算机断层扫描(CT)和MRI诊断为XGP后,行左肾切除术。组织病理学检查结果证实了XGP的诊断。此外,我们评估了XGP的MR图像。MR图像与CT图像相关性良好,显示肾脏增大且呈多房性。多房区域内部在T1加权图像上呈中等强度,在T2加权序列上变得非常亮,提示T2弛豫时间延长。MRI在肾脏肿块病变的检查中似乎具有重要价值。