Chaudhary Ranjit, Singh Kulwant, Jain Nidhi, Biswas Rakesh
People's College of Medical Sciences, Bhopal, India.
BMJ Case Rep. 2011 Oct 4;2011:bcr0820114646. doi: 10.1136/bcr.08.2011.4646.
Xanthogranulomatous pyelonephritis (XGP) is a rare, serious, debilitating illness characterised by an infectious renal phlegmon. Most cases of XGP are unilateral and are often associated with urinary tract obstruction, infection, nephrolithiasis, diabetes, and/or immune compromise. This disease process ultimately results in focal or diffuse renal destruction and is characterised pathologically by lipid-laden foamy macrophages. XGP occurs in approximately 1% of all renal infections. The kidney is usually non-functional. XGP displays neoplasm like properties capable of local tissue invasion and destruction and has been referred to as a pseudotumour. Adjacent organs including the spleen, pancreas or duodenum may be involved. The gross appearance of XGP is a mass of yellow tissue with regional necrosis and haemorrhage, superficially resembling renal cell carcinoma. Renal cell carcinoma may be indistinguishable from XGP radiographically and clinically. The treatment of XGP is almost universally extirpative and can pose a formidable challenge to the surgeon.
黄色肉芽肿性肾盂肾炎（XGP）是一种罕见、严重且使人衰弱的疾病，其特征为感染性肾蜂窝织炎。大多数XGP病例为单侧，常与尿路梗阻、感染、肾结石、糖尿病和/或免疫功能低下相关。该疾病进程最终会导致局灶性或弥漫性肾破坏，病理特征为充满脂质的泡沫巨噬细胞。XGP约占所有肾脏感染病例的1%。肾脏通常失去功能。XGP具有类似肿瘤的特性，能够局部侵犯和破坏组织，因此被称为假肿瘤。包括脾脏、胰腺或十二指肠在内的邻近器官可能会受累。XGP的大体表现为一团黄色组织，伴有局部坏死和出血，表面类似肾细胞癌。肾细胞癌在影像学和临床上可能与XGP难以区分。XGP的治疗几乎都采取切除手术，这对外科医生来说可能是一项巨大的挑战。
