Singh Manpreet, Ethiraj Dillibabu, Indiran Venkatraman, Kanase Niranjan Dhanaji, Maduraimuthu Prabakaran
Sree Balaji Medical College and Hospital, Department of Radio-diagnosis, Chennai, Tamilnadu, India.
Autops Case Rep. 2020 Dec 8;11:e2020200. doi: 10.4322/acr.2020.200. eCollection 2021.
Xanthogranulomatous pyelonephritis (XGP) is a rare variant of chronic pyelonephritis. It is characterized by progressive parenchymal destruction caused by chronic renal obstruction due to calculus, stricture, or rarely tumor, resulting in kidney function loss. Herein, we describe the case of a 36-year-old female who presented with left loin pain, left lower limb pain, and dysuria. On contrast-enhanced computed tomography (CECT), multiple abscesses and an obstructive staghorn calculus were depicted in the left kidney with the classical appearance of "Bear Paw Sign." An abscess with calculi was also present within the left psoas muscle. Though psoas muscle abscess in association with XGP was described, a ureteric fistula and calculi within the psoas muscle have not yet been reported in the literature. Left nephrostomy was performed, which came out to be positive for on culture. The patient underwent left nephrectomy, and the histopathological report of the surgical specimen confirmed XGP.
黄色肉芽肿性肾盂肾炎（XGP）是慢性肾盂肾炎的一种罕见变异型。其特征是由于结石、狭窄或极少情况下肿瘤导致的慢性肾梗阻引起渐进性实质破坏，进而导致肾功能丧失。在此，我们描述了一名36岁女性的病例，她表现为左腰部疼痛、左下肢疼痛和排尿困难。在对比增强计算机断层扫描（CECT）上，左肾显示出多个脓肿和一个阻塞性鹿角形结石，具有典型的“熊掌征”表现。左腰大肌内也存在一个伴有结石的脓肿。虽然有文献描述了与XGP相关的腰大肌脓肿，但腰大肌内的输尿管瘘和结石尚未见报道。进行了左肾造瘘术，培养结果呈阳性。患者接受了左肾切除术，手术标本的组织病理学报告证实为XGP。
