Diffuse xanthogranulomatous pyelonephritis: clinical, anatomicopathological and therapeutic aspects. Concerning nine cases and a review of the literature

Diffuse xanthogranulomatous pyelonephritis is a rare chronic pyelonephritis . This study permitted us to notice the various histological, clinical, rad iological, and the different means diagnoses of this affection. Retrospecti vely series of nine patients is reported. The median age was 43 years. The commonest clinical presentation was urinary tract infection, and lumbar pai n. Urine culture identified a bacteria in seven cases (77%). Intravenous ur ography recovers silent kidney (five cases), hydronephrosis (two cases), ch ronic pyelonephritis (one case) and renal stones in six cases (67%). Treatm ent consisted of nephrectomy. No specific biological or radiological signs of this affection can be identifying this lesion in preoperative. The diagn osis was revealed by the histological examination of the removed kidney. Th e outcome is favorable after a follow-up of six months to four years. The c linical features of the pyelonephritis xanthogranulomatous is not specific. Magnetic resonance imaging can give a specificity to this affection. Only histological examination is able to established the definitive diagnosis. ( C) 2001 Editions scientifiques et medicales Elsevier SAS.