Xanthogranulomatous Pyelonephritis as an Invasive Infiltrative Process: Case Report and Review of the Literature

INTRODUCTION: Xanthogranulomatous pyelonephritis is a rare inflammatory disease associated with chronic infection and obstruction and a typical pathological picture. CASE REPORT: A 63-year-old woman was referred to our outpatient clinic with complaints of general malaise, diffuse abdominal discomfort, weight loss and recurrent urinary tract infections. An abdominal mass could be palpated in the left flank. Laboratory investigations revealed anaemia, leucocytosis and leukocyturia. Imaging showed multiloculated retroperitoneal mass involving two upper thirds of the left kidney and a massive stone in the sinus of the left kidney. The patient was treated with an ‘en bloc’ resection of the left kidney, pancreas tail, spleen and colon transversum. On microscopy, the renal parenchyma showed atrophic with inflammation, necrosis and a widespread infiltration of lipid filled macrophages (xanthoma cells). DISCUSSION: The discussed case is a typical presentation of xanthogranulomatous pyelonephritis. The patient was treated by an extensive resection of the involved organs and recovered well.