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Ultrasound
Diagnosis
Urinary Tract
Urinary Tract Infection
Xanthogranulomatous Pyelonephritis
Xanthogranulomatous Pyelonephritis
Katherine E. Maturen, MD, MS
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KEY FACTS
Terminology
Imaging
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
Xanthogranulomatous pyelonephritis (XGP/XGPN)
Definitions
Chronic renal inflammation usually associated with longstanding urinary calculus obstruction (75%)
Renal parenchyma is gradually replaced by lipid-laden macrophages
Greek prefix "xantho-" refers to yellow color of fat
Diffuse (> 80%) and focal (< 20%) forms
Diffuse: Due to obstruction at ureteropelvic junction
Focal or segmental: Due to obstruction of single infundibulum or 1 moiety of duplex system
3 stages of XGP: Intrarenal → perirenal → perinephric ± retroperitoneal involvement
IMAGING
General Features
Ultrasonographic Findings
CT Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Ifergan J et al: Imaging in upper urinary tract infections. Diagn Interv Imaging. 93(6):509-19, 2012
Arvind NK et al: Laparoscopic nephrectomy in xanthogranulomatous pyelonephritis: 7-year single-surgeon outcome. Urology. 78(4):797-801, 2011
Li L et al: Xanthogranulomatous pyelonephritis. Arch Pathol Lab Med. 135(5):671-4, 2011
Kim JC: US and CT findings of xanthogranulomatous pyelonephritis. Clin Imaging. 25(2):118-21, 2001
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
Xanthogranulomatous pyelonephritis (XGP/XGPN)
Definitions
Chronic renal inflammation usually associated with longstanding urinary calculus obstruction (75%)
Renal parenchyma is gradually replaced by lipid-laden macrophages
Greek prefix "xantho-" refers to yellow color of fat
Diffuse (> 80%) and focal (< 20%) forms
Diffuse: Due to obstruction at ureteropelvic junction
Focal or segmental: Due to obstruction of single infundibulum or 1 moiety of duplex system
3 stages of XGP: Intrarenal → perirenal → perinephric ± retroperitoneal involvement
IMAGING
General Features
Ultrasonographic Findings
CT Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Ifergan J et al: Imaging in upper urinary tract infections. Diagn Interv Imaging. 93(6):509-19, 2012
Arvind NK et al: Laparoscopic nephrectomy in xanthogranulomatous pyelonephritis: 7-year single-surgeon outcome. Urology. 78(4):797-801, 2011
Li L et al: Xanthogranulomatous pyelonephritis. Arch Pathol Lab Med. 135(5):671-4, 2011
Kim JC: US and CT findings of xanthogranulomatous pyelonephritis. Clin Imaging. 25(2):118-21, 2001
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