The aim of this study is to: · present an extremely rare condition in paediatrics - xanthogranulomatous pyelonephritis (XP) · illustrate its two variants · review possible imaging techniques used and their findings · suggest other diseases to differentiate XP with · encourage radiologists and clinicists to include XP in differential diagnosis.
or XP in short,
is a rare form of chronic renal infection ,
making up around 1% of all chronic pyelonephritis.
Even more so in paediatric population,
as patients with this disease are usually between 50 and 70 years old,
with women said to be affected up to 4 times more often. The core of XP are slow but progressive changes that include destruction of renal parenchyma ,
which is then replaced with lipid-filled macrophages .
It is believed to be a response...
Findings and procedure details
The process can affect whole kidney and extend to surrounding tissue,
which then is known as diffuse form XP . This type is the most common,
comprising up to 90% of cases ,
and at the same time boasts the most characteristic imaging findings: · Computed tomography: It is considered a gold-standard in imaging of XP.
At least 2-phase exam is performed with the use of intravenous contrast. First visible change is kidney enlargement,
with the shape staying intact.
Often a hydronephrosis-like...
· Despite its rarity,
xanthogranulomatous pyelonephritis needs to be taken into account in cases of children with renal masses. · Even though CT is the method of choice,
other techniques remain relevant,
with MRI having a similar diagnostic yield compared to tomography. · Cases of focal XP and atypical history require high awareness and are often diagnosed histopathologically after surgery.
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