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1、Xanthogranulomatouspyelonephritis黄色肉芽肿性肾盂肾炎IntroductionXanthogranulomatouspyelonephritis(XGP)isanunusualformofchronicpyelonephritisinwhichtherenalparenchyma（肾实质）isdestroyedandreplacedbylipid-ladenfoamymacrophages（充满脂质的巨噬细胞）.Itisalmostalwaysunilateral(单侧）.Itoccursin1%ofallrenalinfecti
2、ons.XGPis4timesmorecommoninfemalesthaninmenandisusuallynotedinthefifthandsixthdecadesoflife.TheexactetiologyofXGPisunknown,butitisgenerallyacceptedthatthediseaseprocessrequireslong-termrenalobstruction(障碍）andinfection.Stonesmayoccurin75%ofpatientswithXGPbutarenotrequiredtomakethediag
3、nosis.Theclinicalpresentationofpatients:lumbar(腰痛）andabdominalpain,weightloss, urinary(泌尿系）symptoms,paleconjunctiva（结膜）,kidneystonesandchronicevolutionofthedisease.Highfeverandpalpable（明显）abdominalmass.Thelaboratory,inmostcases,revealedanemia,leukocytosis（白细胞增多）veryincreasedESR,pyuri
4、a（脓尿）,hematuria（血尿）andbacteriuria（细菌尿）.pathologyThepathologyonmacroscopicexaminationshowsusuallyakidneyyellow,enlargedinsize,andwithstonesinside.MacroscopicviewoftheinsideofasurgicalspecimenofakidneywithXP.Presenceofmultiplecysticcavities.Microscopicexaminationmacrophagesareloadedwit
5、hfat(histiocytessparkling（闪闪发光的）),explaininghiscolor,inadditiontonecrosisandinfiltration（渗出物）withleukocytesandplasmaticcellshistiocytessparklinggroupedandcontainedlipids,whicharecalledxanthoma（黄色瘤）cellsthatareassociatedwithadiffuseinflamma-toryinfiltrates,wherecellsareround,theplasmo
6、cytes（浆细胞）.foam（泡沫细胞）cells(arrowup),multinucleated(多核）giant(downwardarrow)andmononuclearinflammatoryinfiltrate.ComprehensiveimagingmanifestationofXGPA44-year-oldwomanwhoreportedurinarysymptomsforthepast6months.ComputedtomographywastypicalfordiffuseXGP:enlargedleftkidneywithavoluminou
7、s(大量）centralstaghorncalculusandhydronephrosis.Therenalparenchymaisreplacedbymultipleconfluentfluid-filledmasses).imagingmanifestationofXGPDiffuseXGPinan87-year-oldman.Apost-contrastenhancedCTimagedemonstratesdiffuseenlargementoftheleftkidneywithmassivepelvicdilatationandmajorcaliecta
8、sis.imagingm
