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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%ofallrenalinfection
2、s.XGPis4timesmorecommoninfemalesthaninmenandisusuallynotedinthefifthandsixthdecadesoflife.TheexactetiologyofXGPisunknown,butitisgenerallyacceptedthatthediseaseprocessrequireslong-termrenalobstruction(障碍）andinfection.Stonesmayoccurin75%ofpatientswithXGPbutarenotrequiredtomakethediagnosi
3、s.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,pyuria（脓尿）,
4、hematuria（血尿）andbacteriuria（细菌尿）.pathologyThepathologyonmacroscopicexaminationshowsusuallyakidneyyellow,enlargedinsize,andwithstonesinside.MacroscopicviewoftheinsideofasurgicalspecimenofakidneywithXP.Presenceofmultiplecysticcavities.Microscopicexaminationmacrophagesareloadedwithfat(his
5、tiocytessparkling（闪闪发光的）),explaininghiscolor,inadditiontonecrosisandinfiltration（渗出物）withleukocytesandplasmaticcellshistiocytessparklinggroupedandcontainedlipids,whicharecalledxanthoma（黄色瘤）cellsthatareassociatedwithadiffuseinflamma-toryinfiltrates,wherecellsareround,theplasmocytes（浆细胞）
6、.foam（泡沫细胞）cells(arrowup),multinucleated(多核）giant(downwardarrow)andmononuclearinflammatoryinfiltrate.ComprehensiveimagingmanifestationofXGPA44-year-oldwomanwhoreportedurinarysymptomsforthepast6months.ComputedtomographywastypicalfordiffuseXGP:enlargedleftkidneywithavoluminous(大量）central
7、staghorncalculusandhydronephrosis.Therenalparenchymaisreplacedbymultipleconfluentfluid-filledmasses).imagingmanifestationofXGPDiffuseXGPinan87-year-oldman.Apost-contrastenhancedCTimagedemonstratesdiffuseenlargementoftheleftkidneywithmassivepelvicdilatationandmajorcaliectasis.imagingm
