黃肉芽腫性腎盂腎炎之放射線診斷

Xanthogranulomatous Pyelonephritis-Report of Three Cases

蕭海松(Hai-Sung Hsiao) ； 余昌遺(Chang-Yi Yu)

《中華放射線醫學雜誌》 7卷3期 (1982/09) Pp. 260-268

摘要

黃肉芽腫性腎盂腎炎(Xanthogranulomatous Pyelonephritis)，是一種罕見的慢性腎實質肉芽腫病變。三軍總醫院自民國67年10月至70年12月，共收集了三個病例。其中兩位是女性，為典型之病例，在臨床上都有長期之泌尿道感染，且有腎腫大與腎結石；另一男性病例為不典型之發現，僅有腎腫大，無腎結石與泌尿道感染。經放射線攝影檢查及病理證實，為黃肉芽腫性腎盂腎炎。手術後，患者均已痊癒。

並列摘要

Xanthogranulomatous pyelonephritis is an unusual type of infection of the renal parenchyma. From Oct. 1978 to Dec. 1981, there were three cases of xanthogranulomatous pyelonephrities collected in the Department of Radiology, T.S.G.H. Two of them were wemen with typical manifestations, one was atypical case of young man whom were proved by pathology following nephrectomy.
The typical case of xanthogranulomatous pyelonephritis presents characteric clinical manifestations, it is usually showed by long-standing symptoms and laboratory evidence of urinary tract infection. Roentgen examination is usually consisting of 1) unilateral renal enlargement, either localized or diffuse; 2) renal and/or ureteral calculi, espicially large calculi; 3) non-function or very faint opacification of the collecting system on the intravenous pylonephrography; 4) angiographic demonstration of an avascular mass or masses with streched attenuated intrarenal vessels, benign neovascularity at the margin of the mass, irregular nephrogram and prominent capsular and periureteric vessels. According to these typical findings, xanthogranulomatous pyelonephritis should be suggested preoperatively.