腎に発生する黄色肉芽腫について - 腎カルブンケルに発生した1例と本邦症例の総括 -

Abstract

A 53-year-old woman was admitted with a mass in the right flank and fever. Exploration disclosed carbuncle of the upper pole of the right kidney. Local excision, drainage and chemotherapy cured her condition. E. coli was isolated from the foci and histology proved xanthogranuloma of the kidney. Twenty-two cases of xanthogranuloma of the kidney could be collected from the Japanese literature since 1962, and report of this condition is obviously increasing year by year. Review of the literature may be summarized as follows. 1. Of 22 cases, renal morbidity was obstructive pyonephrosis in 13, pyelonephritis with preserved renal function in 2 and renal abscess in 7. 2. Male to female ratio was 1/2.14, being predominant in woman. 3. Age distributed from 15 to 81. Eighty-two percent of the cases, however, belonged to the third to the sixth decade. 4. Right kidney was involved in 12, whereas the left in 10. 5. Period from the onset of symptoms to surgery ranged from one month to several years. Most of the cases passed more than three months. 6. Isolated organism from the kidney was known in 9 cases, being E. coli in 6, Streptococcus anaerobicus in 1, Pseudomonas in 1, and Enterobacter in 1. 7. Leukocytosis more than 9, 000 was noted in 6 out of 14 available records. Only one case had more than 20, 000 of WBC. 8. Urolithiasis was noted in 8 of 15 available records. Visualization with IVP was possible only in 6 which were all renal abscess cases. 9. The kidney preservation was successful only in our case. It is our opinion that pyelonephritis with xanthogranulomatous change should be separated from renal abscess with xanthogranulomatous change and they should not be included together into xanthogranulomatous pyelonephritis.