チスチン結石を伴つたXanthogranulomatous Pyelonephritis

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Case. A 26-year-old woman. The chief complaints were right abdominal pain and fever. The X-ray film revealed a thump-tip sized shadow of calculus at the right uretero-renal pelvic junction and a little finger-tip sized one in the right kidney. No evidence of excreton was present in the right kidney. The removed kidney was filled with thick pus in the cavernously dilated renal pelvis and calyx having a yellow color. Histological examination revealed infiltrates of infilammatory cells and accumulations of large foamy cells. The fat staining for foamy cells was positive. E. cofl was detected by pus culture. The calculi in both urinary tract and kidney were yellow or yellowish. The surfaces were smooth and had waxy luster. By infrared absorption spectrum, it was proved that the calculi were composed of pure cystine. The calculus powder by resolving with ammonium solution revealed the typical hexagonal form of crystal. We summarized 91 reported foreign cases of xanthogranulomatous pyelonephritis. 31 of which were men and 60, women (the ratio of men to women is 1 : 2). Their ages ranged from 11 months to 82 years. 80 cases (88%), however, were over 30 years old. 75 cases showed the lesional side, of which 42 cases had the lesion in the left, 32 cases in the right and 1 case bilaterally (the third case reported by Schlagenhaufer (1916) was thought to be bilateral) and 54 cases (59%) were associated with renal calculi. In Japan 7 cases had been reported and this presented case was the eighth. Regarding cases of cystine calculi, those reported in Japan amounted to 50 including this case. There was no report on xanthogranulomatous pyelonephritis associated with cystine calculus.
社団法人日本泌尿器科学会の論文

チスチン結石を伴つたXanthogranulomatous Pyelonephritis

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