PMC4193392_01
Well defined soft tissue density mass of right kidney measuring 49 x 35 x 43 mm enhancing from 33 HU to 118 HU with non-enhancing areas of necrosis.
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At one month from presentation and after the serum creatinine improved to 1.47mg/dL, a contrast CT revealed an enhancing mass (enhancement from 33 to 118 Hounsfield units) on the medial aspect of the kidney ( Figure 1; a contrast CT not done at initial presentation due to deranged renal function) with evidence of renal vein thrombosis and multiple paracaval lymph nodes.
Gross specimen showing thrombus in renal vein.
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The gross specimen revealed evidence of renal vein thrombus and Xanthogranulomatous pyelonephritis (XGPN) ( Figure 2).
Microscopic examination at 100X magnification showing collection of foamy macrophages and inflammatory infiltrate diffusely infiltrating the renal parenchyma.
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On H & E (Hematoxylin & Eosin) microscopic examination, it was composed of foamy macrophages admixed with inflammatory infiltrate ( Figure 3).