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| Caption = Xanthogranulomatous pyelonephritis. CD68 immunostain. | | Caption = Xanthogranulomatous pyelonephritis. CD68 immunostain. | ||
| Synonyms = | | Synonyms = | ||
| Micro = | | Micro = abundant (foamy) macrophages (associated with the collecting system - medulla, not cortex), +/-giant cells, +/-cholesterol clefts, +/-interstitial lymphocytes and plasma cells, +/-interstitial fibrosis, +/-calcifications | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = [[malakoplakia]], RCC - especially [[PRCC]], granulomatous disease, [[chronic pyelonephritis]], [[ | | LMDDx = [[malakoplakia]], RCC - especially [[PRCC]], granulomatous disease, [[chronic pyelonephritis]], interstitial nephritis, occasionally [[renal cell carcinoma]] | ||
| Stains = [[PAS-D]] -ve | | Stains = [[PAS-D]] -ve | ||
| IHC = CD68 +ve, CD10 -ve, pankeratin -ve | | IHC = CD68 +ve, CD10 -ve, [[pankeratin]] -ve | ||
| EM = | | EM = | ||
| Molecular = | | Molecular = | ||
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*+/-Interstitial lymphocytes and plasma cells. | *+/-Interstitial lymphocytes and plasma cells. | ||
*+/-Interstitial fibrosis. | *+/-Interstitial fibrosis. | ||
*+/-Cholesterol clefts (common). | |||
*+/-Calcifications - dystrophic. | |||
DDx: | DDx: | ||
*[[Malakoplakia]]. | *[[Malakoplakia]]. | ||
**Basophilic inclusions -- inside or outside of macrophages - often size of RBC or larger ([[Michaelis-Gutmann bodies]]). | **Basophilic inclusions -- inside or outside of macrophages - often size of RBC or larger ([[Michaelis-Gutmann bodies]]). | ||
* | *[[Renal cell carcinoma]] - especially [[papillary RCC]] (as this has foamy macrophages). | ||
*Granulomatous disease. | *[[Granulomatous disease]]. | ||
*[[Chronic pyelonephritis]]. | *[[Chronic pyelonephritis]]. | ||
*[[Interstitial nephritis]]. | *[[Interstitial nephritis]]. | ||
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immunostain. | immunostain. | ||
</pre> | </pre> | ||
===Micro=== | |||
The sections show degenerative renal parenchyma with surrounding histiocytes, other inflammatory cells, fibrosis and cholesterol clefts. | |||
==See also== | ==See also== | ||
*[[Kidney tumours]]. | *[[Kidney tumours]]. | ||
*[[Acute pyelonephritis]]. | *[[Acute pyelonephritis]]. | ||
*[[Xanthogranulomatous cystitis]]. | |||
==References== | ==References== |
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