A CT scan and excretory urogram showed a large, multilobulated mass in the right kidney displacing the collecting system. The mass was characterized by multiple xanthogranulomatous lesions and fatty consistency, consistent with xanthogranulomatous pyelonephritis. A second case showed a segmental multicystic dysplastic kidney involving the medial portion of the right kidney, seen as a large multiloculated renal mass on imaging.

1. 5Unilateral Large, Multilobulated
Kidney

2. CLINICAL IMAGAGING
AN ATLAS OF DIFFERENTIAL DAIGNOSIS
EISENBERG
DR. Muhammad Bin Zulfiqar
PGR-FCPS III SIMS/SHL

3. • Fig GU 5-1 Xanthogranulomatous pyelonephritis.
(A) Excretory urogram shows a unilateral
nonfunctioning right kidney with several large
radiopaque calculi at the ureteropelvic junction
and in the proximal ureter. The arrow points to an
opacified gallbladder. (B) CT scan shows the
characteristic fatty consistency of the multiple
xanthogranulomatous masses. Note the dense
zone at the ureteropelvic junction.

4. • Fig GU 5-2 Segmental multicystic dysplastic
kidney involving only the medial portion of
the right kidney. (A) Excretory urogram shows
a large multiloculated renal mass displacing
the opacified collecting system (arrowhead)
over the spine. (B) Enhanced CT scan confirms
the intrarenal multiloculated mass.4