ABSTRACT
Renal replacement lipomatosis (RRL) is a rare benign condition of the kidney in which there is proliferation of fat within renal sinus, hilum and peri-renalspace, thus replacing the renal parenchyma. The pathogenesis of RRL is unknown, although it is generally associated with aging, renal atrophy, long-standing chronic urinary infections. We report two cases of RRL, one of right kidney and other left, both of them associated with kidney stones. The patients were 45 and 65 years old respectively andwere admitted with fever and pain in abdomen. Autopsy performed showed right RRL associated with staghorn calculus and pulmonary tuberculosis in the first patient and left RRL with renal calculus in the pelvis and left pyelonephritis with perinephric abscess and right sided pyelonephritis in the second patient.
Subject(s)
Autopsy , Aged , Female , Granuloma, Plasma Cell/diagnosis , Humans , Kidney Calculi/diagnosis , Kidney Calculi/diagnosis , Kidney Diseases/diagnosis , Lipomatosis/diagnosis , Male , Middle Aged , Pyelonephritis/diagnosis , Tuberculosis, Pulmonary/diagnosisABSTRACT
Idiopathic renal replacement lipomatosis is a rare condition in which the renal parenchyma, especially the renal sinus is replaced with adipose tissue with increase in perirenal fat. We report a case of renal replacement lipomatosis presenting as a renal mass clinically. The computed tomography scan revealed low density and nodular masses of adipose tissue within the renal parenchyma. The differential diagnosis before surgery was angiomyolipoma, lipoma, and xanthogranulomatous pyelonephritis. After the histological examination and extensive literature search, the diagnosis of renal replacement lipomatosis was made. It is a rare entity and may be missed if not considered due to lack of experience, so we hope that more urologists, radiologists, and pathologists become aware of this entity and recognize it.