Focal Xanthogranulomatous Pyelonephritis Associated with Xanthogranulomatous Cholecystitis: A Case Report

Xanthogranulomatous inflammation is a rare inflammatory reaction, characterized by lipid-laden macrophages, known as xanthomas, in histopathologic examination. Aggressive xanthogranulomatous inflammation often manifests as local infiltration but does not affect distant organs unless combined with rare systemic diseases. We report a case of focal xanthogranulomatous pyelonephritis (XGP) associated with severe xanthogranulomatous cholecystitis. Focal XGP was suspected in radiologic examination that showed a cystic lesion with an infiltrative margin, which were surgically resected and confirmed in pathologic examination. To our knowledge, this is the first report of focal xanthogranulomatous pyelonephritis associated with xanthogranulomatous cholecystitis. Moreover, we found peripheral hypointensity around the cystic lesion in the T2-weighted image, probably reflecting hemorrhage and fibrosis of the xanthogranulomatous inflammation.

Exercise-Induced Paraspinal Muscle Rhabdomyolysis with Seconary Compartment Syndrome: A Case Report

Lumbar paraspinal compartment syndrome is an uncommon cause of acute lower back pain. It can result from intense physical activity or as a complication of surgery or medication. Lumbar paraspinal compartment syndrome without external trauma is rarely reported in literature. We report a case of compartment syndrome that followed back muscle exercise and caused rhabdomyolysis. MRI findings include bilateral bulging of the paraspinal muscle, hyperintensity on T2-weighted image, and heterogeneous enhancement. Moreover, loss of intramuscular vasculature on a contrast-enhanced CT scan attributed to diagnose compartment syndrome in this case.