Author/Authors :
Chen, Szu-Han Kaohsiung Medical University - Kaohsiung Medical University Hospital, Kaohsiung Municipal Ta-Tung Hospital - Department of Urology, Taiwan , Li, Ching-Chia Kaohsiung Medical University - Kaohsiung Medical University Hospital, Kaohsiung Municipal Ta-Tung Hospital - Department of Urology, Taiwan , Yeh, Hsin-Chih Kaohsiung Medical University - Kaohsiung Medical University Hospital, Kaohsiung Municipal Ta-Tung Hospital - Department of Urology, Taiwan
Abstract :
An 81-year-old woman under medical control for hypertension had urgency incontinence and repeated urinary tract infections with intermittent white-colored urine. A calcified lesion in the left kidney was accidentally found on plain kidney, ureter, and bladder radiography during the initial investigations. Noncontrast computed tomography showed hyperdense material in dilated left renal calyces with parenchymal thinning and infundibular strictures. Left nephrectomy was performed since the image illustrated either huge nephrolithiasis or tuberculosis autonephrectomy with sacs of caseous necrotic material. The surgical specimen revealed a large amount of chalky pasty substance with fine carbonate-apatite dust filling the whole renal collecting system. Pathology examination revealed pyelonephritis with cortical tubular atrophy and amyloid deposits, which was demonstrated by Congo red stain under light and polarization microscopy. Granulomatous inflammation was not identified.
